From medical hypnosis to analgesia 4.0
Have you ever heard of medical hypnosis to relieve pain and anxiety? Did you know that this therapeutic technique has been able to adapt to technological advances? Find out how medical hypnosis and its use in virtual reality are changing the way healthcare professionals work and enabling many patients to benefit from a better care pathway.
Pain relief with hypnosis
Pain, is a vast and intriguing subject. It’s a sign that we need to take care of ourselves. Humans have always sought ways of controlling and calming it, and clinical hypnosis has proved to be a remarkable natural response. It is a fascinating therapeutic tool that first appeared in medical practice in the 18th century with the Austrian physician Franz Anton Mesmer. In France, the first operation under hypnosis was performed in 1829! However, the advent of ether (1846) and the first anaesthetists somewhat overshadowed the practice, as there was no solid scientific justification for it at the time. (1. Hammond, 2013)
Things have changed a lot today! With the advent of neuroscience, medical hypnosis, or hypnosis for therapeutic purposes, has rightfully regained its place among medical practices. In 2015, a public health survey revealed that 72% of the French population aged between 18 and 65 were in favour of using so-called “complementary” medicines! (2 Viavoice survey for the Institut Curie, 2015).
Numerous scientific studies have demonstrated the effectiveness of hypnosis for relieve pain and anxiety and improve comfort It is important to note that medical hypnosis is an approach that is increasingly used in conjunction with conventional treatments, to maximise therapeutic results. (3. INSERM report, Gueguen, 2015). The Société Française d’Anesthésie et Réanimation (French Society of Anaesthesia and Intensive Care) is also in favour of the use of hypnosis as a complement to local or loco-regional anaesthesia (https://sfar.org/lutilisation-de-lhypnose-par-les-anesthesistes-reanimateurs/).
How does a medical hypnosis session work?
In practical terms, medical hypnosis involves accompanying the patient, using words or even music (music therapy: https://hypnovr.io/fr/musicotherapie), through three stages: induction, hypnotic trance and return, each based on specific exercises and mechanisms. The speech is simple, the therapist’s voice is low-pitched and the rhythm of the speech is specifically designed to induce a hypnotic state.
Initially reserved for psychotherapy, the therapeutic aims of music therapy have been greatly expanded, particularly in relation to pain, stress and anxiety. Music therapy is part of a care programme (surgery, nursing care, medical imaging, etc.) and is aimed at all populations (children, adolescents, adults, the elderly).
Induction aims to bring the patient into a state of deep relaxation and increased focus. This can be achieved by various techniques, such as fixing on a point, breathing deeply or visualising a peaceful place. The aim is to prepare the patient’s mind to be receptive to the suggestions that follow.
Following induction, the therapist puts the patient into a hypnotic trance. This state is characterised by a dissociation of the patient’s consciousness from their immediate reality, allowing access to buried memories, emotions and experiences. Hypnotic trance also makes it easier to connect with the unconscious mind, allowing the patient to concentrate on specific problems without being influenced by distractions or preoccupations of the moment. Techniques to induce hypnotic trance may include imagination, the use of metaphors or direct suggestions from the therapist to guide the patient’s mind towards a deep inner experience.
The final stage is the return journey. During this phase, the therapist gradually guides the patient back to a normal state of consciousness. This can be achieved by using suggestions to regain full body awareness, by counting slowly or by using metaphors, such as climbing a staircase or leaving an imaginary place. The aim of the return is to allow the patient to gently reintegrate the experiences and learning from the hypnosis session into their ordinary state of consciousness.
Three factors are fundamental to the success of hypnosis: the patient’s motivation and cooperation, and their trust in the therapist (8. Virot and Bernard, 2010).
The patient’s ability to imagine and project are also criteria that help the session to run smoothly.
When is medical hypnosis used?
This technique works for both adults and children, and effectively manages pain and anxiety, reducing the side effects associated with taking sedative, analgesic or anxiolytic drugs. (3. Gueguen, 2015).
Hypnosis can be used to :
pain management
(hypnoanalgesia)
sedation and anxiety management
(hypnosedation)
psychological disorders
It is used as much in the operating theatre as in care, or even from the moment the patient is taken into care, to manage pain and anxiety. The simultaneous use of hypnosis and medication can potentiate their respective effects and, in some cases, reduce the amount of medication required. This synergy can offer patients greater comfort, minimise side effects and promote faster recovery. Hypnosis can also form part of the multimodal management of chronic pain.
For psychological disorders, it is more commonly used in outpatient clinics, to help patients overcome difficult moments in their lives (quitting smoking, accepting a major change, managing phobias or post-traumatic stress disorder).
Who are the practitioners of medical hypnosis?
Carers are the guarantors of this therapeutic act. This practice is mainly found in :
– Ambulance staff (to reduce pain and anxiety when caring for patients)
– Nurses (in care departments, surgery, private practice)
– Doctors, in particular anaesthetists (to assist with general or local anaesthesia)
– Psychologists (to treat phobias, stop smoking, anxiety disorders, depression)
These healthcare professionals have undergone specific training. For nursing staff, this is usually a University Diploma (DU). In fact, there are training institutes specifically for nursing staff.
