Long, drawn-out or constant pain wears us down and steals our joy.
“Life will bring you pain all by itself. Your responsibility is to create joy.”
– Milton H. Erickson
Have you ever been in real pain? I don’t mean the sudden, sharp, thankfully short-lived acute pain of a stubbed toe. I’m talking about pain that drags, cuts, enervates. Pain that nags, that crumples up your time into little blocks of endurance. Pain that steals your wellbeing, humour, and zest.
Long, drawn-out or constant pain wears us down and steals our joy.
In this brief piece I want to show how we can start to help clients overcome or at least improve pain so that it no longer makes life feel not worth living.
It might seem strange to consider how we can ease pain in others through the power of our words. We might pay lip service to the idea of mind and body being one, but we also live in a world of pill popping in which, for many of us, the mind is treated by a counsellor and the body by a pharmaceutical rep.
The Cartesian split is alive and well, living in what we do, not what we say!
And yet you may have seen it with your own eyes. How hypnosis or other mindfulness meditative techniques can help ease or even entirely stop physical pain; how certain methods of the mind can hold sway over the workings of the body.
So let’s look at this case study.
The loneliness of chronic and debilitating pain
My client from Uncommon Practitioners TV (UPTV) came to me for help with long-term, intractable pain. I’ve blurred her face in the following clips but of course inside UPTV you can see her unedited. I’ll refer to her here as Lucy.
Lucy was diagnosed with myalgic encephalomyelitis (ME) in 2006 after a second bout of glandular fever. (She had first had glandular fever at the age of 14 after catching the Epstein-Barr virus.) Since then she’d had recurring pain. She’d tried everything from acupuncture and meditation to all different kinds of pain medication.
I want to show you clips from her first and second sessions to show how we can put into practice some of the pain-diminishing techniques discussed in my previous blog post on pain. Video can be worth a thousand words!
You’ll see that one particularly useful approach for Lucy is regressing her back to a time before she ever had the pain. She tells me at one point that relaxation doesn’t help the pain, so we can distinguish the benefits of the hypnotic work specifically from those she might receive from simply feeling calm.
Living in fear
Lucy experienced pain every day. A few times a week the pain would be so severe she would just have to go to bed.
Somehow Lucy was managing to hold down a full-time job and look after her family, but she lived in fear of having a bad day, as the pain was truly debilitating. Watch here as she describes the pain and the effects it was having on her life.
When working with pain it’s important to let the client describe not just the pain itself but also the effect it has on them. We also need to understand from our client’s perspective the meaning of the pain.
For example, a person might relate to the pain from a broken jaw after being assaulted in the street differently than they would to the pain of healing after a life-saving operation. The physical pain may be similar in both cases, but the emotional meaning of the pain will be very different. So we need to know: What is the context surrounding the pain?
The way Lucy described her pain put me in mind of a curse that just wouldn’t seem to leave her alone. She’d been told she just had to live with it, but she wasn’t willing to accept this.
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When seeking to treat pain, we should start by learning everything we can about the pattern of the pain: when it happens, its intensity, when it started, and so on. We do this so that we have elements of the client’s experience to work with later such as when reframing the pain. We also want the client to know we are making an effort to understand their experience.
But what other approaches can we take?
When doesn’t it happen?
When seeking to help heal any problem, it’s important to discover when the problem doesn’t happen. As you can see here, when I ask Lucy about this I get a rather (to me at least) unexpected answer.
Lucy doesn’t have any pain when she’s asleep. She tells me that not only doesn’t she feel pain when she’s asleep, but she doesn’t have to think about it. This shows us that she’s spending a lot of time ruminating about the pain.
So to be pain-free, or at least to experience greatly reduced pain for a longer period, is going to be a novel experience.
Can you give me a description?
Next I wanted to discover what the pain felt like for Lucy. She described it as… well, see for yourself:
I think it’s useful to use the way the client thinks about their pain as a way to help them overcome it. Because Lucy ended up telling me how the approach I’m about to describe hadn’t worked for her in the past, I soon jettisoned it – but I still want to go into it briefly here, as it’s a very useful principle.
Getting a description of pain can be really useful because, as you may have noticed, people get very creatively metaphorical when talking about their pain. And when you are given metaphors in therapy, you are given material to build something with (if you’ll pardon the metaphor!).
Anyway, where pain is concerned you’ll often hear words like burning, tender, sharp, dull, hot, boiling, searing, nagging, ripping, angry, pulsating, screaming, shooting, violent, and so on.
Once we have a metaphor, we can hypnotically work with it. We are then working on the level of the client’s reality.
So a ‘stabbing’ pain might be cushioned, a ‘burning’ pain cooled, an ‘angry’ pain calmed.
This is how pain can be reframed. We are joining the client in their reality of the pain because it’s their metaphor. We do need, though, to be flexible enough to not use an approach if we suspect the client has tried it before and it didn’t work.
