Alison Farrall Module Eight Word Count 1871

Choose a medical condition that interests you and research it. Write about the possible uses of hypnosis in the treatment of the condition as you see them.

For this assignment I have chosen to discuss fibromyalgia
Fybromyalgia simply means pain (algia) coming from muscles (my) and fibrous tissues (fibro) such as tendons and ligaments. It is usually accompanied by other symptoms in addition to the pains and is sometimes called fibromyalgia syndrome. It is a chronic persistant condition.
“ The cause of fibromyalgia is not known....research has shown that people with fybromyalgaia have certain subtle changes in some chemicals in the brain and nervous system.....there seems to be a minor change in the level of neurotransmitters, the chemicals responsible for transmitting messages between nerves and brain cells. Research studies have shown that there is also an increased amount of a chemical substance called substance P in the cerebrospinal fluid and that this may be involved in the way pain messages are transmitted.”
( www.patient.co.uk/health/fybromyalgia)
As the cause of fibromyalgia is thought to be from the processes in the brain and spinal cord there is little evidence that the disease is due to a problem with the peripheral muscles, tendons and ligaments although the pain is often felt there.
Fybromyalgia affects one in fifty people, it usually develops between the ages of twenty five to fifty five and is more common in women.
Common symptoms of fibromyalgia are pain, particularly in the neck and back, sensitivity to touch, joint sorenesss, tiredness, and problems sleeping.
“ People diagnosed with fibromyalgia often experience chronic pain that can be very debilitating to their lives and careers. As many as 30% of people with fibromyalgia report having trouble simply doing their work.”
(www.naturalnews.com/025468therapyFybromyalgiahypnotherapy)
More symptoms include:
Painful periods
Pins and needles in fingers or toes
A feeling of swelling in hands or feet even if their hands and feet are not actually swollen
Depression or anxiety; although this may be the result of having the condition.
Chronic fatigue syndrome /myalgic encephalomyelitis.
With reference to fibromyalgia and chronic fatigue syndrome Michael Heap states that
“ All illnesses have a biopsychosocial aetiology. Genetic makeup interacts with biological factors such as viral infections psychological factors such as anxiety and resilience, and contextual factors such as the work environment and relationships....often patients are resistant to the idea that their condition does not have a physical cause because they feel that a psychological cause is less acceptable or valid.....depression, anxiety, post traumatic stress disorder and functional bowel and bladder disorders are often co morbid with fibromyalgia and chronic fatigue syndrome. Buskila and Cohen (2007) reported that 80% of patients suffered with depression and 63.5% with anxiety.”
( Hypnotherapy A handbook Michael heap second edition p 98) Hence using hypnosis to explore and resolve these past traumas may be useful.
Fybromyalgia does not shorten life expectancy, symptoms of the condition may ease or disappear after a few months. In most cases however it is a chronic persistent condition in which quality of life can become affected. Although there is no cure for fibromyalgia, symptoms of the disorder can be reduced by use of prescription drugs, psychological therapy, exercise, holistic therapy and hypnotherapy. Haanen et al (1991) compared hypnotherapy with physical exercise therapy in forty randomly allocated fibromyalgia patients, they received either form of therapy for 12 weeks. All participants were assessed by the researchers at a 12 and 24 week follow up, in which the participants in the hypnotherapy group reported a reduction in pain and fatigue and they also reported better sleep. The success of this study demonstrates that hypnotherapy has therefore, been shown to be an invaluable tool to the client in order to better manage the condition. It can also be used to address the mental and emotional difficulties associated with this disorder.
As a therapist it is important to assess the client on:
The explanation of their pain and background history
The length of time they have been suffering from the pain
Whether the problem is iatrogenic pain
The frequency and times of pain
A description of the pain
Possible secondary gains ( a worsening condition can start to have hidden benefits)
It is also very important that the clients condition has been diagnosed by a medical practitioner and that written permission has been obtained before commencing treatment.
(Psychotherapeutic counselling year one module eight)
Furthermore, hypnotherapy should be part of a comprehensive treatment plan and never used to mask symptoms that may be developing.
To successfully implement hypnotherapy for a client living with fybromyalgaia it is important to understand the psychological and physical effects of living with the constant insecurity, changes and loss that affect him/her.
Changes can be categorized into “Practical”
Such as changes to the environment due to loss of mobility, ability to perform tasks for daily living, financial and employment changes.

