by Dr. Mark Jensen, Department of Rehabilitation Medicine, University of Washington School of Medicine
People with cancer—both patients and survivors—often experience significant problems with pain, fatigue and sleep associated both with the cancer diagnosis and side effects of the treatments.
The problem is that the medical treatments for these three problems often have significant side effects. For example, people can build a tolerance to powerful analgesics used for pain. These medicines can cause also cause significant constipation and affect one’s ability to think clearly. So people will often try the medications, but find the side effects are so annoying that they’d rather have the symptom than the side effects.
The same holds true for sleep medications. Sleep aids can be helpful in the short term, but some patients have concerns about their long-term use.
So, the available treatments for these symptoms are often inadequate. Another approach is to learn self-management skills; things you can do yourself to improve problems with pain, fatigue and sleep.
In the last two decades, a great deal of research has studied self-hypnosis training as a method for pain control. The result of this research is clear—self-hypnosis is effective. People can learn to alter activity in their brains through self-hypnosis, so that they experience less pain. It’s not magic or voodoo. It’s simply learning to shift brain states so the brain processes less pain information. As a result, you hurt less. Once people learn how to use it, they often report that just a minute or two of self-hypnosis results in hours of significant pain relief. Over time, many people report that their background or usual pain intensity has dropped significantly as well. In our clinical trials of self-hypnosis, patients reported to us that not only did they feel less pain, they felt more energy and slept better.
Since pain, fatigue and sleep problems are common in individuals who have a history of cancer, about a year ago we did a pilot study in women, both those in active cancer treatment and survivors. As we found when teaching self-hypnosis to people with other types of pain problems, the women in the cancer study with significant pain problems reported significant decreases in their pain with self-hypnosis. They were able to use this skill to feel less pain on a daily basis.
We also found that the women who presented with sleep problems reported improvements in their sleep quality. Indeed, learning to calm the mind and get control over the mind enabled people to stop the so-called "gerbil brain" at night. When they did that, they were able to get to sleep easier and they got better quality sleep. Of course, when you sleep better, you also feel less pain, so maybe part of the reason people felt less pain was they slept better or vice versa. It doesn’t really matter, because it all worked!
We also found there were significant improvements in fatigue; that is, people felt more energy. However, in our pilot study, the fatigue returned after about three months. But the improvements in pain and in sleep quality maintained. It raises the possibility that the effects on fatigue may require more treatment than we offered.
Our plan is to study this in a larger group of people who have a history of cancer.
One of the nice things about hypnosis is that unlike medications that often have significant negative side effects, hypnosis has significant positive effects. For example, people say they feel calmer and more in control and relaxed. When one part of your life improves, other parts of your life improve—it’s all connected.
It shouldn’t surprise us that when people start taking charge and control of their lives and doing things to feel better, their lives improve. This is what this type of treatment is all about: teaching people self-management and self-control.
Q: Will self-hypnosis make me lose control?
A: Hypnosis, unfortunately, has a history of being viewed as something that is done to somebody, like the evil scientist controlling someone’s mind or an entertainer making an audience member cluck like a chicken. But the type of hypnosis portrayed in movies and on stage is very different than true clinical hypnosis.
Clinical hypnosis is all about teaching patients more control. It teaches patients how to use their ability to hypnotize themselves to feel better, more relaxed and have more energy. So clinical self-hypnosis is about more self-control rather than less control.
Q: Can self-hypnosis put me in a trance?
A: Sometimes people worry they will enter a trance and will say something they didn’t mean to or give up some secret while they are hypnotized. Actually, everyone goes in and out of trances all day, every day. It’s a natural state. For example, you might drive to work and when you arrive, you don’t really remember the trip. That’s because the brain automatically relaxes throughout the day at different times.
When someone experiences hypnosis, they recognize the experience. It doesn’t feel unusual. It’s just a relaxed, focused and natural state. No one will say anything they don’t want to say or do anything they don’t want to do. They’re in control.