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Hypnosis in Auto­im­mune Dise­ases: Where Does Medi­cine stand?

Hypnosis is a psycho­the­ra­peutic proce­dure to put the patient in a deep state of rela­xa­tion. Hypnosis can trigger beha­vioral changes that, according to psycho­neu­ro­im­mu­no­logy, can influ­ence the func­tio­ning of the immune system. In addi­tion, hypnosis can help learn a better way of dealing with stress and make chan­ging habits easier.

To date, there are only a few studies and case studies on the use of hypnosis in auto­im­mune dise­ases. However, hypnosis has been shown to improve disease acti­vity in pati­ents with rheu­ma­toid arthritis. In small studies, psoriasis and the quality of life of multiple scle­rosis pati­ents could also be posi­tively influ­enced by hypno­the­rapy.1,2

Indi­vi­dual cases and case series in which hypnosis has had a posi­tive impact have been described in the following auto­im­mune diseases:

  • Rheu­ma­toid Arthritis (rando­mized study with 66 subjects))
  • Systemic Lupus Erythe­ma­tosus (several single cases described)
  • Psoriasis (small pilot study)
  • Multiple scle­rosis (study and case series)
  • Sclero­derma (single case)
  • Secon­dary Raynaud’s syndrome (pilot study with sclero­derma patients)
  • Auto­im­mune peri­car­ditis (single case)
  • Derm­ato­myo­sitis (single case)

Possible Trig­gers of Auto­im­mune Disease

In auto­im­mune dise­ases, there is a dysre­gu­la­tion of the immune system. This is likely due to an inter­play of a wide variety of factors. These include:

  • genetic dispo­si­tion (predis­po­si­tion)
  • envi­ron­mental influences
  • hormonal influ­ences and gender
  • trig­ge­ring factors

Trig­ge­ring factors can be, for example, infec­tions that lead to incre­ased acti­vity of the immune system, or physi­cally as well as psycho­lo­gi­cally stressful experiences.

A retro­spec­tive study showed that pati­ents with auto­im­mune dise­ases often went through a strong emotional stress phase (job loss, divorce or death of a close rela­tive) before the first disease episode.3 There­fore, stress could play a role in immune dysre­gu­la­tion by influ­en­cing the hormonal system.

possible triggers autoimmune disease

Auto­im­mune Dise­ases and Stress

A study of the disease course of Swedish pati­ents over a period from 1981 to 2013 showed that psych­iatric dise­ases trig­gered by massive stress, such as an adjus­t­ment disorder or post-trau­matic stress disorder, are asso­ciated with an incre­ased risk of deve­lo­ping auto­im­mune dise­ases and espe­cially multiple auto­im­mune dise­ases (more than three).4

It should be noted, however, that corre­la­tion does not mean causa­tion and that type 2 diabetes was also included among the auto­im­mune dise­ases, which is not correct since it is a meta­bolic disease without immu­no­lo­gical invol­ve­ment.5

Also, suffe­ring from an incurable chronic disease, at least as of today, is usually accom­pa­nied by pain, anxiety, and finan­cial and other emotional burdens. Like­wise, inflamma­tory messenger subs­tances can influ­ence sensa­tion and feeling and cause depres­sion. In addi­tion, auto­im­mune dise­ases are often only diagnosed after years of suffering.

Thus, a vicious circle of worry and pain due to the disease and stress often deve­lops, which promotes auto­im­mune processes and has an unfa­vor­able effect on the course of the auto­im­mune disease and the pain level.

This article is about a health issue. It is important that you have your symptoms examined and treated by medical profes­sio­nals. This article is not intended to be, and cannot be, a substi­tute for the care and advice of medical profes­sio­nals that may be avail­able to you.

Hypnosis for Rheu­ma­toid Arthritis (Rheu­ma­tism)

Rheu­ma­toid arthritis, popu­larly known as rheu­ma­tism, is an auto­im­mune disease that mainly affects the joints and without treat­ment is also capable of destroying them.

In a study of 66 pati­ents with rheu­ma­toid arthritis, hypnosis was applied to 26 subjects, while 20 other pati­ents learned rela­xa­tion tech­ni­ques, and the other 20 pati­ents served as a control group. 

After ten hypnosis sessions, the pati­ents were given an audio recording of the hypnosis, which contained sugges­tions and images intended to have a calming effect on the immune system. Study parti­ci­pants were inst­ructed to prac­tice at least three times a week.

