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Hypnosis and Pain Management in HIV/AIDS Patients

Matilde Zayas, PhD, CHt, CAHA 

Abstract

 Since the mid 1970’s HIV/AIDS epidemic has invaded millions of people lives through the diagnosis of human immunodeficiency virus. Some individuals with HIV/AIDS infection develop what it known as neurocognitive disorders (NCD), which generally shows a subcortical problem with prominently impaired executive functions, slowing of processing speed, with more demanding attention to tasks, and difficulties in learning new information but, may experience fewer problems with recall of information that has already been learned.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states, that it depends on the stage of HIV/AIDS disease the said client has been diagnosed that determines whether the individual has a mild or severe neurocognitive disturbance. It is said that approximately one- third to over one-half of HIV/AIDS infected individuals have at least mild neurocognitive disturbance and that some of these disturbances may not meet the full criteria for mild neurocognitive disorders (NCD).

Even though thousands of people died because, of our lack of scientific knowledge, opportunistic infections and Kaposi Sarcoma and other related diseases thirty years after, we can see the advances in this area and the millions of people throughout the world that are alive because, of antiretroviral medications, medical, psychotherapeutic and nutritional knowledge. Because, of those scientists and researchers that enlighten the medical profession in the treatment for this specific population we are able to provide the adequate care and maintain these clients healthy and living a normal life. The information in this article will bring to light how all of these professionals are helping these HIV/AIDS survivors who are diagnosed with neuropathy and how the treatment of hypnosis and pain management help decrease the client’s peripheral pain.

 Millions of people have been diagnosed with the HIV/AIDS virus in the United States; these individuals who are long time survivor have done so through the help of Protease Inhibitors and antiretroviral therapy and these medications have helped them lead normal lives.

HIV/AIDS is a sexually transmitted infection that can be spread through contact with infected blood, sexual contact, and mother to child during pregnancy, child birth and breast feeding. It is also known that the infection of HIV/AIDS could take years before it weakness the clients immune system to the extent that the disease can be diagnosed as AIDS.

Therefore, AIDS is the latter part of the human immunodeficiency system that increases the susceptibility of the of the individual and this creates a way for opportunistic infections such as pneumocystis Carinii, pneumonia, Candidiasis and certain cancers such as Kaposi’s Sarcoma and neurological disorders that develops by the intake of antiretroviral medications.

Since these clients has survived and have been on medications for several decades they have developed physical problems such as neuropathy which is a disease or dysfunction of one or more peripheral nerves that causes numbness and weakness. It is also a degenerative state of the nervous system that causes muscular atrophy.

Most clients who suffers from neuropathy usually experience a lot of pain. The International Association for the Study of Pain (2014), define pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage and described it in terms of damage to nerves and muscle tissues. Melton (2014), stated that pain motivates the client to withdraw from damaging situations and protects their body from further injury.

All of these symptoms produces psychological and emotional issues such as depressive mood and anxiety which increases the clients stress level and increases their pain threshold. Working with this specific population Dr. Zayas, have not only educated them on the HIV/AIDS disease but, how the medication reacts with their blood stream. Psychotherapy helps the clients decrease their depressive mood, anxieties and panic attacks that is caused because of the tensions.

Once these clients are more familiar and adjusted to their diagnosis they are able to concentrate on their psychological and neurological problems. It is at this time that the psychotherapist begins to work with them using hypnotherapy. Hypnotherapy is a modality that combines hypnosis and psychotherapy that creates subconscious changes in the client mind through the process of new responses, thoughts, attitudes, behaviors or feelings. It is also a variety of treatment modalities that are applied through hypnotic suggestion to induced hypnotic sleep.

The psychotherapist before beginning hypnotherapy sessions on these HIV/AIDS clients, needs to acquire a few items to determine what hypnotic modality would be best and what the precise form of therapy should be given. The said client will complete a history questionnaire, and suggestibility Questionnaire 1 and 2.and a sexuality questionnaire 1 and 2.

Suggestibility is defined as an interpersonal state that is composed of three parts: The verbal content, the extra verbal or non-verbal content and the state of mind which is known as the receiver. There are also within the suggestibility state five different laws and these are: The Law of Repetition, The Law of Suggestions and Association, The Law of Dominance and The Law of Delay Action. The Law Reverse Reaction is used for impersonal, family, and in business situations as well as in advertising because, this produces a positive or negative connotations within the individual.

