Us­ing self-hyp­no­sis to con­trol pain

Doc­tor/au­thor cham­pi­ons ben­e­fits of hyp­nother­apy

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Grow­ing up, Dr. Jef­frey En­nis was into box­ing, wrestling, mar­tial arts and gym­nas­tics. But at 16, he dis­lo­cated his knee play­ing soc­cer, mark­ing the start of a life­long strug­gle with chronic pain.

For En­nis, now 63, med­i­ca­tion never worked as well as he’d like it to. One thing that has helped is hyp­nother­apy, a set of tech­niques used to in­duce hyp­no­sis in a per­son whereby the in­di­vid­ual fo­cuses on their in­ter­nal state, mak­ing it eas­ier to con­trol pain. Although hyp­no­sis has been con­tro­ver­sial, stud­ies show it can be an ef­fec­tive ther­a­peu­tic tool.

For the last three decades, En­nis has used self-hyp­no­sis ev­ery day, re­duc­ing his pain by about 30 per cent for an hour. When the pain re­turns full-force, he sim­ply does it again.

As the med­i­cal di­rec­tor of The En­nis Cen­tre for Pain Man­age­ment, a bustling clinic in Hamil­ton he started more than 20 years ago, En­nis teaches self­hyp­no­sis to pa­tients grap­pling with a range of con­di­tions. They in­clude fi­bromyal­gia, back dis­or­ders and pain from trauma such as car ac­ci­dents or work­place in­juries. He’s one of the only doc­tors in the re­gion teach- ing self-hyp­no­sis and says it’s a poorly un­der­stood prac­tice, which is why it isn’t part of the main­stream med­i­cal com­mu­nity.

“Any­one can do it and ev­ery­one can ben­e­fit, some more than oth­ers,” says En­nis, a psy­chi­a­trist and spe­cial­ist on manag­ing chronic non-can­cer pain. “I’m in an out­ly­ing group and get less ben­e­fit than most peo­ple will. And I’m quite happy with what I get be­cause I have yet to take a pill that does bet­ter.”

In his re­cently pub­lished book, Hyp­nother­apy for Pain Con­trol: A Safe and Non-ad­dic­tive Way to Re­lieve Chronic Pain, En­nis talks about his per­sonal strug­gles, the prob­lem with re­ly­ing on pills such as opi­oids, the sci­ence be­hind hyp­no­sis and a step-by-step guide on self-hyp­no­sis.

Torstar News Ser­vice re­cently spoke with En­nis, who’s also as­sis­tant clin­i­cal pro­fes­sor in the Depart­ment of Psy­chi­a­try and Be­havioural Neu­ro­sciences at Mc­mas­ter Univer­sity and a staff physi­cian at Hamil­ton Health Sci­ences in the Depart­ment of Phys­i­cal Medicine and Re­ha­bil­i­ta­tion.

When peo­ple think of hyp­no­sis, they think of the stage hyp­no­tist. So how is it used to con­trol pain? Stage hyp­no­sis is not clin­i­cal hyp­no­sis … Clin­i­cal hyp­no­sis is putting a per­son into a trance-like state, which makes them turn more in­ward. If

I get some­one into a good trance, they don’t hear the traf­fic out­side or the clock tick­ing in the room. They’re more in­ter­nally fo­cused. In that state, peo­ple are able to take ad­van­tage of skills they didn’t oth­er­wise rec­og­nize they had — one is to con­trol their pain more ef­fec­tively.

How do they do that? They’re ac­cess­ing a part of the brain that al­lows them to, by in­ten­tion, push down the pain … At its most ba­sic, even if it helps a per­son re­lax a bit, they’re re­lax­ing mus­cles and that will make the pain less. Some­one who’s a lit­tle bet­ter at self-hyp­no­sis can ac­tu­ally stop it.

How long does it take to do self-hyp­no­sis and what does it look like? For in­stance, can some­one do this at work while sit­ting at their desk?

As a new­bie, you may be at your desk and have your eyes closed for a bit. You need about five to 10 min­utes — if you’re good at it. If not it will take you longer. You have to prac­tise. Each of us are dif­fer­ent … The bet­ter you get at it, the more you’ll get out of it. And the longer you do it, the quicker it takes. I don’t look like I’m do­ing any­thing. I don’t have to do a for­mal trance. I can do this stand­ing, walk­ing. It didn’t start this way. It took me a year un­til I got into my first trance­like state.

You’re not anti-medicine and aren’t sug­gest­ing folks toss out their med­i­ca­tions. Rather you want them to think of hyp­no­sis as an­other tool in the ther­a­peu­tic tool box. It’s a tool when other things aren’t work­ing as well as you’d like. The data is very clear that, for the most part, opi­oids really don’t work so great … I do pre­scribe opi­oids. I’m a very con­ser­va­tive user of them. I think peo­ple have to be will­ing to de­velop other skills. The big­gest prob­lem in North Amer­ica is that we teach peo­ple to be pas­sive. The eas­i­est thing you can do is take a pill — and the eas­i­est thing for a doc­tor to do is pre­scribe one. Ev­ery­body is quite happy if a pill works. The prob­lem in chronic pain is there is noth­ing on the ta­ble that works great. If it did, I’d be tak­ing it.

Have you seen pa­tients use hyp­no­sis to re­duce their pain and their re­liance on opi­oid med­i­ca­tions?

Yes. One fel­low was a long-dis­tance run­ner who de­vel­oped rheuma­toid arthri­tis, so his joints are ba­si­cally crum­bling. He was put on opi­oids and got up to a high dose, near 400 miligrams a day, and they weren’t do­ing what he wanted. I taught him self-hyp­no­sis and he was a nat­u­ral. He found that when he did it, he could get 100 per cent pain re­duc­tion … Right now he’s tak­ing a low dose of opi­oid, prob­a­bly below 50 mg. He’s a great ex­am­ple of what’s pos­si­ble.

Is­tock; con­trib­uted

Dr. Jef­frey En­nis, in­set, says a five- to 10-minute pe­riod of self-hyp­no­sis buys him an hour or two of re­lief from chronic pain.

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