Toward a theory of pain: Relief of chronic pain by prefrontal leucotomy, opiates, placebos, and hypnosis.

Abstract

The response to a nociceptive stimulus normally includes at least four components: "the sensation of pain"; discomfort; withdrawal movements; and some measurable physiological alteration, e.g., a transient or prolonged increase or decrease in blood pressure (Nafe & Wagoner, 1938;Goetzl, Bien, & Lu, 1951). This paper is concerned with the neurological correlates of this total response-hereafter termed the pain response-and how this total response or some components of this response can be mitigated or eliminated by prefrontal leucotomy, opiates, placebos, and hypnosis. THE NEUROPHYSIOLOGICAL COR-RELATES OF THE PAIN RESPONSE Free Nerve Endings: The So-Called "Pain Receptors"It has generally been assumed that the free nerve endings, which are found widely scattered near the cutaneous and visceral surfaces, are the specific receptors for noxious stimuli. However, Sinclair, Weddell, and Zander (1952) have shown that 5s can discriminate cold, heat, touch,

Hypnosis and Attention: A Review

“…The question of whether or not hypnosis is effective in reducing pain, subjectively or physiologically, will not be reviewed in depth here; the reader is referred to several excellent reviews (Barber, 1959(Barber, , 1963Shor, 1967). The general consensus among investigators is that "hypnotic analgesia" is, to some degree, successful in reducing pain.…”

Psychophysiological Mechanisms of Hypnosis

“…Most stress resistance reports have appeared in the form of clinical anecdotal studies of natural stress situations such as war, internment in concentration camps and physiological trauma (Ax, 1967;BARBER, 1959;ApPLEY, 1967). Though these studies have much value in their own right, they do not offer the opportunities that might be presented by laboratory experiments for precise examination of the effects of stressful environmental stimuli and resistance efforts on the interactions of physiological mechanisms and psychological variables.…”

An Empirically-Based Formulation of Hypnotism

“…Non-surgical pain is at times very much reduced (a) when placebos are administered with the implication that they are pain-relieving drugs (Barber, 1959;Beecher, 1959), (b) when a close interpersonal relationship is formed between the subject and the experimenter or physician (Barber, 1963;Butler, 1954), and (c) when attempts are made to induce relaxation, or to produce distraction, or to reduce anxiety and anticipation of pain (Barber and Calverley, 1968b;Wikler, 1952a, 1952b;Jacobson, 1938Jacobson, , 1954Kornetsky, 1954;Shor, 1967).…”