Stage hypnosis is not clinical hypnosis … Clinical hypnosis is putting a person into a trancelike 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 practice. 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.
And a five-to-10-minute investment of time buys someone how much time of pain relief?
Each person is different. For me, it's an hour, sometimes two. One fellow I talk about (in the book) gets three to four hours of no pain and he has dropped his use of narcotics way down because of this.
You're not antimedicine 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 milligrams 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 … On the other side of it is me: It took me a year to learn self-hypnosis. But I went from 90 mg of morphine down to 10 mg and I used these skills to help me do it.
(In May, Canada updated opioid-prescribing guidelines for chronic non-cancer pain. The upper limit used to be 200 mg per day, now it's 50 to 90 mg.)
You're one of the only doctors teaching self-hypnosis. Given that nearly 30 per cent of people live with chronic pain, why do you think other doctors resist hypnotherapy?
It's useful. There's no harm. And there's data to support its use. From a science and medical point of view there's every reason to say, "Let's consider it." But why not? Because no one is trained to do it. And my guess is that when you say hypnosis, people think of the guy on the stage, with a watch and the person clucking like a chicken.
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