Migraine is not just an adult condition. It is common in children, and it can mean missed school, cancelled plans and a child lying in a dark room being sick. Parents are often reluctant to put a young child on daily preventive medication, and understandably so.
In 1987 an American paediatrician published a study that offered an alternative. It has been cited ever since.
The study
Karen Olness and colleagues studied children aged 6 to 12 with classic migraine who had not previously had specific treatment.
The design had three stages.
- Three months on either propranolol, a drug widely used to prevent migraine, or a placebo, assigned at random.
- Three months on the other one. Neither families nor doctors knew which was which.
- Three months of self-hypnosis, taught to each child after the drug stages were over.
Throughout, families recorded every headache.
What it found
The average number of headaches per child over three months was:
- Placebo: 13.3
- Propranolol: 14.9
- Self-hypnosis: 5.8
The reduction with self-hypnosis was statistically significant. The drug did no better than the dummy pill.
Neither treatment changed how severe the headaches were when they did happen. Self-hypnosis made them less frequent, not milder.
How much weight can it bear?
The study has real limitations, and they should be stated.
- It was small.
- Self-hypnosis always came last. It was not randomised against the drug. Children may have improved with time, or with nine months of attention and diary-keeping.
- Nobody could be blind to the fact that they were learning self-hypnosis.
- It was a long time ago, and migraine treatment has moved on.
Even so, the size of the difference was striking, and later research has supported the general finding. Reviews of psychological treatments for children’s headaches conclude that relaxation, biofeedback and related methods, which overlap heavily with self-hypnosis, reduce headache frequency. Guidelines include these approaches among the options for preventing migraine in young people.
Why children do so well
- Children are more hypnotizable than adults, peaking at around 9 to 11.
- They move easily into imagination.
- They enjoy having a “trick” that is theirs.
- They practise more readily if it is made into a game.
- Learning that they can do something about their headaches reduces fear, and fear feeds headaches.
What children are taught
The method is simple and usually takes two or three sessions.
1. Relaxing. Often by blowing out slowly, or by going floppy like a rag doll.
2. A favourite place. Somewhere the child loves, imagined in detail.
3. Hand warming. Imagining holding a warm mug or sitting by a fire. This comes from biofeedback, where learning to warm the hands has been linked to fewer migraines.
4. A pain control. Whatever image the child likes: a dial, a light switch, a volume knob, a “pain switch” in the brain’s control room.
5. Daily practice. Five to ten minutes, twice a day.
6. Early use. At the first sign of a headache.
A script to use at home
Read slowly, in a calm voice.
“Get comfy and let your eyes close if you like. Take a big breath in, and blow it out slowly, like blowing out birthday candles. And again.
Let your body go floppy, like a rag doll. Floppy arms. Floppy legs.
Now go to your special place in your imagination. Look around. What can you see? What can you hear? It feels lovely there.
Imagine your hands are wrapped round a warm cup of hot chocolate. Feel them getting warm and cosy.
Now picture the control room in your head. Find the headache switch. You are the boss of that switch. Turn it down, nice and slowly.
Every time you practise, you get better at this. Take one more big breath, have a stretch, and open your eyes when you’re ready.”
Tips for parents
- Call it practice or imagination, not treatment.
- Let the child choose the place and the image.
- Tie it to a routine: after school and at bedtime.
- Keep it short.
- Do not nag. Encourage, and practise alongside them if they like.
- Keep a simple headache diary with stickers.
- Praise the effort, not the result.
Do not forget the basics
Many children’s migraines are triggered by ordinary things.
- Regular meals and enough to drink
- Regular sleep, including at weekends
- Limited screen time, and breaks
- Regular activity
- Looking for triggers such as stress, missed meals or lack of sleep
See a doctor
Any child with recurring headaches should be assessed. Seek urgent help if a headache:
- Is sudden and very severe
- Wakes the child from sleep or is worst in the morning, especially with vomiting
- Comes with fever, a stiff neck, a rash, confusion, drowsiness, weakness or problems with vision or balance
- Follows a head injury
- Is getting steadily worse, or comes with a change in personality or school performance
If your child takes preventive medication, do not stop it without talking to the doctor. Self-hypnosis can be used alongside.
The bottom line
A classic study found that children with migraine had fewer than half as many headaches when using self-hypnosis as when taking a standard preventive drug. It was a small study with limitations, but the idea has held up. For a child with frequent headaches, a few minutes of practised imagination a day is safe, free and worth trying.
Next in the series: Hypnosis for Musicians: Taming Stage Fright
This article is for general information and is not medical advice.