Essay: Medical hypnosis being used to evaluate pain and PTSD

Medical hypnosis being used to evaluate pain and PTSD revealed pre-term psychic trauma underlying the PTSD.
CASE REPORT: A 32-year old Caucasian male Vietnam combat veteran presented with post-traumatic stress disorder (PTSD), chronic lumbar back pain, and addiction to opioid agonist pain medications, heroin and cannabis. Past history was positive for mild developmental cognitive disability, but was negative for history of childhood trauma. He sustained injury to his back during an enemy ambush during which he was thrown by an explosion, landing on his back, onto a tank turret. Medical evaluations at presentation revealed no radiological evidence of current or prior fractures, vertebral displacement, or disc narrowing. Straight leg-raising exam was negative, with no tenderness, neurological disruption, guarding, or decreased range of motion. He experienced flashbacks, startle responses, nightmares and psychic numbing; he used heroin and marijuana to avoid feeling. Hypnotic age regression (traveling backwards in memory during trance) allowed him to re-experience the onset of his back pain in order to obtain more detailed history of its onset. Once he reached the injury incident, he provided a running narrative starting just before the ambush, describing the unexpected incoming firing and explosions, and his fate as he flew through the air and landed on the turret; his description was expressed with strong emotion in the form of a controlled flashback that lasted about 5-7 minutes. He observed a layer of dirt and debris covering him as he lay on the turret; initially he was convinced that he had died until he noticed the back pain which convinced him that he was still alive. This association continued until the present. A post-hypnotic suggestion was given that he could pinch himself if he ever wondered whether he was still alive, making it no longer necessary to suffer from the back pain. Upon emerging from trance, he remarked that his back pain was gone, and it did not return subsequently. Before bringing him out of trance, on request to go back further in time to see if there were any other scary events in his life, he revealed another incident in a similar flashback with running narrative. He described being in a dark, warm, safe place until suddenly there was an abrupt jerking movement, followed by screaming, then sirens and people yelling. He reported feeling quite scared, even though the warmth and darkness continued. He was not able to explain what this memory was about. Later, during an interview with his mother, she reported her son having had no known childhood traumatic experiences, but she revealed an auto accident during her eighth month of pregnancy with this patient. She was rushed to the hospital by ambulance and kept for observation. They released her, and a month later she delivered him at term. She wondered if the accident was responsible for him being cognitively impaired, as none of her other children were. She denied ever telling her son about that incident and doubted that he ever could have learned about it from any other source. DISCUSSION: Medical hypnosis may be used to assist in the management of pain. In cases where pain is caused by diagnosed medical conditions, hypnosis may facilitate decreasing attention to the pain, diminishing suffering, or reducing the intensity of the pain. In cases where the origin of the pain is psychosomatic, the pain may be eliminated entirely. Post-traumatic Stress Disorder following adult traumatic incidents usually occurs in persons who sustained prior childhood trauma. This case highlights the occurrence of a pre-term traumatic experience setting the stage for later PTSD. Hypnotic age regression provides a means to access repressed memories that might otherwise be inaccessible to the patient and therapist. Maternal adrenalin and cortisol release would have crossed the placenta and affected the fetus causing him to become frightened and to recall the event. CONCLUSION: Unconscious memories may include recall of pre-term experiences that might otherwise be inaccessible to the patient and therapist. These memories may have a lasting detrimental effect on the person. Medical hypnosis may assist in unraveling the mystery and treating the symptoms.