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HYPNOTIC ANALGESIA IN PERSONS WITH DISABILITIES
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problems, and about half of these report severe pain (Engel, Jensen,
Hoffman, & Kartin, 2003; Schwartz, Engel, & Jensen, 1999). Pain is also
common among persons with multiple sclerosis (MS) (Ehde, Jensen,
et al.). In one survey study, 44% of a sample with MS reported chronic
pain problems, and about a quarter of these reported severe pain
(Ehde, Jensen, et al.). This issue is also problematic in persons with
neuromuscular disease (NMD) and postpolio syndrome (PPS),
although the frequency and severity of pain problems in persons with
NMD appear to vary somewhat as a function of specific diagnosis
(Jensen, Abresch, Carter, & McDonald, in press). Chronic pain is
clearly a serious problem for many persons with disabilities.
Unfortunately, chronic pain in persons with disabilities is notori-
ously difficult to treat. Few treatments have been found to be effective
in the treatment of pain in persons with SCI, acquired amputation, or
other disabilities (Ehde, Jensen, et al., 2003). Moreover, survey data
indicate that, despite the fact that many individuals with disabilities
have tried or have received a wide variety of treatments for their
chronic pain, most report that these treatments are not usually very
effective (Engel, Kartin, & Jensen, 2002; Jensen et al., in press; Warms,
Turner, Marshall, & Cardenas, 2002). There is a clear, unmet need for
the identification and development of additional treatment options for
chronic pain in persons with physical disabilities.
Hypnotic analgesia has the potential to benefit at least some indi-
viduals with a disability and chronic pain. For example, Jensen and
Barber (2000) reported on the effects of hypnotic-analgesia treatment
in 4 patients with SCI who scored in the medium to high range in
hypnotizability. The interventions were tailored to each study partici-
pant over the course of treatment (e.g., by including induction and
analgesia suggestions that the participants specifically requested or
seemed to respond best to), and the participants in this study were given
the option of choosing when treatment was discontinued. Each of the 4
patients reported decreases in pain and sleep disturbance pre- to post-
treatment, and the 3 patients who continued self-hypnosis practice
using practice tapes during the 2 months following treatment main-
tained, or built upon, their treatment gains. At 1-year follow-up, 2 of the
patients had maintained their treatment gains. The patient who did not
maintain his treatment gains at 1-year follow-up reported that he had
discontinued self-hypnosis practice because he lost his practice tape and
noted that a gradual increase in pain had occurred after he stopped
practicing. These findings, although based on a small sample of partici-
pants, provide preliminary support for the potential of hypnotic anal-
gesia to reduce chronic pain in at least some individuals with SCI and
also raise the interesting hypothesis that the maintenance of treatment
gains might be influenced by the frequency of ongoing self-hypnosis
practice.