HYPNOTIC CONTROL OF PAIN - HISTORICAL PERSPECTIVES AND FUTURE-PROSPECTS

Hypnotic analgesia has occupied a pivotal place in experimental and cl inical hypnosis. It emerged early in the 19th century when effective c linical techniques for pain management had not yet developed, and the relief of pain and suffering had not even become a well-defined social goal. Its acceptance was further complicated by political struggles s urrounding the humanitarian transformation of medicine during this era as well as a redefinition of the physician-patient relationship that wrested control from the patient. The initial struggle for professiona l acceptance was won only when the debate became almost entirely local ized within the professional community. Acceptance of hypnosis by prof essional organizations has been followed by alternating periods of int erest and indifference. While the evidence for the powerful effects of suggestion and related variables has often been observed and reported in nonhypnotic contexts, their relationship to hypnotic phenomena has often not been appreciated. Since the mid-20th century, scientific in formation about hypnotic analgesia has grown substantially and has had significant influence on strategies for acute and chronic pain manage ment. If recent calls for its wider application in pain management are to succeed, it will require additional data from clinical populations and a balanced and scientifically prudent approach by its advocates.