Lucy tells me sometimes the pain is “burning”. But she says she’s tried cooling it imaginatively and that hasn’t worked. So I have to be flexible and drop that idea (a hard ask, as I know how powerful it can be!).
However, I do ask her in the session to reframe the pain as colour, shape, and texture and then work to change those submodalities (cooler colours, smaller shape, smoother texture), and that seems to work.
Next we can get solution-focused.
What will life be like?
We need to know the person and their likes and loves beyond just their experience of pain because more time living life, free of pain, is what we are aiming for. By getting to know them properly, we can help build a picture of how they might live their life more fully once the pain has been dealt with.
This can be very useful, as we tend to focus so much on our problems that we rarely imagine life beyond them. I sometimes liken this to holding up a rock to your eyes so that’s all you can see, which makes you forget there’s a whole world beyond that, landscapes and vistas.
Lucy tells me she loves animals and has three dogs, three cats, and a parrot! She describes how she would love to meet friends in the evenings sometimes – but at the moment the pain is too much for her so she never does.
When I ask Lucy what she’ll be doing more of in her life when pain is less of an issue , she tells me simply that she would love to enjoy her life. Having gotten to know a bit about her already, I was able to guide her to explore what this might look like, specifically.
I want now to give you a little flavour of some of the hypnotic strategies I employed.
Harnessing the mind’s great power
First I use confusional language to tie up Lucy’s conscious mind and facilitate hypnotic trance, then I begin to elicit hypnotic anaesthesia/numbness, as you can see here:
Notice there that I don’t ask Lucy to directly experience numbness but rather appeal to the part of her that knows how to produce hypnotic anaesthesia by simply offering her scenarios, universal examples, of when numbness might happen anyway: playing in the snow as a kid without gloves, sitting in one position for too long. I can then ask her to notice that numbness going to where it’s needed in her body.
I go on to use reframing of the colour and texture and shape of the pain as she had described it. I suggest her unconscious mind is going to know the pain is diminishing before she does, thereby facilitating ongoing physical disassociation. A disassociated, ‘out-of-body’ experience is a classic hypnotic pain-control technique. You can see me suggest Lucy experience being outside of her body, and therefore pain free, here:
I utilize Lucy’s earlier description of the pain feeling “heavy” by making suggestions for Lucy to “feel generally lighter”. I also make suggestions for a powerful sense of “healing energy” which will be helping Lucy even when she’s not aware of it. I suggest she begin to heal rapidly now.
I go on to suggest that Lucy’s head can come out of hypnotic trance while her body stays in trance and therefore pain free. Here she is coming out of trance:
Lucy enjoyed her first session. But did it do any good?
Freedom from a world of pain
Lucy had an almost miraculous improvement after the first session. For up to six weeks she was “90%-plus better” and loved the way she felt – a way she’d thought she’d never feel again.
Here she is in her second session around six weeks later, describing some of what she got from the first session. She says has had a bit of a setback because she came under a lot of pressure and stress at work, but even then it was better than it had been before. So we are not entirely done yet. But she’s much improved and has grown in confidence that she can live a better life.
Most of the second session is spent using trancework: I use conscious/unconscious ‘splitting’ in which I delineate my communication between her conscious and unconscious minds, and elicit more hypnotic numbness through the use of hypnotic catalepsy. I utilize mindfulness for pain, regression to carefree childhood times, disassociation, and age progression. I also make suggestions for Lucy to experience a different version of the past in which she had never actually had glandular fever at 14 (which seems to be the origin of the pain).
When we use the principles of hypnotic pain soothing, we can often help our pain clients more than even we ourselves expect.
So, in summary, we should always explore with the client:
- What is the pattern of the pain? When does it happen, when did it start, and what were the circumstances around its genesis?
- When doesn’t the pain occur or bother them so much? (We can evoke these times during hypnosis.)
- What is the emotional meaning of the pain to them?
- How do they describe the pain? What metaphors do they give you? (We might use these metaphors in later trancework.)
From there, we can:
- Ask the client to describe the pain as a shape, colour, and texture then help them alter those submodalities to alter and diminish the pain.
- Use hypnosis to evoke numbness, enable disassociation from the pain, and reframe the pain.
- Utilize hypnotic regression to pre-pain times, and time progression to pain-free futures.
- Make both direct and indirect suggestions for physical healing.
Other approaches I haven’t really addressed here can be useful too, like scaling the pain.
Working with pain is rarely about a magic bullet; it’s about opening doors clients thought were forever locked.
When we help someone rediscover that their mind can soothe, reshape, and even silence their pain, we offer more than relief: we give back hope, control, and possibility.
As therapists, our words can become tools of healing, and when those words meet a client’s courage, whole new futures become imaginable.
And that, perhaps, is the most powerful medicine of all.
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About Mark Tyrrell
Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.
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