As with many uses of hypnosis, pain relief has significant ethical and practical issues. Pain is a useful symptom, and before manipulating pain we need to recognize that it is usually the body’s warning to avoid certain movements. Any time I work with an athlete on pain reduction, I work in conjunction with the physician or athletic trainer who is treating the injury. It is important that my work complement any treatment the athlete is receiving.
Using drugs to reduce pain is an accepted part of rehabilitation, and hypnosis can usefully complement or substitute for drugs in the pain-reduction aspect of the rehabilitation. Hypnosis often reduces or eliminates the need for chemical pain relievers and thus reduces the possibility of side effects. With hypnosis, it is possible not only to reduce pain almost immediately but also to give posthypnotic suggestions that the athlete can use later, whenever the athlete would normally use a chemical pain reliever. With some athletes, it is also appropriate to teach self-hypnosis for easing later pain symptoms.
While it is frequently useful to diminish the pain level, it is clearly unethical to use hypnosis to eliminate pain so that an athlete can compete—and possibly cause irreparable further injury.
When an athletic injury requires pain relief, I do not usually give suggestions for the complete relief of the pain. Although excruciating pain is unnecessary and can be helped, some minor remnant helps keep the patient interested in continuing the appropriate treatment procedure.
My initial session with Bart was to completely anesthetize his leg so the trainer could manipulate it. In a later session I worked with Bart to help him control the pain, which was still a problem. I gave him a posthypnotic suggestion that when he felt an uncomfortable amount of pain in his knee he could close his eyes, take a deep diaphragm breath, and ease the pain. I suggested that the pain would not completely disappear, but it would get down to a much more comfortable level. While he was still in a trance, I had him image a time when he had considerable pain in his leg, then reduce this pain by taking such a breath. I repeated this several times. He later reported that this was a valuable technique. He could get an intense pain down to a tolerable level.
Although beyond the usual application in athletics, some surgeons feel that when hypnosis is substituted for chemical anesthetics in surgery or parturition, the infection rate and the recovery time are less. When the person is in a trance, suggestions can be made for a speedy recovery (see chapter 11) as well as a reduction of the pain. For a susceptible person with an appropriate therapist, hypnosis is safer than a chemical pain reliever; hypnosis has no side effects and it activates no allergies, drug reactions, or drug dependencies. However, the variation in individual susceptibility to hypnosis and the time required to teach hypnosis makes hypnosis a less preferred anesthetic procedure than the more common chemical anesthetics.