The Nature of Hypnotic Analgesia and Placebo Response to Experimental Pain

Abstract

The effects of hypnotically induced analgesia and placebo response to "a powerful analgesic drug" were investigated. Highly motivated Ss, who were either very responsive or essentially insusceptible to hypnosis, performed a task which induced ischemic muscle pain. Special procedures and a modified double-blind condition were adopted to establish plausible expectations in both groups that the two treatments effectively reduce pain intensity. Changes in pain threshold and tolerance following hypnotic and placebo analgesia (compared to an initial baselevel performance), were evaluated and were related to changes in the Ss' subjective ratings of pain intensity. The results support the hypothesis that there are two components involved in hypnotic analgesia: One component can be accounted for by the nonspecific or placebo effects of using hypnosis as a method of treatment; the other may be conceptualized as a distortion of perception specifically induced during deep hypnosis../XLTHOUGH dramatic demonstrations of the use of hypnotically induced anesthesia during major surgery have been reported, 9 ' 2Si 24 controlled experimental

Hypnotizability and Placebo Analgesia in Waking and Hypnosis as Modulators of Auditory Startle Responses in Healthy Women: An ERP Study

“…We conceived this result assuming that hypnosis disrupted the upper-mentioned significant associations found in waking condition. This result supports previous findings suggesting that placebo and hypnosis involve, at least to some extent, different processes of top-down regulation [ 19 ]. This observation also corroborates our previously reported pain-hypnosis ERP findings [ 31 ]…”

“…The present results extend current findings on hypnotic modulation of brain activity in a nonclinical sample [ 31 , 33 , 157 , 158 ] and support the view that the effects of placebo and hypnosis on pain relief are, at least to some extent, separate processes [ 19 , 27 , 32 – 35 ]. However, it is important to underline that current source findings are purely speculative and must be considered with caution, since they were obtained using only 30 scalp electrodes and the modeling is based on a standard head model (instead of individual MRI data).…”

“…We found that higher pain expectation was associated with higher levels of pain reduction through placebo treatment in waking condition, but during hypnosis this association was under the significance level. We thought that this observation supports the hypothesis that placebo analgesia in waking and hypnosis reflects two different top-down processes [ 19 ].…”

Hypnotizability and Placebo Analgesia in Waking and Hypnosis as Modulators of Auditory Startle Responses in Healthy Women: An ERP Study

“…We conceived this result assuming that hypnosis disrupted the upper-mentioned significant associations found in waking condition. This result supports previous findings suggesting that placebo and hypnosis involve, at least to some extent, different processes of top-down regulation [ 19 ]. This observation also corroborates our previously reported pain-hypnosis ERP findings [ 31 ]…”

“…The present results extend current findings on hypnotic modulation of brain activity in a nonclinical sample [ 31 , 33 , 157 , 158 ] and support the view that the effects of placebo and hypnosis on pain relief are, at least to some extent, separate processes [ 19 , 27 , 32 – 35 ]. However, it is important to underline that current source findings are purely speculative and must be considered with caution, since they were obtained using only 30 scalp electrodes and the modeling is based on a standard head model (instead of individual MRI data).…”

“…We found that higher pain expectation was associated with higher levels of pain reduction through placebo treatment in waking condition, but during hypnosis this association was under the significance level. We thought that this observation supports the hypothesis that placebo analgesia in waking and hypnosis reflects two different top-down processes [ 19 ].…”

Effects of active alert and relaxation hypnotic inductions on cold pressor pain.

“…The inquiry also revealed that some of the low hypnotizable simulator subjects felt the analgesia suggestion was helpful. This finding, although impossible to quantify within this study, is remarkably similar to the McGlashan et al (1969) finding that some insusceptible subjects responded to an analgesia suggestion but that their subjective ratings did not show a corresponding change in objective performance.…”

Analgesic effects of posthypnotic suggestions and virtual reality distraction on thermal pain.

