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Old 05-03-2018, 02:41 PM
nelliebly nelliebly is online now
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How does hypnosis block pain?

I've read a few credible accounts by doctors and patients where women under hypnosis but on no other medications went through childbirth and felt no pain. I understand that hypnosis is merely a deeply relaxed, suggestible state. What I don't understand is how merely being deeply relaxed and suggestible can block pain, particularly the agonizing pain of labor.

What happens physiologically? Does the deeply-relaxed brain release chemicals that work as natural anesthetics? Or does the suggestion do this? After all, if you're deep into stage four sleep and someone stabs you, you're going to wake up, right? And if it's the suggestion itself that does the trick, how and why would the brain respond by releasing whatever chemicals block the pain?

Or is there no chemical reaction whatsoever, in which case, what the hell happens???

Is this merely a version of the placebo effect? Hmm. I guess I don't understand the physiology of that, either.
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Old 05-03-2018, 06:14 PM
Ludovic Ludovic is offline
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I too am wondering if it is an example of the placebo effect. If it is it should be blockable by Naloxone since the analgesic effect of the placebo effect is caused by endorphins which are endogenous opioids and are thus blocked by opioid blockers. This is borne out by studies, although childbirth is painful enough that I'm wondering if one could get a grant to test out that specific scenario due to ethical concerns.

On the other hand, pain reduction from hypnosis might also be caused by either a reduction in subjective pain, or a willingness to not report the pain in order to please the hypnotizer, the effects of which are less measurable and testable.
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Old 05-03-2018, 06:43 PM
Bijou Drains Bijou Drains is offline
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people use meditation to really reduce pain , don't think they can block it 100%
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Old 05-03-2018, 06:48 PM
TimeWinder TimeWinder is offline
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Quote:
Originally Posted by nelliebly View Post
I've read a few credible accounts ...
Step one: dump the anecdotes, get actual data. Before we figure out "how" something happens, first we figure out "if" it happens. Especially in the woo-heavy fields like hypnosis.
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Old 05-03-2018, 06:58 PM
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puzzlegal puzzlegal is offline
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The birth of my first child was only moderately painful. I meditated some, which helped deal with the pain, which is what I imagine hypnosis would do. But subjectively, it wasn't enormously worse than cramps from a stomach bug.

My second was breech, and was much more painful....
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Old 05-03-2018, 08:16 PM
nelliebly nelliebly is online now
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Originally Posted by TimeWinder View Post
Step one: dump the anecdotes, get actual data. Before we figure out "how" something happens, first we figure out "if" it happens. Especially in the woo-heavy fields like hypnosis.
Thanks for pointing this out. I guess I should have rephrased the OP, but I didn't want to launch a debate over whether or not hypnosis is a bona fide medical practice or the stuff of woo-woo. While I'm definitely woo-woo adverse, I'm certainly not a scientist. The use of hypnosis in medicine is pretty well established, though. A meta-analysis published in the British Journal of Anesthesia, which included 3 randomized controlled trials and 2 non-randomized controlled trials and both UK and US trials, and which the authors claim is "the most comprehensive review of the literature to date on the use of hypnosis for analgesia during childbirth*," notes that

Quote:
The effectiveness of hypnotic analgesia in the perioperative setting has been demonstrated previously.5 A number of reports have now shown hypnosis to be of value in decreasing: (i) operating times for minor radiological procedures;6 (ii) the use of intra-operative sedation; and (iii) analgesia requirements postoperatively
There are many, many published studies on the use of hypnosis in medicine, but hopefully this will do for now.

But the article raises an interesting (to me, anyway) observation:
Quote:
The anterior cingulate gyrus has been demonstrated, by positron emission tomography, to be one of the sites in the brain affected by hypnotic modulation of pain.4 This suppression of neural activity, between the sensory cortex and the amygdalaŚlimbic system, appears to inhibit the emotional interpretation of sensations such as pain.
So if someone has no emotional interpretation of pain sensation, then apparently there is decreased perception of pain?
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Old 05-03-2018, 08:20 PM
nelliebly nelliebly is online now
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I too am wondering if it is an example of the placebo effect. If it is it should be blockable by Naloxone since the analgesic effect of the placebo effect is caused by endorphins which are endogenous opioids and are thus blocked by opioid blockers. This is borne out by studies, although childbirth is painful enough that I'm wondering if one could get a grant to test out that specific scenario due to ethical concerns.

On the other hand, pain reduction from hypnosis might also be caused by either a reduction in subjective pain, or a willingness to not report the pain in order to please the hypnotizer, the effects of which are less measurable and testable.
Good point. That would make an interesting study.

I'm not sure about the unwillingness to report pain as a factor. It makes sense, but I can't imagine not reporting the pain of labor. Even if I were really, really anxious to please the hypnotizer, I think my clenched fists and occasional screams would probably give me away.
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Old 05-03-2018, 09:20 PM
Melbourne Melbourne is offline
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So if someone has no emotional interpretation of pain sensation, then apparently there is decreased perception of pain?
My anaesthetist has the opinion that opiates don't really decrease pain. They just make you not mind it.

