Women who undergo hypnosis just before breast-cancer surgery need less anesthetic and experience lower levels of pain and other side effects after the operation, a study has found.
The U.S. study also found that patients who had a hypnosis session with a psychologist an hour before surgery spent less time in the operating room, resulting in significant cost savings, mainly because of reduced operating time.
"Breast-cancer patients are a population in need," said Guy Montgomery, a clinical psychologist at the Mount Sinai School of Medicine and lead author of the study, in an interview from New York. "They're going through a lot both from a psychological perspective as well as a physical perspective from the surgery itself. ...
"Our patients at discharge had less pain intensity, less pain unpleasantness, less nausea, less fatigue, less discomfort, and they were less emotionally upset about the whole experience," Dr. Montgomery said of those who were hypnotized.
To conduct the study, published online in the Journal of the National Cancer Institute, 200 women scheduled for surgical breast biopsy or lumpectomy were randomly assigned to have either a 15-minute session of hypnosis or a short period of empathic listening with a psychologist.
Those assigned to hypnosis were first reassured about the technique, with psychologists debunking myths about hypnosis popularized in movies and television, Dr. Montgomery said.
"We answer any patient questions, and the typical 'Will I cluck like a chicken?' " he said, laughing. "We explain that hypnosis is not mind control; you're not going to be asked to do anything embarrassing. It's not like taking a powerful drug that leaves you zonked out. ... It's more like focused attention, focused concentration, where you're able to let yourself relax and you're the person in charge."
Each woman was asked to close her eyes and imagine herself in a special place, perhaps lying on a beach on a warm summer day. The psychologist then directed the patient to become deeply relaxed. Once hypnotized, the women were given suggestions specifically related to recovery from surgery.
"We say: 'You might experience some pain after surgery, but your special place will protect you and ... it will hardly bother you,' " Dr. Montgomery said.
"We do tell the patient this is not magic. It's not like we're going to make 100 per cent of everyone's pain go away. But, rather, it's a way to reduce your pain. So if your pain might have been an eight [on a sale of zero to 10] we want to get it to a four."
Researchers found that because those in the hypnotism group experienced reduced side effects, they spent less time in hospital recovering, while less time in the operating room resulted in an average saving to a hospital of $773 (U.S.) for each patient.
"The most important point is this is an easy thing we can do for patients, it saves institutions money, so basically it's a win-win," he said. "We can reduce side effects of surgery without using basically any health-care-dollar resources. It pays for itself."
David Spiegel, a psychiatrist at Stanford University's medical school in California, said the "impressive study" builds on other research that has shown the pain-modulating potential of hypnosis.
In an editorial accompanying the study, he said neurological studies have demonstrated that hypnosis alters the perception of pain, rather than merely a person's response to pain.
"It has taken us a century and a half to rediscover the fact that the mind has something to do with pain and can be a powerful tool in controlling it," Dr. Spiegel writes. "It is now abundantly clear that we can retrain the brain to reduce pain: 'float rather than fight.' "
Dr. Montgomery said he would like to test hypnosis on men having prostate surgery and on patients slated for other operations. He would also like to see it become standard practice in hospitals.
"Hypnosis is easy to use. It can be administered briefly. It's a practical intervention that we can use with everything else that's going on in the surgical clinics ... It's something in addition that has no side effects that makes people feel better and you can do it in about 15 minutes."