Getting to the roots of pain

Press, 31 August 1985, Page 19

Getting to the roots of pain

It seems no-one understands precisely why, under hypnosis, people suffer less pain. One theory is that through the process of amnesia, people forget to remember that they are in pain, as it were.

Dr Spiegel’s theory concerns what he terms a trade-off between focal attention and peripheral awareness. “Until I mention it, you are probably not thinking about the sensations in your back and your legs resting on the chair,” he tells me. (But, as he says, as soon as he mentioned it, I became aware of the feelings.) “Because you were more interested in the person you were talking to, you made an uncon-

scious decision to channel attention away from those sensations,” he continues.

In a trance, a person can focus on one sensation, thereby putting pain in the periphery. It is not a question of consciously fighting pain, but focussing on a substitute sensation — a warm, tingling numbness for example; or cold, like rolling in snow; or re-living what dental anaesthesia was like.

People can change their skin temperature 4 deg C. in a few minutes by concentrating on making some part of their body warm, the professor says. “They produce physiological change, and alter the way they are reacting to sensations in their body.”

Dr Spiegel makes no claim that, under hypnosis, cancer victims can fight the disease more effectively. He is aware of a theory which suspects that the level of circulating antibodies and certain cells felt in the immune system may be affected, but says there is no clear evidence this happens.

“We all know there are remissions nobody can explain but, in the absence of hard data it is a terrible disservice to cancer patients to tell them that this theory works." he savs.

“It’s bad enough to be dying of cancer without feeling guilty you are not doing more to fight it." Coming out of hypnosis is no problem, according to the psychiatrist. He teaches patients how to do it themselves, perhaps by counting from three backwards, and making a decision to end the trance state, “which is not that different from ordinarv awareness.”

One problem with hypnosis, particularly in anaesthesia, has always been that some people cannot be hypnotised. Dr Spiegel says that one or two people out of 16 are in this group. They are of two types — the sceptical, thought-oriented people who have an extreme emphasis on logic, and those with serious psychiatric disorders that impair concentration, like schizophrenia, or extreme anxiety. A few people suffer from spontaneous trance “attacks,” and there are rare individuals who lose periods of time, and not because they are drunk or unconscious. They can be taught how to control this problem and are usually people who have had stress or trauma in their lives.

Dr Spiegel would like medical practitioners to realise it does not take long to put a patient under hypnosis. “I can do an induction and testing response to a series of suggestions, get a score telling me how hypnotisable a patient is, and discuss it with him, in 10 minutes.”

Can he tell just by looking at a person? One test is called the eye roll which involves looking up while the patient closes his eyes. This is thought to be moderately correlated with hypnotisability. “So look up as high as you can, and while you keep looking at the ceiling, slowly close your eyes.” he tells me.

“Hard isn’t it... keep looking up. “On a zero-to-four scale you would be a one. The suggestion is that probably, if hypnotisable, you would be on the low side.

“Do you consider yourself more logical, not an easily influenced kind of person? Yes? “That would fit.”