学際的痛みセンターにおける慢性痛患者に対する催眠療法

抄録

Chronic pain is a complex state that involves unpleasant emotion, autono­mic responses, helplessness against pain and movement disorder, as well as the sensation of pain itself. These memorized responses influence the present experience and behavior of the patient. A single treatment option is not enough to treat such a complex clinical state. Thus, our facility has several treatment programs to fit individual patients’ needs. We applied an individualized hypnotic approach to 161 patients who had not shown satisfactory improvement and were considered suitable subjects for psychotherapy.

A hypnosis session consisted of the introduction stage, which prepared the therapeutic contexts accommodated to the change in chronic pain as well as each patient’s history, and the induction stage, which mainly targeted non–pain body sensations. Among the patients who tried hypnosis, 71.1% experienced in–session analgesia (ISA), and 46.3% experienced out–of–session analgesia (OSA). The most of the first ISA was experienced before approximately the 10^th session, and the most of the first OSA was experienced by approximate­ly the 15th session after ISA.

Based on the process and degree of analgesia, the number of sessions, the leaning rate of self–hypnosis, and the patients’ characteristics and experiences in the above process, we attempted to determine the conditions under which the patients were successfully engaged in hypnosis, the stage of changes in their chronic pain, and the inhibitory factors against analgesia. Despite clinical differences among the patients and their pain situations, their responses to the hypnosis implied the importance of achieving pain cessation through their own therapeutic efforts.