After three and six months, the subjects were each examined and inter­viewed. Results showed that joint pain, joint swel­ling, and stiff­ness had improved more in the hypnosis group than in the control group, but also compared to the rela­xa­tion group. These impro­ve­ments could not be attri­buted to a change in medi­ca­tion or more pain­killer consump­tion and there­fore seem to stem from the hypnosis.1

Hypnosis in the Case of the Auto­im­mune Disease Lupus

In addi­tion to forms of lupus that usually affect only the skin, such as cuta­neous lupus erythe­ma­tosus (CLE), which is itself auto­im­mune in origin, there is also systemic lupus erythe­ma­tosus (SLE). In systemic lupus, the following symptoms often occur:

  • Skin symptoms and UV intolerance
  • Joint pain/swelling
  • Elevated tempe­ra­ture
  • Morning stiff­ness
  • Blood count changes
  • Pleu­risy or pericarditis
  • Damage to internal organs, for example the kidneys (lupus nephritis)

In the case of lupus dise­ases, there have been no rando­mized studies on the use of hypnosis. However, in systemic lupus erythe­ma­tosus, there are some very impres­sive case reports on the use of condi­tio­ning and hypno­the­rapy.2,6,7

One casu­istry is by psych­ia­trist Moshe S. Torem, who describes the case of a lupus patient who, under hypnosis, used imagery to trans­form the “aggres­sive” parts of her immune system into “gentle” parts in the form of white horses. She went into remis­sion after several sessions.2

Now, lupus is a disease that, like most other auto­im­mune dise­ases, occurs in flares and thus can not only worsen but also spon­ta­ne­ously subside quite inde­pendently of treat­ment attempts. In addi­tion, it was not precisely described which treat­ments the patient under­went at the same time. There­fore, it is diffi­cult to say how large the contri­bu­tion of hypnosis to remis­sion was.

Hypnosis for Psoriasis

In a small study of 11 psoriasis pati­ents, skin-related hypnosis was used in 5 subjects, and neutral hypnosis was used in a control group consis­ting of 6 subjects, in which no skin impro­ve­ments were suggested.

After three months of diffe­rent hypnosis appli­ca­tions, disease-related sugges­tions were applied in both groups to observe whether this would produce changes in the group previously treated by neutral hypnosis. Parti­ci­pants were not allowed to take any medi­ca­tion and only use a nouris­hing cream — without ingre­dients contai­ning cortisone.

Rese­ar­chers found that psoriasis pati­ents who were highly suscep­tible to hypnosis bene­fited slightly more. Like­wise, it became appa­rent that a skin-related hypnosis inter­ven­tion in the subse­quent three months could still produce impro­ve­ment in more moder­ately hypno­tiz­able indi­vi­duals who had previously expe­ri­enced little impro­ve­ment under neutral hypnosis.8

Rese­ar­chers hypo­the­size that hypnosis and rela­xa­tion tech­ni­ques affect the invol­un­tary nervous system and, through it, the immune system. Via the influ­ence of the immune system, there is even­tually an impro­ve­ment in skin disease.9

Accom­panying Hypno­the­rapy for Multiple Scle­rosis (MS)

Multiple scle­rosis is an auto­im­mune disease of the nervous system that often has a relap­sing-remit­ting course, but there is also a chronic progres­sive form.

Dentist and hypno­tist Howard D. Sutcher, himself a sufferer of MS, describes in a case series how symptoms improved under hypnosis and self-hypnosis even in progres­sive MS courses that other­wise did not respond to other treat­ment attempts. Alle­viated symptoms included signi­fi­cantly incre­ased sali­va­tion, incre­ased urina­tion, gait unsteadi­ness, and paresthe­sias (ting­ling, “formi­ca­tion”).10

In another study, self-hypnosis was shown to have a greater effect on daily pain in multiple scle­rosis pati­ents than a beha­vioral therapy inter­ven­tion. However, the group that combined self-hypnosis and beha­vioral therapy proce­dures did best.11

Psych­ia­trist Moshe S. Torem describes the case of an MS patient in whom the woman imagined her immune system easily reco­gni­zing her own cells as not foreign to her body and thus no longer attacking them. The patient then went into remis­sion after a period of prolonged acti­vity. Again, unfor­tu­n­a­tely, further treat­ment moda­li­ties are missing in the case report. One only learns that thera­pies were not changed.2

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Hypnosis in Scleroderma-patients

Sclero­derma, like lupus erythe­ma­tosus, belongs to a group of disor­ders called colla­ge­nosis. Colla­ge­noses are rheu­matic, auto­im­mune disor­ders affec­ting the connec­tive tissue.