(e.g. Emergence, Institut Français d’Hypnose).
Although there is no precise census, the IFH and Emergence directories put the total number of trained practitioners at 3,800.
Hypnosis and Virtual Reality: when medicine meets new digital technologies.
Virtual reality offers the possibility of simulating a visual and audio environment, the immersive qualities of which are ideally suited to running a hypnosis session, while at the same time making it easier to access.
It’s really about facilitating the practice of care while focusing more on the patient and the quality of care.
Virtual reality hypnosis complements conversational hypnosis, offering hypnotherapists greater flexibility. They can use this tool to reinforce their own hypnotic discourse or to select the patients who most need their attention while offering an alternative to the others. In addition, virtual reality simplifies the task of untrained carers by offering them a new therapeutic tool to improve their support. Ultimately, patients have easier access to the benefits of hypnosis whatever the scenario.
The use of virtual reality in hypnosis therefore consists of reproducing the structure of a traditional hypnosis session (induction, hypnotic trance and return) using the same techniques (type of communication, verbal structures, rhythm, etc.) but with the addition of total visual and auditory immersion.
Virtual reality sessions are prepared at the time of the medical procedure and the hypnotic suggestions are standardised to meet very specific needs (interventional procedures, chemotherapy, colonoscopy, etc.). The patient’s imagination, with which the hypnopractor normally interacts, is compensated here by a virtual visual and auditory pathway that can be personalised but with a limited degree of freedom.
In the case of HypnoVR, patients and carers have access to a wide variety of content that can be used to personalise sessions, with over 21,000 combinations available:
– The carer chooses the hypnotic suggestions and their duration, adapted to the medical procedure, to maximise the therapeutic effectiveness of the session.
– The patient chooses the environment, the musical ambience, the language and the voice to make the experience familiar and maximise adherence and comfort.
What are the benefits of virtual reality medical hypnosis?
The first advantage is ease of use. The equipment is installed on the patient and in just a few clicks the session begins.
This means that healthcare professionals who have not trained in hypnosis can easily incorporate the practice into their care, while hypnotherapists gain in flexibility by being able to vary between traditional and virtual reality approaches.
The attraction of the virtual reality experience can also overcome reticence towards conversational hypnosis. Some people feel more comfortable and accept this solution because of its innovative and fun aspect.
With virtual reality hypnosis, the 25% of people who are not usually receptive to hypnosis can enjoy a relaxing experience, even if they do not benefit from the full potential of hypnotic suggestions.
In addition, multisensory immersion encourages rapid and effective focusing(9. Marucci et al., 2021). Patients can concentrate on the session without being disturbed by the anxiety-provoking visual and auditory stimuli of the medical context, such as the noise of machines or the lights in an operating theatre.
What are HypnoVR’s values and strengths?
The company, founded by 2 anaesthetists and hypnotherapists, has set up a 5-strong R&D department to guarantee product development that is as close as possible to medical practices, with a certified regulatory approach (ISO 13485) and scientific validation at the heart of its concerns.
With more than 20 scientific papers (https://hypnovr.io/recherche), the benefits of HypnoVR have been proven in a wide range of applications.
Another of HypnoVR’s strengths is its ability to tailor the session to the specific situation and needs of each patient. At this stage, more than 21,000 scenario combinations are possible. This capacity for personalisation maximises patient adherence, the therapeutic effectiveness of sessions and the number of use cases during a course of treatment. From patient intake to surgery, rehabilitation or even just well-being, there’s always a suitable scenario.
Finally, supporting and training care teams is a priority for HypnoVR. The HypnoVR team is trained in therapeutic communication and is an expert in the use of virtual reality to manage pain and anxiety. We train and support healthcare professionals in the use of technology, ensuring that it is as effective as possible. This ensures that patients receive the best possible care and that healthcare professionals are able to use technology effectively and responsibly.
Sources:
1. Hammond DC. A review of the history of hypnosis through the late 19th century. Am J. 2013
2. Viavoice survey for the Institut Curie (2015)3. Juliette Gueguen, Caroline Barry , Christine, Hassler Bruno Falissard, Inserm report on the evaluation of the effectiveness of the practice of hypnosis. 2015
4. Elkins GR, Hypnotic Relaxation Therapy: Principles and Applications. Washington. 2014
5. Thompson T, Terhune DB, Oram C, et al. The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials. 2019
6. Valentine KE, Milling LS, Clark LJ, Moriarty CL. THE EFFICACY OF HYPNOSIS AS A TREATMENT FOR ANXIETY: A META-ANALYSIS. 2019
7. Dienes Z, Hutton S. Understanding hypnosis metacognitively: rTMS applied to left DLPFC increases hypnotic suggestibility. 2013
8. Hypnose, douleurs aïgues et anesthésie, Virot, Claude, Bernard, Franck 2010
9, Marucci M, Di Flumeri G, Borghini G, et al. The impact of multisensory integration and perceptual load in virtual reality settings on performance, workload and presence. 2021
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