Building Bridges of Understanding
Self-Hypnosis Techniques for Management of Pain, Relaxation and Sleep
By Mark P. Jensen, PhD.
Hypnosis is based on a single simple idea: when people focus their attention and become very absorbed on a single object, they are more able to change how they feel. Virtually any absorbing activity can induce the state of relaxed yet focused awareness associated with hypnosis.
You need not worry about getting “stuck” in a hypnotic state. In fact, you should find that the state of focused awareness feels very familiar to you. Have you ever sat on a beach watching a sunset while on vacation, or engaged in some interesting and absorbing hobby? You might sometimes lose track of time in these situations, but you do not get “stuck” in them. When it is time for you to return to your usual day-to-day state of mind, you will do so.
What Is a Hypnotic Induction?
The hypnotic induction is the first step in any self-hypnosis or clinician-led hypnosis session. The classic stimulus that many people have seen in old movies and cartoons is a swinging pocket watch, but virtually any object can be used, such as a candle, a spot on a wall, the clinician’s voice or even your own breathing. It could also be some image that you generate yourself; like an image of being in some safe and relaxing place.
When people focus their awareness in this way, changes happen in the brain. There is an overall decrease in activity—the brain calms down. During this experience, the part of the brain that keeps track of time can become so inactive that you might lose track of time. The nerve cells in the part of the brain that prompt feelings of worry or anxiety are less active, so you feel less anxious during and after a hypnotic induction. As a result of these brain activity changes, people often respond to hypnotic inductions by feeling more calm and relaxed, and also more focused.
You may sometimes choose to use the induction to simply get into a hypnotic “state,” given that you will likely find the state relaxing and very comfortable, not unlike meditation. Entering this state has many positive health benefits on its own. However, you can also follow your self-guided induction with self-suggestions for reductions in your pain, improvemens in your mood, and improvement in your sleep. Because problems sleeping is so common in people with chronic pain, and because self-hypnosis can be so helpful for improving sleep quality, the rest of this article will focus on the use of self-hypnosis for improving sleep. But you can find more information about how you can use self-hypnosis for managing your pain, mood, and even your thoughts and behavior, in Hypnosis for Chronic Pain Management: Patient Workbook, published by Oxford University Press.
Getting Ready to Slip into Sleep
Using a hypnotic induction can help you get to sleep faster, stay asleep longer, and feel more rested when you wake up.
Virtually anytime you focus your awareness on a stimulus or image, the brain’s response is to decrease fast-wave (beta) activity and increase slow-wave (alpha and theta) activity. There is less “chatter” in the mind; you are too busy noticing the details of your safe place or experiencing feelings of relaxation to worry and ruminate. From this state, if the brain and body need sleep, you will more easily slip into sleep.
For some people, a natural muscular response to relaxation is to “twitch.” This is a sign that you are relaxing. You might find it interesting to count the twitches, but don’t be surprised if you can’t. This inability to count and keep track is another sign that your brain is drifting into the first stages of sleep.
A second experience sometimes associated with drifting off to sleep is that of random visual images—either “dreamlike” images of objects or people, or simply colors and patterns. If you experience these images, your job is to simply notice and enjoy them as they occur, and to understand that they are a sign that you are getting control over the process of getting to sleep. Focusing on these images will keep you from focusing on your thoughts, and this will help you to get to sleep faster.
When you wake up in the middle of the night—and most adults, in particular older adults, do—you can simply use your favorite hypnotic induction to get your mind into a state where it is easy to get to sleep again.
Self Hypnosis Induction Techniques
In teaching people hypnosis inductions, and in the workbook, I offer three typical techniques that give you something interesting to focus on as your mind slows down.
These detailed scripts are modeled on the inductions used in our research on hypnosis and chronic pain management—studies that support the efficacy of hypnosis treatment for chronic pain. Therefore, they can be viewed as inductions that have scientific support.
However, everyone is different and you will likely find that you respond better to some inductions than to others. You may modify the inductions to make them even more effective for you. If you are working with a clinician experienced in the use of hypnosis, he or she will also work with you to find the hypnotic inductions that are most effective.
