Headaches - Headache, Hypnosis And Stress, A Case History
Headache, Hypnosis And Stress, A Case History
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Now, more that ever, concerned physicians are beginning to ask
about and understand the role of non-drug therapies to assist
patients with headache. These therapies, alone or in combination
with medications can significantly impact on headache treatment.
This pleases me. As a Family Physician and Clinical Hypnotist
with thirty years experience in the field, I applaud this trend.
Certainly, a capable and compassionate physician will struggle
to assist his/her patient find headache relief by whatever
methods, complimentary, traditional or both. Much can be gained
if we look at hypnosis as a helpful tool in the battle for
headache relief.
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As our understanding of how the brain works and which compounds
or "neurotransmitters" control our pain response develops, we
begin to suspect that relaxation therapies including hypnosis,
may alter in a positive and fundamental way our brain chemistry
such that pain relief is more likely. An interesting study was
performed with patients who learned relaxation skills. The
researchers checked the subjects' monoamine oxidase levels-since
monoamine oxidase is what metabolizes serotonin, a pain relief
chemical, and found changes in those levels consistent with what
you would expect with preventive drug therapy! The study
suggests that it is not just a matter of feeling relaxed that's
important but actually learning via these relaxation therapies
to turn off and on certain pain pathways in the nervous system
by changing monoamine oxidase levels and consequently serotonin
levels.
In this paper, I would like to introduce you to hypnosis and
self-hypnosis as a modality of pain relief for patients who
suffer from headache. Hypnosis is fun, effective, relaxing and
has no side effects. What is this thing they call hypnosis? No,
Virginia, it is NOT clucking like a chicken, barking like a dog
or being " put under", helpless, and at the control of the
master. Rather for most people, most of the time, it is a
focused state of attention or harmony. It is easily achieved by
visiting a professional skilled in hypnosis. This pleasant state
has two fascinating and useful properties:
1) It is profoundly relaxing. In our stressful lives what person
would not enjoy a few minutes of deep relaxation in the middle
of the day from hell!
2) The mind becomes open to positive and therapeutic
suggestions. Only suggestions given with your permission and for
your own benefit are accepted. No one can be forced or coerced
into doing something they do not wish to do.
Hence, when I help patients use hypnosis for headache and
stress, I offer them headache specific suggestions as well as
relaxation and stress reduction instructions. I find this
process fun and creative. I get to know my patient not just as
Mr. Jones with a headache, but also as a real person in a
stressful situation. This stressor in combination with his or
her biological predisposition to headache is creating more pain.
Let's take a look at a case history and see how it all fits
together. Mr. X, a hard driving chief financial officer of a
high tech company is known as the "firing man" and is
responsible for downsizing a company whose expenses exceed its
revenues, and whose market share is declining. His neurologist
has referred him to me for help with his chronic daily headache
that has not responded well to numerous medications. His
executive decisions in the short run will result in layoffs and
suffering for many. However, with his expertise, talent,
intelligence and hard work, he may "turn the company around" and
in the long run, his efforts will benefit far more people than
those who will suffer in the short term. He is not well liked by
his co-workers and worries a lot about his health and finances.
He is a pleasant man, rather intense and self confident to the
point of arrogance. At this time, he is wiling to consider
non-drug therapies to diminish the pain and discomfort of his
daily headaches.
As I get to know him, I will develop for him the three elements
essential to our success. First, in order to benefit from the
therapy he must be motivated. Motivated to want to use hypnosis
for his purposes, not mine, and motivated to put aside ten
minutes each day to develop via hypnosis relaxation sufficient
to impact on the pain chemicals in his brain.
Second, I must establish with him a positive and supportive
rapport. Trust is an essential element of the hypnotic process.
For this gentleman who is used to firing people and always being
in control in a "one up one down" situation, I must simply be
his assistant. Without this rapport, hypnosis will not be
effective.
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Third, I must make sure he has sufficient hypnotizablity. Most
of us can experience hypnosis without difficulty. Probably, only
about 10 percent of us will not be able to enjoy the hypnotic
process. I have little to worry about with this patient. Most
high functioning individuals in our society have good hypnotic
skills, as hypnotizability is associated with creativity,
intelligence and imagination.
After a brief explanation of hypnosis and after gaining his
permission, 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 was
informed that this would not happen but nonetheless, in spite of
his level of awareness, the relaxation and ability to accept
suggestion would be pleasing to him.
With this mixture of trust, motivation (based on correct
information) and hypnotizablity, I was not at all surprised that
Mr. X achieved some initial success at relaxation using hypnosis
and self-hypnosis.
Mr. X was pleased and agreed to return for further sessions. Not
surprisingly, he canceled most of them because he was too busy
at work! Nonetheless, he was very positive about the hypnosis
that we did. He reported that the relaxation lessened the pain
from his headache.
It is a principal of hypnosis that all suggestions require
reinforcement. Additionally, practice and repetition are
required to develop these skills so they can produce both a
biologically medicated pain relief (via altered brain chemicals)
and a psychological harmony that helps the patient deal more
easily with daily stress.
As with most of my patients, I asked Mr. X to set aside ten
minutes daily (preferably at work and without interruption) to
listen to an audiocassette that I created for him to recapture
the relaxed feeling and increased suggestibility that he
experienced in my office. With some practice on his part, I was
confident that these daily and pleasant practice sessions would
reinforce positive suggestions relating to his particular
headache and attitude toward work.
Results have been very satisfactory so far. Mr. X has not
returned for further work. When last I inquired he reported an
improvement in the severity of his daily headache. Once again,
he said he had little time for therapy but he was enjoying the
ten minute practice sessions via his personalized audio
cassette.
This particular case history will illustrate to the reader the
value 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 and
psychologically 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 a
powerful complimentary or stand-alone therapy to those who
suffer from headache. Stress reduction and relaxation techniques
have an important role to play in the treatment in one of the
more vexing problems physicians face in practice, the patient
with headache. A recent paper, New Treatment Options In Migraine
by neurologists Drs. Brandes, Edvinson, Marcus, and Rapoport
rates relaxation therapies as "effective" as a non-drug therapy
for migraine.
About the author:
Dr. Larry Deutsch is a practicing family physician and
hypnotherapist. His proven self-help and hypnotherapy programs
have helped thousands of people achieve happier and healthier
lives. As a Family Doctor, he is able to amplify sound medical
counseling with a unique and artistic style of self hypnosis
accompanied by beautiful and relaxing music. http://www.drlarry.com Dorothy Musgrave
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As our understanding of how the brain works and which compounds
or "neurotransmitters" control our pain response develops, we
begin to suspect that relaxation therapies including hypnosis,
may alter in a positive and fundamental way our brain chemistry
such that pain relief is more likely. An interesting study was
performed with patients who learned relaxation skills. The
researchers checked the subjects' monoamine oxidase levels-since
monoamine oxidase is what metabolizes serotonin, a pain relief
chemical, and found changes in those levels consistent with what
you would expect with preventive drug therapy! The study
suggests that it is not just a matter of feeling relaxed that's
important but actually learning via these relaxation therapies
to turn off and on certain pain pathways in the nervous system
by changing monoamine oxidase levels and consequently serotonin
levels. 