Health: Mind over Medicine

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The differences in the subjects' brain scans were equally striking. The typical pain signal follows a well-worn path from the brain stem through the midbrain and into the cortex, where conscious feelings of pain arise. In Schulz-Stübner's study, the hypnotized group showed subcortical brain activity similar to that of nonhypnotized volunteers, but the primary sensory cortex stayed quiet. The "ouch" message wasn't making it past the midbrain and into consciousness.

The new findings have fostered interest in the U.S., where doctors are using hypnosis for procedures in which sedation is inappropriate or for patients who are allergic to anesthetics. Dr. David Spiegel, associate chair of the department of psychiatry and behavioral sciences at Stanford University, hypnotizes Parkinson's sufferers during the implantation of deep-brain electrodes--a process that requires tremulous patients to remain conscious and calm. He has also coaxed children into imagining that a balloon tied to their wrist will fly them to their favorite places, a hypnotic technique that has lessened anxiety in pediatric patients undergoing bladder catheterizations. In Iowa, Schulz-Stübner hypnotizes patients to reduce pain and anxiety while they receive presurgery nerve blocks, such as epidurals. He finds that the calming effects of hypnosis often last through the entire operation.

Yet even the most enthusiastic proponents of hypnosedation don't suggest that it replace anesthesia entirely. For one thing, not everybody can be hypnotized. Some 60% of patients are hypnotizable to some degree, Spiegel says; an additional 15%, highly so. The rest seem to be unresponsive. Moreover, many patients are fully sedated before surgery not because the surgeon requires it but because they choose to be. "People don't want to feel or hear anything. They want to be out," says Schulz-Stübner. "That's what you hear most of the time."