HYPNOTIC ANALGESIA - 1 - SOMATOSENSORY EVENT-RELATED POTENTIAL CHANGES TO NOXIOUS STIMULI AND 2 - TRANSFER LEARNING TO REDUCE CHRONIC LOW-BACK-PAIN

Fifteen adults with chronic low back pain (M = 4 years), age 18 to 43 years (M = 29 years), participated. All but one were moderately to hig hly hypnotizable (M = 7.87; modified Ii-point Stanford Hypnotic Suscep tibility Scale, Form C [Weitzenhoffer & Hilgard, 1962]), and significa ntly reduced pain perception following hypnotic analgesia instructions during cold-presser pain training. In Part 1, somatosensory event-rel ated potential correlates of noxious electrical stimulation were evalu ated during attend and hypnotic analgesia (HA) conditions at anterior frontal (Fp1, Fp2), midfrontal (F3, F4), central (C3, C4), and parieta l (P3, P4) regions. During HA, hypothesized inhibitory processing was evidenced by enhanced N140 in the anterior frontal region and by a pre stimulus positive-ongoing contingent cortical potential at Fp1 only. D uring HA, decreased spatiotemporal perception was evidenced by reduced amplitudes of P200 (bilateral midfrontal and central, and left pariet al) and P300 (right midfrontal and central). HA led to highly signific ant mean reductions in perceived sensory pain and distress. HA is an a ctive process that requires inhibitory effort, dissociated from consci ous awareness, where the anterior frontal cortex participates in a top ographically specific inhibitory feedback circuit that cooperates in t he allocation of thalamocortical activities. In Part 2, the authors do cument the development of self-efficacy through the successful transfe r by participants of newly learned skills of experimental pain reducti on to reduction of their own chronic pain. Over three experimental ses sions, participants reported chronic pain reduction, increased psychol ogical well-being, and increased sleep quality. The development of ''n eurosignatures of pain'' can influence subsequent pain experiences (Co derre, Katz, Vaccarino, & Melzack, 1993; Melzack, 1993) and may be exp anded in size and easily reactivated (FIor & Birbaumer, 1994; Melzack, 1991, 1993). Therefore, hypnosis and other psychological intervention s need to be introduced early as adjuncts in medical treatments for on set pain before the development of chronic pain.