Stress and pain are intimately related. When being in pain causes stress or being stressed worsens pain, psychological therapies — including hypnosis, meditation, and relaxation — may help break the cycle.

For pain therapists, these treatments, which focus on the relationship between the mind and body, are considered mainstream. For other health professionals, they may be considered alternative or complementary therapies. Regardless of how they are labeled, there is evidence that for many people they work.

If you’re considering trying one of these approaches to pain relief, here’s what you need to know.

Hypnosis

For many, hypnosis brings to mind a parlor game or nightclub act, where a man with a swinging watch gets volunteers to walk like a chicken or bark like a dog. But clinical, or medical, hypnosis is more than fun and games. It is an altered state of awareness used by licensed therapists to treat psychological or physical problems.

During hypnosis, the conscious part of the brain is temporarily tuned out as the person focuses on relaxation and lets go of distracting thoughts. The American Society of Clinical Hypnotists likens hypnosis to using a magnifying glass to focus the rays of the sun and make them more powerful. When our minds are concentrated and focused, we are able to use them more powerfully. When hypnotized, a person may experience physiologic changes, such as a slowing of the pulse and respiration, and an increase in alpha brain waves. The person may also become more open to specific suggestions and goals, such as reducing pain. In the post-suggestion phase, the therapist reinforces continued use of the new behavior.

Benefits of Hypnosis

Research has shown medical hypnosis to be helpful for acute andchronic pain. In 1996, a panel of the National Institutes of Health found hypnosis to be effective in easing cancer pain. More recent studies have demonstrated its effectiveness for pain related to burns, cancer, and rheumatoid arthritis and reduction of anxiety associated with surgery. An analysis of 18 studies by researchers at Mount Sinai School of Medicine in New York revealed moderate to large pain-relieving effects from hypnosis, supporting the effectiveness of hypnotic techniques for pain management.

If you want to try hypnosis, you can expect to see a practitioner by yourself for a course of 1-hour or half-hour treatments, although some practitioners may start with a longer initial consultation and follow up with 10- to 15-minute appointments. Your therapist can give you a post-hypnotic suggestion that will enable you to induce self-hypnosis after the treatment course is completed.

Alternatively, audio recordings exist that walk the listener through the steps necessary to achieve the benefits from hypnosis.

To find a hypnotherapist, speak to your doctor or contact the American Society of Clinical Hypnosis.

Meditation

Meditation involves using a number of awareness techniques to help quiet the mind and relax the body. The two most common techniques are:

• • • Transcendental meditation . The patient repeats a single word or phrase, called a mantra, and is taught to allow other thoughts and feelings to pass.
  • • Mindfulness Meditation. The person focuses all of his or her attention on thoughts and sensations. This form of meditation is often taught in stress-reduction programs.

Benefits of Meditation

Studies suggest that meditating can increase pain tolerance, activity levels, and self-esteem and decrease anxiety, stress, depression, and use of pain medications.

Mindfulness meditation has been used successfully in programs to reduce pain and improve mood in patients with chronic pain from a variety of conditions, including headache, low back pain, chest pain, and gastrointestinal pain.

There are varied forms of meditation and training certification organizations; for example, one can get certified in mindfulness-based stress reduction (MBSR), but if you’re not sure, speak to your doctor, who may be able to recommend a good teacher or teaching facility.

To practice meditation, repeated meetings with the instructor may not be necessary. A recent study examining the perception of pain and various mental training techniques has found that relatively short and simple mindfulness meditation training can have a significant positive and long-term effect on pain.

Relaxation Therapies

Relaxation therapies include a range of techniques with the goal of reducing stress. In addition to meditation, the major types of relaxation techniques are:

Progressive muscle relaxation .Also known as systematic muscle relaxation and Jacobson relaxation, this technique involves slowly tensing, briefly holding, and then releasing each muscle group in a systematic fashion, starting with the muscles in the toes and moving upward. During this exercise, the person should notice the differences between tension and relaxation.

Autogenic training . This technique uses visual imagery and body awareness to achieve relaxation. The person imagines being in a peaceful place and then focuses on different physical sensations, such as heaviness of the limbs or a calm heartbeat. People may practice on their own, creating their own images, or be guided by a therapist. Patients may also be encouraged to see themselves coping more effectively with stressors in their lives.

Breathing. Breathing techniques teach people to breathe effectively to relieve stress. While placing one hand on the chest and another on the belly, the person is instructed to take a slow, deep breath, taking in as much air as possible. During this, the belly should press against the hand. After holding their breath for a few seconds, patients are instructed to slowly exhale.

Benefits of Relaxing

While research is ongoing, there is evidence to suggest the effectiveness of relaxation techniques for reducing chronic pain related to a variety of medical conditions, including stress-related disorders. Other benefits may include reduced muscle tension and insomnia and increased activity level.

The best way to learn relaxation techniques is with the help of a trained practitioner. Usually, these techniques are taught in a group class and then practiced regularly at home.

There is no widely accepted license for practicing relaxation therapy. However, it is often practiced by therapists and psychologists. Ask your doctor for a recommendation.

Risks of Mind-Body Therapies

Although mind/body therapies don’t have the risks of medical or surgical therapies, there have been rare reports of adverse reactions from them.

If you have poorly controlled cardiovascular disease, experts recommend avoiding progressive muscle relaxation, because abdominal tensing can cause increased pressure in the chest cavity, slowing of the pulse, decreased return of blood to the heart, and increased venous pressure.

If you have a history of psychosis or epilepsy, you may wish to speak with your doctor before trying meditation. There have been reports of some people having further acute episodes following deep and prolonged meditation.

Hypnosis or deep relaxation can sometimes worsen psychological problems in people with post-traumatic stress disorders or a susceptibility to false memories. Its use should be avoided in patients with borderline personality disorder, dissociative disorders, or with patients who have histories of profound abuse. Because competent hypnotherapists are skilled in recognizing and referring patients with these conditions, only appropriately trained and experienced practitioners should undertake hypnosis.