The Law of Repetition can be seen in the individual through his or her responses and how the individual have adapted to their situation. The Law of Dominance can be applied to any of the other laws because, it is also known as the communal law since its structure is of authoritarian influences. The Law of Delayed action is a suggestive idea that is inferred, the individual reaction to it and to others which has been used in its original format. Inference or Inferred is defined as a judgment or conclusion that is reached on the basis of a former judgment (Wolman, 1973).

And, finally The Law of suggestions and of Association is known as the law that pertains to certain person, who have responded to a particular stimulus and eventually has become associated with the idea. It is also known for the suggestions and the experiences that these individuals have already come in contact and have related themselves too. And, those suggestions and associations that were unknown will become a new emotion and stimulus within their lives.

Suggestibility questionnaire measures the client’s ability to determine the percentage of hypnotic depth and state, he or she could be able to reach.

The sexuality questionnaire determines if the client is a physical or an emotional in their behaviors. Kappas (1975), describe the physical sexual as an individual who has very deep feelings about relationships and this is the most important thing in their world. The emotional sexual are naturally analytical and somewhat detached in their emotional characteristics and they learn their behaviors from their father, who rarely shows any type of emotion. The emotional sexual see the world almost completely on a mental level.

Once the hypnotherapist have acquired all of the information, he or she will begin explaining the outcome to the client and will start explaining the theory of mind which is a hypnotic hyper suggestibility state that works with the conscious and subconscious mind. The Theory of Mind has four distinct areas: The conscious mind which consist of 12% of our consciousness and it deals with our reasoning, analysis, logic, decision and will power; the critical mind is usually developed when the child’s has reached the tender age of seven or eight and the subconscious mind is composed of 88%. The subconscious mind contains all of the information that are known to us since birth and those associated conceptions that the individual has acquires through their life experiences as well as their memories.

Finally, the primitive mind which all human beings shares because, it is born with us is the area of our mind where the concept of fight and flight instinctiveness begins. It is here in the subconscious area of the mind where our primitive memories lies dormant as well as our genetic heritages are found. It is also within this area that we find our repressed memories and traumatic events which are felt beyond the individual’s reasoning and when this area is exacerbated the individual will have a tendency to fight or flight.

The Study’s Outcome

There were ten HIV/AIDS client’s that were selected for this study to find relief of their neuropathy pain through pain management and hypnosis. All of the clients were asked to complete the Questionnaire of Pain Management and Subject Unit of Discomfort which measures the individual’s level of discomfort. The pain management questionnaire revealed that 3 of the clients scored between 10 and 9 of pain intensity 3 scored between8 and 6. The other clients reported that their pain intensity fluctuated between 3 and 7 depending on the type of activities they had done that day or the day before. According to these clients they have been taking medication for their neuropathy conditions for several years and they reported that these medications alleviate the pain for several hours and that during this time their activities should be minimal because, if for any reason they exert themselves they may be bed ridding for several days.

Results

The ten clients that participated in the study of hypnosis and pain management for six weeks were clients that have been suffering from neuropathy for several years and are also on medication for pain. At the end of the six weeks these clients were once again given the suggestibility questionnaire and subject unit of discomfort as a post test to determine if any changes had occurred in their discomfort. Once the data was collected and analyzed Dr. Zayas found the following results: Four of the ten clients that participated in the study reported their pain intensity level had decreased to the range of 4 and 5; three reported of having weeks at about a 5 and being able to performance household duties and even work for several hours. The remaining three clients reported that their pain had decreased to a level of 1 to 3 in the subject unit of discomfort. Most of these client also stated that their pain medication for the neuropathy had been decreased and that they were feeling better about themselves and were able to enjoy their families and friends. A follow up study of these clients and their progression after their hypnosis and pain management will be done after a year to determine if their pain threshold has decreased further or their discomfort level is at zero.

Bibliography

 Dictionary of Behavioral Science (fifteen Edition, 1973), Van Nostrand Reinhold, New York, New York.

Diagnostic and Statistical Manual of Mental Disorders (fifth Edition, 2013), American Psychiatric Association, (pages 632 and 633).

Kappas, J.G. (2009), Professional Hypnotism Manual (Fifth Edition), Panorama Publishing Company.

Melton, J.R. (2014), Hypnosis and Pain Management, American Hypnosis Association, Tarzana, CA.

Matilde Zayas, PhD, CHt, CAHA is the president and founder

of Hope for a Positive Tomorrow & Hope for a Brighter Day, Inc.