And pain is certainly not the only sensation that increases in how much attention it demands if you think it's important.
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Old 08-19-2018, 07:09 AM
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RivkahChaya RivkahChaya is offline
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I had horrible, awful, intense labor pain, and was begging for the epidural-- and I'm glad I did, because my labor lasted 27 hours. Every women I know personally who has bragged about her unmedicated labor, it always turns out, had a labor than was less than 7 hours. And yes, I've heard the argument that epidurals prolong labor because you can't move around-- but then, I also know women who endured five or six hours of horrendous labor that was not progressing in spite of moving around, and decided on an epidural, and labored for another 12 hours or so. Seriously, how are you supposed to have the energy to push after an unmedicated labor that lasts more than a day?

But that's not my point.

I remember that that contractions were just awful, but I don't really fully, remember just what they felt like. I don't fully remember what a lot of pain I've experienced exactly felt like. I remember that a lot of it was just horrible, but I don't remember the exact sensation.

So I think a lot of the forgetting is perfectly natural.

I believe in hypnosis to the extent that it is a slightly altered (but natural) state-- a sort of semi-sleep, just what the name implies, and the person is highly suggestible, so if the hypnotist says that the pain isn't too bad, the person may be able to work through it.

Labor pains to come in waves-- they aren't constant, like a migraine headache, and that probably helps too.

If a person really WANTS an unmedicated birth, and believes in hypnotism, and is destined to forget the pain to an extent whatever is used, then yes, I can see hypnosis "working."

I would guess that someone who is going to use hypnosis in labor probably needs to work with a hypnotherapist several times prior to delivery, to make sure that that particular practitioner can induce hypnosis in that patient, though.
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Old 08-19-2018, 04:08 PM
Tim@T-Bonham.net Tim@T-Bonham.net is offline
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Originally Posted by nelliebly View Post
What I don't understand is how merely being deeply relaxed and suggestible can block pain, particularly the agonizing pain of labor.
Human women have been withstanding the "agonizing pain of labor" for about a quarter million years or so before this, without hypnosis or drugs. What's so hard to understand about that? It's what has to be done if you want to have children. And most women withstood it much more often than modern women, who tend to average only 1 or 2 children. In fact, a sizable percentage of women in history kept withstanding it until they died giving birth.
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Old 08-19-2018, 04:55 PM
Stranger On A Train Stranger On A Train is offline
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Originally Posted by Melbourne View Post
My anaesthetist has the opinion that opiates don't really decrease pain. They just make you not mind it.
That is essentially true. Opioids bind to inhibitory G protein-coupled receptors in the periaqueductal grey and essentially produce a state of well-being and euphoria that dulls sensitivity to pain and the associated affective responses (fear, rage, panic); they do nothing to actually block signals from nociceptors. Whether you regard this as not actually decreasing pain or not is something of a semantic argument as the net result is that the person in question will report a decrease in pain on a subjective threshold.

It is difficult to even hypothesize about why (and objectively how well) hypnosis works to decrease pain sensation as there is no real consensus in cognitive neuroscience as to what hypnosis even is other than being a somnambulistic-like state with a high degree of suggestibility. One might presume that it somehow involves the brain producing endorphins (endogenous opiates) but there is no real evidence for this and actually a couple of studies using Naloxone (which blocks opioids) which tend to falsify that assertion. So I think the only real answer is that we don't really know.

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Old 08-19-2018, 11:26 PM
Wesley Clark Wesley Clark is offline
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According to section two of this article, hypnosis alters activity in the parts of the brain collectively called the neuromatrix.

Also hypnosis can be used to make you feel pain as well as to alleviate it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324744/
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Last edited by Wesley Clark; 08-19-2018 at 11:26 PM.
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Old 08-20-2018, 12:30 AM
nightshadea nightshadea is offline
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Quote:
Originally Posted by Melbourne View Post
My anaesthetist has the opinion that opiates don't really decrease pain. They just make you not mind it.

And pain is certainly not the only sensation that increases in how much attention it demands if you think it's important.
isn't that supposed to be the selling point of oxy? it doesn't get rid of the pain it just numbs you to where you don't feel anything at all ?
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Old 08-20-2018, 03:31 AM
clairobscur clairobscur is offline
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Originally Posted by nelliebly View Post
So if someone has no emotional interpretation of pain sensation, then apparently there is decreased perception of pain?
That's how I always seen "anesthesia" under hypnosis explained : the stimulus is still transmitted and recived, but the brain ignores it or interpret it in a different way.


When you think of it, pain is a really weird thing anyway. What exactly makes it unbearable while other data received by the brain isn't perceived as such? There are some people who don't experience pain. Are there people who experience pain as a result of stimuli that would be perceived as neutral or even pleasant my most others?
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Old 08-20-2018, 03:35 AM
clairobscur clairobscur is offline
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My anaesthetist has the opinion that opiates don't really decrease pain. They just make you not mind it.
I've read this statement already, but it hasn't been my experience the only time when I was given morphin. It's not that I didn't mind anymore. I didn't have the sensation anymore.
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Last edited by clairobscur; 08-20-2018 at 03:35 AM.
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