Applying Hypnosis in Dermatology

Philip D. Shenefelt

Disclosures

Dermatology Nursing. 2003;15(6) 

In This Article

Abstract and Introduction

Hypnosis is a tool with many useful dermatologic applications. It involves guiding the patient into a trance state for a specific purpose such as relaxation, pain or pruritus reduction, or habit modification.

Hypnosis is the intentional induction, deepening, maintenance, and termination of the natural trance state for a specific purpose. The hypnotic phenomenon has been used since antiquity to assist healing. For medical hypnotherapy, the intent is to reduce suffering, to promote healing, or to help the person alter a destructive behavior pattern. We all experience spontaneous mild trances daily while absorbed in watching television or a movie, reading a book or magazine, or other focused activity. After appropriate training, we may intensify this trance state and use this heightened focus to induce mind-body interactions that help alleviate suffering or promote healing. The trance state may be induced by using guided imagery, relaxation, deep breathing, meditation techniques, self-hypnosis, or hypnosis-induction techniques. Individuals vary in their ability to enter the trance state, but most can obtain some benefit from hypnosis. In dermatology, suggestions given during trance may help decrease skin pain and pruritus, intervene in psychosomatic aspects of skin diseases, and lead to the resolution of some skin diseases, including verruca vulgaris. Even without formal trance induction, suggestion alone may be effective in some cases. Sulzberger and Wolf (1934) reported on the use of suggestion to treat verrucae.

A precise definition of hypnosis is challenging. Marmer (1959) described hypnosis as a psychophysiologic tetrad of altered consciousness consisting of narrowed awareness, restricted and focused attentiveness, selective wakefulness, and heightened suggestibility. For a more detailed discussion of the definitions of hypnosis, see Crasilneck and Hall (1985) or Watkins (1987). Many myths exist about hypnosis that overrate, underrate, or distort the true capabilities of hypnosis.

Hypnosis can regulate blood flow and other autonomic functions not usually under conscious control. The relaxation response that occurs with hypnosis also affects the neurohormonal systems that in turn regulate many body functions. An amazing report by Braun (1983) on different allergic responses, dermatologic reactions, and effects on seizure disorders, pain control, and healing in the same individual person with multiple personality disorder (now called dissociative identity disorder) depending on the personality present showed how much influence the mind can have on physiological reactions and disease processes.

Hypnosis may be used to increase healthful behaviors, decrease situational stress, reduce needle phobias, control harmful habits such as scratching, provide immediate and long-term analgesia, ameliorate symptoms related to disease such as pruritus, accelerate recovery from surgery, and enhance the mind-body connection to promote healing. Hypnosis can be especially helpful when dealing with skin diseases that have a psychosomatic aspect. Griesemer (1978), who was trained both in dermatology and psychiatry, recorded the incidence of emotional triggering of dermatoses in his patients during 1 year. He developed an index for various skin diseases, with 100 indicating an absolute psychosomatic component and zero indicating no psychosomatic component for the skin disease.

Good reference sources on the responsiveness of skin diseases to hypnosis are found in the somewhat outdated book by Scott (1960) and in the chapter on the use of hypnosis in dermatologic problems in Crasilneck and Hall (1985). Koblenzer (1987) also mentions some of the uses of hypnosis in common dermatologic problems. A review of hypnosis in skin diseases is provided by Shenefelt (2000). Grossbart and Sherman (1992) discuss mind-body interactions in skin diseases and include hypnosis as recommended therapy for a number of skin conditions in an excellent resource book for patients. Some of the common skin conditions that have responded to hypnotherapy are discussed below.

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