Evaluation of Adjuvant Psychological Therapy with Clinical Hypnosis and Self-hypnosis for Pain, Anxiety and Psychosomatic Symptoms Relief, in Patients with Severe Chronic Diseases in Palliative Care

This research, is a proposal to study the effectiveness of the use of hypnosis, and self-hypnosis to relief pain, anxiety and pain-related symptoms in severe chronic illnesses (cancer, disabilities and chronic diseases). We study how hypnosis provides a reliable adjunct as an add- on -therapy, that supplements contemporary pharmacological approaches. A large number of studies have provided evidence for the efficacy of clinical hypnosis and other non-pharmacological interventions in the treatment of chronic pain, anxiety and pain-related symptoms in severe chronic illnesses. “Hypnosis is a procedure involving cognitive processes (like imagination) in which a subject is guided by a hypnotist to respond to suggestions for changes in sensations, perceptions, thoughts, feelings, and behaviors. Hypnosis can alter and eliminate the psychological experience of pain and also the brain’s neurophysiologic processing of pain.” ( ASCH American Society of Clinical Hypnosis http://www.asch.net/public/generalinfoonhypnosis/definitionofhypnosis.aspx and APA American Psychological Association, Division 30 http://psychologicalhypnosis.com/info/ ) Rainville and his associates showed that strategically worded suggestions can dissociate the two components of pain, selectively altering one but not the other. (Rainville, Duncan, Price, Carrier, & Bushnell, 1997). The two components of pain have different biological substrates: sensory pain in the primary somatosensory cortex, and psychological suffering in the anterior cingulate cortex. Background and objectives Scientific background and explanation of rationale • A large number of studies have provided evidence for the efficacy of psychological and other non-pharmacological interventions in the treatment of chronic pain, anxiety and pain-related symptoms in severe chronic illnesses. • “Hypnosis is a procedure involving cognitive processes (like imagination) in which a subject is guided by a hypnotist to respond to suggestions for changes in sensations, perceptions, thoughts, feelings, and behaviors. Hypnosis can alter and eliminate the psychological experience of pain and also the brain’s neurophysiologic processing of pain.” ( ASCH American Society of Clinical Hypnosis http://www.asch.net/public/generalinfoonhypnosis/definitionofhypnosis.aspx and APA American Psychological Association, Division 30 http://psychologicalhypnosis.com/info/ ) • Chronic illnesses and Noncommunicable diseases (NCDs), such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are the leading cause of mortality in the world. This invisible epidemic is an under-appreciated cause of poverty and hinders the economic development of many countries (WHO, 2014). Contrary to common belief, these diseases do not only affect men in high income countries: 80% of chronic disease deaths now occur in low and middle income countries and they affect men and women almost equally. Another unfortunate reality is that chronic diseases account for 60% of all deaths – corresponding to a projected 36.65 million deaths worldwide in 2007 (WHO, 2014). • Pain is defined by IASP as "An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Chronic pain is defined as pain that has lasted longer than three to six months (IASP, the International Association for the Study of Pain) Specific objectives and hypotheses: This research, is a proposal to study the use of hypnosis, and self-hypnosis to relief pain, anxiety and pain-related symptoms in severe chronic illnesses (cancer, disabilities and chronic illnesses.). Conclusions: the coefficients from the linear regression models show the hypnotic therapy and the VAS score at baselines have a significant and independent association with the decrease of the VAS score after 1 year; in particular the persons who had the hypnotic treatment had also a decrease of 16 points in the VAS score compared to the group that had not the hypnotic treatment. The coefficients from the quantile regression models show the hypnotic therapy and the Hamilton anxiety score at baselines have a significant and independent association with the decrease of the Hamilton anxiety score after 1 year. In particular, the group who had the hypnotic treatment had also a decrease of 7 points in the Hamilton anxiety score compared to the group that had not the hypnotic treatment. Who practice hypnosis has a less risk of 60% to have to increase the pharmacological therapy.