“…The results suggest that hypnosis and VRD involve different mechanisms. They also replicate the earlier results that hypnotic analgesia is more than simply a placebo (demonstrated by an absence of an interaction between treatment condition and hypnotizability; Hilgard & Hilgard, 1975; McGlashan et al, 1969).…”

Hypnotizability and Placebo Analgesia in Waking and Hypnosis as Modulators of Auditory Startle Responses in Healthy Women: An ERP Study

“…We conceived this result assuming that hypnosis disrupted the upper-mentioned significant associations found in waking condition. This result supports previous findings suggesting that placebo and hypnosis involve, at least to some extent, different processes of top-down regulation [ 19 ]. This observation also corroborates our previously reported pain-hypnosis ERP findings [ 31 ]…”

“…The present results extend current findings on hypnotic modulation of brain activity in a nonclinical sample [ 31 , 33 , 157 , 158 ] and support the view that the effects of placebo and hypnosis on pain relief are, at least to some extent, separate processes [ 19 , 27 , 32 – 35 ]. However, it is important to underline that current source findings are purely speculative and must be considered with caution, since they were obtained using only 30 scalp electrodes and the modeling is based on a standard head model (instead of individual MRI data).…”

“…We found that higher pain expectation was associated with higher levels of pain reduction through placebo treatment in waking condition, but during hypnosis this association was under the significance level. We thought that this observation supports the hypothesis that placebo analgesia in waking and hypnosis reflects two different top-down processes [ 19 ].…”

Effects of active alert and relaxation hypnotic inductions on cold pressor pain.

“…The inquiry also revealed that some of the low hypnotizable simulator subjects felt the analgesia suggestion was helpful. This finding, although impossible to quantify within this study, is remarkably similar to the McGlashan et al (1969) finding that some insusceptible subjects responded to an analgesia suggestion but that their subjective ratings did not show a corresponding change in objective performance.…”

Analgesic effects of posthypnotic suggestions and virtual reality distraction on thermal pain.

“…The results suggest that hypnosis and VRD involve different mechanisms. They also replicate the earlier results that hypnotic analgesia is more than simply a placebo (demonstrated by an absence of an interaction between treatment condition and hypnotizability; Hilgard & Hilgard, 1975; McGlashan et al, 1969).…”

Hypnotizability and Placebo Analgesia in Waking and Hypnosis as Modulators of Auditory Startle Responses in Healthy Women: An ERP Study

“…We conceived this result assuming that hypnosis disrupted the upper-mentioned significant associations found in waking condition. This result supports previous findings suggesting that placebo and hypnosis involve, at least to some extent, different processes of top-down regulation [ 19 ]. This observation also corroborates our previously reported pain-hypnosis ERP findings [ 31 ]…”

“…The present results extend current findings on hypnotic modulation of brain activity in a nonclinical sample [ 31 , 33 , 157 , 158 ] and support the view that the effects of placebo and hypnosis on pain relief are, at least to some extent, separate processes [ 19 , 27 , 32 – 35 ]. However, it is important to underline that current source findings are purely speculative and must be considered with caution, since they were obtained using only 30 scalp electrodes and the modeling is based on a standard head model (instead of individual MRI data).…”

“…We found that higher pain expectation was associated with higher levels of pain reduction through placebo treatment in waking condition, but during hypnosis this association was under the significance level. We thought that this observation supports the hypothesis that placebo analgesia in waking and hypnosis reflects two different top-down processes [ 19 ].…”

Effects of active alert and relaxation hypnotic inductions on cold pressor pain.

“…The inquiry also revealed that some of the low hypnotizable simulator subjects felt the analgesia suggestion was helpful. This finding, although impossible to quantify within this study, is remarkably similar to the McGlashan et al (1969) finding that some insusceptible subjects responded to an analgesia suggestion but that their subjective ratings did not show a corresponding change in objective performance.…”

Analgesic effects of posthypnotic suggestions and virtual reality distraction on thermal pain.

“…The results suggest that hypnosis and VRD involve different mechanisms. They also replicate the earlier results that hypnotic analgesia is more than simply a placebo (demonstrated by an absence of an interaction between treatment condition and hypnotizability; Hilgard & Hilgard, 1975; McGlashan et al, 1969).…”