Hypnotherapy for pain management, self esteem, and re-establishing sexuality & intimacy after surgery. Part 1: Case presentation

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The effects of various types of surgery can disfigure the body, effect sexual functioning and intimate relationships, and consequently self esteem. Pain management, as part of a rehabilitation program, can also be an issue. This article is the first in a series of articles pertaining to the use of hypnosis for the treatment of pain management, improving self-esteem, and re-establishing sexuality and intimacy after cancer surgery. This first article will present a case study demonstrating how the use of hypnotic interventions combined with counseling strategies assist with pain management and improve self-esteem in a 55-year-old male. It will discuss options and information that is relevant to surgery that affects sexual functioning, and consequently self esteem and intimacy. It will discuss psycho educational strategies for clinical consideration, including how to empower the clients with information that broadens their knowledge of sexual functioning.

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Background We measured the prevalence of stigma, self-blame, and perceived blame from others for their illness among men with colorectal cancer (CRC) and examined whether these factors were associated with depressive symptoms, independent of clinical and sociodemographic factors.Methods Self-administered questionnaires were returned in the fall of 2009 by 1109 eligible male US veterans who were diagnosed with CRC at any Veterans Affairs facility in 2008. Questionnaires assessed stigma, feelings of blame, and depressive symptoms as well as other facets of health, cancer characteristics, and quality and type of medical care. We report the prevalence of cancer stigma, self-blame, and perceived blame from others. We used multivariate linear regression to assess the association between these factors and a measure of depressive symptoms. Covariates included several measures of overall health, cancer progression, symptom severity, and sociodemographic factors.ResultsThirty one percent of respondents endorsed at least one item in a measure of cancer stigma and 25% reported feeling that it was at least ‘a little true’ that they were to blame for their illness. All three independent variables were associated with depressive symptoms in bivariate models; cancer stigma and self-blame were significantly associated with depressive symptoms in the multivariate model.Conclusions Cancer stigma and self-blame are problems for a significant minority of men with CRC and are independent predictors of depressive symptoms. They may represent an important source of stress in men with CRC. Copyright © 2011 John Wiley & Sons, Ltd.
Although there remains much to be learned, a great deal is now known about the neurophysiological processes involved in the experience of pain. Research confirms that there is no single focal "center" in the brain responsible for the experience of pain. Rather, pain is the end product of a number of integrated networks that involve activity at multiple cortical and subcortical sites. Our current knowledge about the neurophysiological mechanisms of pain has important implications for understanding the mechanisms underlying the effects of hypnotic analgesia treatments, as well as for improving clinical practice. This article is written for the clinician who uses hypnotic interventions for pain management. It begins with an overview of what is known about the neurophysiological basis of pain and hypnotic analgesia, and then discusses how clinicians can use this knowledge for (1) organizing the types of suggestions that can be used when providing hypnotic treatment, and (2) maximizing the efficacy of hypnotic interventions in clients presenting with pain problems.
This article reviews controlled prospective trials of hypnosis for the treatment of chronic pain. Thirteen studies, excluding studies of headaches, were identified that compared outcomes from hypnosis for the treatment of chronic pain to either baseline data or a control condition. The findings indicate that hypnosis interventions consistently produce significant decreases in pain associated with a variety of chronic-pain problems. Also, hypnosis was generally found to be more effective than nonhypnotic interventions such as attention, physical therapy, and education. Most of the hypnosis interventions for chronic pain include instructions in self-hypnosis. However, there is a lack of standardization of the hypnotic interventions examined in clinical trials, and the number of patients enrolled in the studies has tended to be low and lacking long-term follow-up. Implications of the findings for future clinical research and applications are discussed.