The doctor-patient consultation
There is an increasing interest in the therapeutic effect of beneficial clinical communication where the fundamental elements of hypnosis are applied (8, 11). Many patients will automatically fall into a trance-like state – with focused attention and increased susceptibility to suggestions – when they enter a doctor's office, are admitted to hospital, experience pain, are about to undergo a painful medical procedure or treatment, or receive important information on worrisome symptoms (11).
What the doctor, therapist, nurse or biochemist is communicating to the patient in the clinical encounter may therefore have a decisive impact on the patient's expectations for what is about to happen, assessment of risk, expectations about control and coping, and thereby also on the patient's illness behaviour (8, 11, 13). For example, it seems as though negative suggestions ('It's nothing dangerous, don't cry!') do more harm than good ('This will be fine, you can be calm and confident!') (11, 13). Communicating a lack of understanding or recognition of the patient's experiences may also have a negative effect on the course of illness and symptoms ('We cannot find any explanation for your pain – it must be all in your mind') (13).
It is essential that knowledge and skills in hypnosis are integrated into clinical practice, and not only seen as an instrumental procedure
Arguably, we can say that changing the patient's expectations about the course of symptoms and illness or the experience of control in a given situation is an important part of the treatment (11, 14)? If so, the medical consultation provides a golden opportunity. As we see it, deliberate use of hypnotic communication in the doctor-patient consultation to promote healing powers in the patient and represents a large and unused potential.
In an elegant study it was shown that the meaning of pain changed from negative to positive in healthy participants through positive verbal information (suggestions) given before a painful procedure. The only difference in the research setup between the groups that were compared, was the use of positive versus negative verbal information ('This procedure is beneficial for your muscles' versus 'This procedure will cause you some pain'). The researchers concluded that '... when the meaning of the pain experience is changed from negative to positive through verbal suggestions, the opioid and cannabinoid systems are co-activated and these, in turn, increase pain tolerance' (14). Furthermore, a person's experience of control has been reported to reduce pain and discomfort from acute-onset pain, and is associated with better functioning in chronic pain conditions (15).