“Personal”
Acceptance of care needs, effects on intimate relationships, change in desired or expected future, aspirations.
“Emotional”
Loss and the associated grief, anger, insecurity, denial, loss of independence, fear, change in identity, dealing with the emotion or hidden emotions of others, confusion.
Many chronic conditions will not prevent the person from living a full life, but will always be part of that life. This can be difficult to accept and is often made worse by the fluctuating nature of a condition like fibromyalgia. With the aid of psychotherapeutic methods and hypnosis the client may learn to develop the following coping skills to help them to move forward with their lives:
Relaxation, Pain relief, ( especially when analgesic suggestions are added to relaxation hypnosis) Seeking realistic goals,
Motivation,
Accepting and finding the right help, Dealing with anger and emotions, Living actively in society, Living in the present (letting go of the past identity and perception of the future in order to enjoy the present moment. Hypnotherapy can help with this by allowing the client to appreciate the outside world around them to intensify their sensory perception of the world allowing these feelings to become present at a conscious and unconscious level.
As part of a comprehensive effective treatment plan hypnotherapy can be used to address the broad spectrum of physical and psychological issues associated with fibromyalgia.
Helping the client to relax and to manage debilitating pain is within the scope of hypnotherapy. Pain is inextricably linked with emotion. Anxiety and pain apprehension may be greater than the pain itself, depending upon the situation. The memory or previous experience and associations with the pain may also govern the intensity of the pain experienced. If you associate pain with a pleasant experience like resting and staying in a caring environment then it may not be felt with as much discomfort. If you associate your pain with an expectation of agony then you are more likely to experience it that way.
Erikson described pain as ” a construct of past remembered pain, the present pain experience and the future anticipated pain. Thus immediate pain is augmented by past pain and is enhanced by the future possibilities of pain. The immediate stimuli are only the central third of the entire experience.”
(Hilgard and Hilgard)
Through relaxation and the use of a specific pain control induction in hypnosis the client would learn to control the intensity of the pain. With regular use, over several sessions and home treatments the client would more easily reduce symptoms of the pain. It would be essential to incorporate relaxation and focus on reducing anxiety for the treatment to be effective. As the pain became more manageable I would expect the client’s anxiety levels to reduce. As fibromyalgia is a chronic pain condition the regular use of the relaxation induction would help prevent the stress which in turn weakens the body’s defence against pain.
As the symptoms of Fybromyalgia affect the client on a psychological and emotional level, the most prevalent of these would have been identified during initial consultation process or during subsequent treatment sessions. These issues could then be addressed by use of positive affirmations with reference to motivation toward realistic goals and self esteem, spoken in the induction and suggested for repetition throughout his/her daily routine.
I would use a pain control induction which contained positive imagery, where the client watches the pain undergo a transformation from a symbol of discomfort (like a burning red ball) to symbol that is no longer threatening or harmful (a small ball that gradually changes to a cool blue and disappears).
Another method that could be used in the reduction of pain for a client with fibromyalgia is to suggest that at the onset of pain they can just imagine leaving their aching body behind and leave the room and the pain behind them. Erickson gives the example of a client who was sick and would suffer periodically from agonising pain. He suggested to her that at the onset of pain she go into a trance state and take herself away mentally from her sick body.
She would go into her wheelchair and into the next room and watch TV while her painful body remained in the bedroom.
Hadly and Staudacher state that there are three specific objectives for pain control to achieve a reduction or elimination of pain: 1 You will transform alter or displace your pain 2 You will directly address your pain and suggest that it decrease 3 You will direct your attention away from you pain and experience the benefits of tranquil peaceful imagery

(Hypnosis for change p 143)
They recommend a deep relaxation to reduce stress and anxiety which includes a muscle relaxation and stress reduction. The pain should then be transformed into a specific visible form to make it less ambiguous and more controllable. As the pain can be controlled it can be intensified or reduced in intensity. Visualisations could involve walking away from the pain, focusing on a specific area and using imagery to heal it, numbing the affected area or focusing on positive images to direct attention away from pain.
As a result of the hypnosis I would expect the client to enjoy a better quality of life, with more energy, increased ability to relax and so improved sleeping patterns.
A greater sense of control, motivation, self esteem, and confidence, and over all a greater sense of self efficacy.
In conclusion it is clear that whilst hypnotherapy cannot treat or cure fibromyalgia it can provide a valuable tool in pain management especially when combined with other treatments. It also empowers the client to become stronger mentally and emotionally as he/she acknowledges the transition from previous practical and physical abilities to the acceptance of the current situation and his/her perception of it.
If the client is open to the success of the treatment then this will influence the treatment outcome.
If the client is willing and the therapist is well equipped, then the possibilities of assisting a fibromyalgia patient through pain management, emotional and personal difficulties with the use of hypnotherapy is immense.

Bibliography
Hadley J and Staudacher C Hypnosis for Change third edition Harbinger Publications 1996
Heap M Hypnotherapy A Handbook Second edition McGraw Hill 2012
Hilgard E and Hilgard J Hypnosis in the Relief of Pain
Module 8 Chrysalis Psychotherapeutic Counselling Year One wwwpatient.co.uk/health/fibromyalgia (www.naturalnews.com/025468therapyFybromyalgiahypnotherapy)