Sclero­derma pati­ents suffer from an extreme harde­ning of the skin: Often, the appearance of the face changes, and in addi­tion, the opening of the mouth and the mobi­lity of the tongue decrease due to a shor­tened lingual fren­ulum. As a result, the psycho­lo­gical suffe­ring is high because of the disfi­gu­ring features of the disease.

A case study describes a patient who had to stop her dental treat­ment for the time being because of the restricted mouth opening (micros­tomy) due to the exis­ting sclero­derma. However, after hypno­the­rapy, which was intended to prepare her for the dental treat­ment that was again to come, she showed a markedly improved mouth opening. The dentist could finish the desired dental treat­ment and prost­hetic resto­ra­tion after the inter­ven­tion.12

Successful use of hypnosis in secon­dary Raynaud’s syndrome due to scleroderma

Raynaud’s syndrome is a vascular spasm that causes the extre­mi­ties, espe­cially fingers and toes, to lose proper blood flow. This is very painful. In the case of secon­dary Raynaud’s syndrome, which occurs more frequently as an accom­panying symptom in rheu­matic dise­ases, it can even lead to destroyed tissue in severe cases. These so-called necroses arise due to reduced blood flow.

One study examined the skin tempe­ra­ture of the fingers of 12 pati­ents with progres­sive sclero­derma and Raynaud’s syndrome treated with hypnosis or auto­genic trai­ning. Rese­ar­chers found that pati­ents in both the hypnosis and auto­genic trai­ning groups were able to briefly increase the skin tempe­ra­ture of their fingers, which was attri­buted to improved blood flow.13

However, due to the short obser­va­tion period, no long-term effects could be studied. There­fore, unfor­tu­n­a­tely, we do not know if the mental status of the pati­ents improved or if there was a general posi­tive influ­ence on Raynaud’s syndrome and disease acti­vity.13

Derm­ato­myo­sitis, auto­im­mune peri­car­ditis and other immune phenomena

Like sclero­derma, derm­ato­myo­sitis is an auto­im­mune disorder belon­ging to the group of colla­ge­noses. However, in addi­tion to changes in the skin, muscle weak­ness is the main feature here.

Auto­im­mune peri­car­ditis is an inflamma­tion of the heart sac that can occur in a variety of auto­im­mune diseases.

For both condi­tions (derm­ato­myo­sitis and auto­im­mune peri­car­ditis), there are case reports of improved symptoms or improved disease progres­sion under hypnosis. However, the often relap­sing-remit­ting course of auto­im­mune dise­ases makes a clear elabo­ra­tion of cause-and-effect rela­ti­ons­hips impos­sible, as mentioned above.2

Conclu­sion

I am a hypno­the­ra­pist and a sufferer of severe auto­im­mune dise­ases myself combined in one person. But, I wanted to paint as unbiased a picture as possible and leave my own expe­ri­ences out of it. My expe­ri­ences have been posi­tive concer­ning my auto­im­mune disease and there­fore I started studying the fasci­na­ting world of hypno­the­rapy. Self-hypnosis helps me to deal with pain and has improved my mental health and in doing so also my physical health. ‑at least I like to think so. 😉

Unfor­tu­n­a­tely, the multi­fac­to­rial trig­gers and the circum­s­tances that lead to the immune dysre­gu­la­tion in auto­im­mune dise­ases have not been enti­rely and conclu­si­vely clari­fied yet. Nevertheless, when properly applied, I consider hypnosis an inter­ven­tion that is gene­rally free of side effects.

The good thing is that suffe­rers can use hypno­the­rapy in the context of self-hypnosis, even without thera­peutic guid­ance. This can help combat the feeling of being helpless and at the mercy of your own body. With self-hypnosis, you can proac­tively do some­thing for your own mental and possibly also physical health.

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Natur­o­path, hypno­the­ra­pist, owner of an immune system gone crazy with various auto­im­mune special effects. She likes reading through medical papers and is an avid learner of all things regar­ding the human immune system. When her joints and body allow it: enthu­si­astic do-it-your­selfer around the house.

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