It is a good idea to begin each induction with a deep and satisfying breath, hold it for 5–10 seconds, and then let it go. It takes advantage of the fact that there is a natural relaxation response that follows an exhalation. You will associate the cue with your own hypnotic response. The following are summaries of these techniques; more details are in the workbook mentioned at the end of the article.
In the countdown induction the script suggests you slowly imagine yourself going down an elevator. You can imagine the numbers appearing in your mind’s eye.
As you count from one to 10, take a deep, satisfying breath, hold it … and then let it all the way out. Imagine that you feel yourself settling down, one level of comfort at a time, into a deeper and deeper experience of comfort and relaxation. So that, when you reach the tenth level, you can really enjoy an experience of deep, comfortable ease.
Once you reach the number 10, you can then enjoy the feelings of relaxation that you have created for yourself for as long as you wish. Just a couple of minutes would be fine if you are taking a short break. Many patients choose to stay in this state for 5 or 10 minutes, as they find it so calming and relaxing.
Relaxation inductions are useful for individuals with chronic pain because the mental calm that often accompanies relaxation is inconsistent with the suffering sometimes associated with pain. Patients with chronic pain who are able to learn to experience relaxation whenever they wish are often able to feel less pain, and less distress associated with their pain.
In this induction, you focus on different parts of the body and different muscle groups, allowing each part to relax in sequence. Simply allow your mind to move from one body part to the next, letting each body part feel relaxed before moving on. Notice the specific sensations that you feel as your body relaxes. Is it heaviness, warmth, lightness, a slight tingling, something else? Whatever the sensations are for you, you should pay attention to those sensations and allow them to grow.
Going to a Safe Place
This induction takes advantage of many people’s ability to imagine themselves in a specific location, and. If you can imagine yourself in a place where you feel very safe and comfortable—and picture in your mind’s eye the details of that place—then feelings of relaxation and comfort will naturally follow the images that you create.
Safe place inductions and suggestions are particularly useful for individuals who have a talent for imagery, and who are able to visualize a place in enough detail so that the feelings associated with the place are elicited automatically.
It is also useful to include all of the senses when imagining the safe place. To smell the smells (for example, the salty air if it is at a beach), hear the sounds (for example, the rush of water if it is in a meadow next to a mountain stream), and feel the textures (for example, of sand or dirt if it is outside) and temperature. You may find that some senses help you to experience yourself as being in your safe place more easily than other sensations. If so, it would be wise to focus on those senses as you enter your place and experience yourself being there.
I learned about an excellent self-hypnosis induction—the “3-2-1” technique—from a colleague and clinician named Björn Enqvist.
The 3-2-1 technique is very simple. First, just listen for three things. Any three things that you hear as you are going to sleep will do: the noise of your breathing—one; or maybe a sound of a far-off airplane—two; or maybe the sound of your skin against the sheet—three.
Next, feel three things. For example, the feeling of the sheet against your skin—one; an interesting tingling sensation in your arms—two; and cool or maybe warm air on your face—three. Just feel them and count them, 1, 2, 3.
And then, see three things. Allow three images to come into the mind. Just let them appear, on their own. A rose—one. A blue sky—two. Some third image; it does not matter what it is, maybe a beach—three. Any three images.
Then, after you have seen the third thing, go back and hear two things, and count them in the mind. Then feel two things. Then see two things. Then hear one thing, feel one thing, and see one thing.
And then start again. Hear three things, feel three things, see three things. Then hear two things, feel two things, see two things. Then hear, feel, and see one thing. And back to three.
As the mind focuses on and is experiencing what it hears, feels, and sees, and as it starts to drift to sleep, you will likely lose count. That is fine; just start over. You can use this strategy and discover what interesting things you can experience as you drift into a deep, restful sleep.
Once you learn to create a hypnotic state for yourself – a state where the mind is relaxed and you feel more comfortable – you can practice it on a regular basis. Research shows that the beneficial effects of self-hypnosis can last for hours after you practice, even if you practice for just one or two minutes at a time. By allowing yourself to experience the hypnotic state many times during the day, you will become better at using hypnotic skills, and can feel much better as a result.
Much of the information presented in this article is a summary of portions of “Hypnosis for Chronic Pain Management: Patient Workbook” by Mark P. Jensen, published by Oxford University Press. This patient workbook is available from Amazon.com.