Many medical procedures are done while you are awake: biopsies, angiograms, scans, endoscopies. They are usually not agonising, but they are uncomfortable, they go on for a while, and they are frightening. Sedatives help, but carry risks of their own.
In 2000, a trial published in The Lancet showed that a simple hypnotic technique could make these procedures easier on patients and, unexpectedly, quicker for the hospital.
The trial
The radiologist Elvira Lang and colleagues studied 241 patients having procedures on blood vessels and kidneys through the skin, the kind of work done in an interventional radiology suite with local anaesthetic.
Patients were randomly assigned to one of three groups:
- Standard care
- Structured attention: a trained person stayed with the patient, attentive and encouraging
- Self-hypnotic relaxation: the same attention, plus guiding the patient through a self-hypnosis script
All patients could give themselves pain and sedative medication through a pump.
The results
Pain. In the standard care group, pain rose steadily the longer the procedure went on. In the attention group it rose more slowly. In the hypnosis group it stayed flat.
Anxiety fell in all three groups, and fell fastest with hypnosis.
Medication. Patients in the standard group used about twice as much medication as those in the attention and hypnosis groups.
Safety. One patient in the hypnosis group had unstable blood pressure or heart rate during the procedure. In the attention group it was ten, and in the standard group twelve.
Time. Procedures took an average of 61 minutes with hypnosis, 67 with structured attention and 78 with standard care.
The authors concluded that both structured attention and self-hypnotic relaxation were beneficial, with hypnosis having the more pronounced effect on pain and anxiety and the added advantage of keeping patients more stable.
Why would it save time?
A calm, comfortable patient lies still, needs fewer pauses, has fewer complications to manage and needs less medication. A later analysis by the same group estimated that the approach saved money as well.
The attention group matters
Notice that simply having an attentive, encouraging person present produced a good share of the benefit. How staff speak to patients matters. Lang went on to train clinical teams in language that comforts instead of alarming: “You may feel some pressure” in place of “This is going to hurt.”
Where else it is used
- MRI scans, for claustrophobia
- Breast biopsy
- Endoscopy and colonoscopy
- Needle procedures and blood tests
- Lumbar puncture and bone marrow tests, particularly in children
- Radiotherapy, including for people who struggle with the mask
The MRI problem
An MRI scanner is a narrow, noisy tube, and a meaningful minority of people cannot complete a scan because of panic. Some need sedation or have to abandon the scan altogether. Hospitals have tested hypnosis and relaxation training to reduce this, and reports describe more scans completed and less sedation used.
A routine for your scan
In the days before
- Ask what will happen and how long it takes.
- Ask what the department offers: music, a mirror, a blanket, a panic button, an open scanner, someone staying in the room.
- Practise this for ten minutes a day:
– Close your eyes and breathe slowly.
– Go to a place you love, in detail.
– Imagine the scanner noise becoming something else: drumming rain, a train on the tracks.
– Tell yourself: “My body lies still and comfortable while my mind is somewhere else.”
On the day
- Tell the staff you are nervous.
- Close your eyes before you go into the scanner and keep them closed.
- Breathe out slowly and go to your place.
- Let the noise be part of the scene.
- Count your breaths if your mind wanders.
- Remember you have a call button and can stop.
For a needle or biopsy
- Look away.
- Breathe out as the needle goes in.
- Imagine the area cool and numb, as if packed in snow.
- Put your attention firmly on something else: your feet, a memory, a tune.
If the hospital does not offer hypnosis
Most do not have trained staff. You can still:
- Bring headphones and a relaxation recording, if allowed.
- Bring someone with you.
- Ask staff to tell you what is happening.
- Ask about sedation if you know you will struggle. That is a legitimate choice.
The bottom line
Hypnosis during medical procedures is one of the best-evidenced uses there is. It reduces pain, anxiety and medication, and can be learned in minutes. If you have a scan or procedure coming, it is worth practising beforehand.
Next in the series: Hypnosis for Tics and Tourette Syndrome
This article is for general information and is not medical advice.