Clinical Hypnosis in Palliative Care

Clinical Hypnosis in Palliative CareTori Rodriguez, MA, LPC  – December 01, 2016

“In recent years, clinical hypnosis and modified states of consciousness, like meditative states, have become significant topics of researchers in psychology, philosophy, medicine, and neuroscience,” author Maria Paola Brugnoli, MD, from the Department of Surgical Sciences, Anesthesiology, Intensive Care and Pain Therapy at the University of Verona in Italy, told Clinical Pain Advisor.

Clinical hypnosis aligns with the World Health Organization‘s global perspective for palliative care, including the aspect of providing relief from symptoms such as pain, anxiety and depression, fatigue, nausea, and sleep impairment.

Results of brain imaging studies demonstrate that “hypnosis influences all of the cortical areas and neurophysiological processes that underlie pain and emotions,” according to a review.  

Neurophysiological top-down regulatory processes–like attention, cognitive control, and monitoring–play a central role in mediating responses to hypnotic suggestions for pain relief,” said Dr Brugnoli.

Hypnotic analgesia has been linked with more significant reductions in pain-related outcomes, compared to standard care and non-hypnotic interventions such as education and physical therapy.

In the review, Dr Brugnoli details various hypnotic techniques that clinicians may use with pain patients, as well as brief self-hypnosis techniques that patients can use.

Another technique uses mental imagery to shift attention from the painful sensation to a different part of the body that is unaffected by pain

In self-hypnosis for acute pain relief, a patient might do a brief exercise in which they say to themselves, “Now I will sleep for X minutes while my pain decreases,” and then, count down from 20 to 1.

Summary and Clinical Applicability

A variety of hypnotic techniques may be effectively used as adjuvant treatment in the management of pain and other distressing symptoms in patients with severe chronic diseases.


The references to specific studies back up what was said in the article, so hypnosis must be effective. However… not all of us can be hypnotized and not all hypnotists are effective.

Clinical hypnosis for palliative care in severe chronic diseases: a review and the procedures for relieving physical, psychological and spiritual symptoms. Ann Palliat Med. 2016; 5(4):280-297. Tononi G, Koch C. (free full-text article)


Hypnotic treatment in severe chronic diseases, for pain and symptoms relief, has proven efficacy as adjuvant therapy, and should be offered to any individual, who expresses an interest in this method.

While some theorize hypnotizability as a changing attribute of the individual, there is a growing body of literature that indicates hypnotizability may be characterized as a constellation of potentially modifiable attitudes and skills, which are strongly influenced by related factors, as suffering, in severe chronic diseases.

In this article, I briefly review representative studies recognizing how clinical hypnosis in medicine is an effective complementary therapy, for pain and symptom’s relief in severe chronic diseases and in palliative care.

This paper highlights:

(I) a scientific review to underline how clinical hypnosis has an important impact on the treatment goals and integration in relieving pain and symptoms;

(II) the advanced techniques for effectively relieving pain and symptoms.

A meta-analysis of hypnosis for chronic pain problems: a comparison between hypnosis, standard care, and other psychological interventions. Int J Clin Exp Hypn. 2014; 62(1):1-28.


Hypnosis is regarded as an effective treatment for psychological and physical ailments.

However, its efficacy as a strategy for managing chronic pain has not been assessed through meta-analytical methods.

When compared with standard care,hypnosis provided moderate treatment benefit.

Hypnosis also showed a moderate superior effect as compared to other psychological interventions for a non-headache group.

The results suggest that hypnosis is efficacious for managing chronic pain.

Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia. JAMA. 1996; 276(4):313-318. Brugnoli MP.

The neural correlates of consciousness: an update. Ann N Y Acad Sci. 2008; 1124:239-261. Adachi T, Fujino H, Nakae A, Mashimo T, Sasaki J.


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