by Tony Edwards

All physical diseases including cancer, heart disease and even skin complaints have been helped with Hypnotherapy and Psychotherapy. The power of suggestion and mental imagery is a tool all too often overlooked by physicians; yet it can be of immense help to sufferers of degenerative diseases such as Osteoarthritis and Rheumatoid Arthritis. Before discussing how hypnotherapy can assist arthritis sufferers it is proper to examine the aetiology of the disease.

Aetiology is the study of causation: The term (deriving from the Greek aitia, cause, and logia, discourse) is used in philosophy, physics, psychology, and biology in reference to the causes of various phenomena. Generally speaking it is the study of why things occur, or even the reasons behind the way that things act. In medicine in particular, the term means the occurrences, reasons, and variables of diseases or pathologies.

The word "arthritis" is taken from the Greek words arthron, joint, and itis, inflammation. In other words, arthritis literally means "joint inflammation."

In order for the hypnotherapist to provide successful assistance to sufferers of arthritis it is important that a basic understanding of the nature of the disease is held. Having some understanding of the client’s problem will help the hypnotherapist devise a sensible and workable treatment strategy.  Since the subconscious controls all of the circulatory, muscular, chemical, and hormonal actions, hypnosis can also direct the production of chondrocytes, which increase the growth of healthy new cartilage. The more protection in the joints, the more comfort and mobility is created.

Hypnosis can also be used to regulate the flow and distribution of endorphins, which are the ‘feel good’ chemicals the body uses to create comfort and relaxation. Using hypnosis to regulate endorphin production plays a big role in putting the client in control.

Osteoarthritis

Osteoarthritis, sometimes referred to as degenerative joint disease or osteoarthrosis, is the most common form of arthritis. Osteoarthritis is characterised by the breakdown of joint cartilage and may affect any joint in the body. It is not exclusive to any joint or set of joints.   It includes those in the fingers, hips, knees, lower back and feet. At the commencement of the disease, osteoarthritis may strike only one joint. However, when the fingers are affected, then multiple hand joints may become arthritic.

In a healthy joint, the ends of the bones are encased in smooth cartilage. These are protected by a joint capsule lined with a synovial membrane that produces synovial fluid. The capsule and fluid protect the cartilage, muscles and connective tissue.  With osteoarthritis the cartilage becomes worn away. Spurs grow out from the edge of the bone, and synovial fluid increases. The result of this is that the affected joint or joints feel stiff and sore.

There is no known cure for osteoarthritis, but available treatments can relieve pain and help the sufferer to remain active. However, if osteoarthritis is actively managed a measure of control over the pain may be gained.  The exact cause of osteoarthritis remains unknown. It is believed that it is a combination of factors, including being overweight, the aging process, joint injury or stress, heredity, and muscle weakness. The cartilage damage may be due to the action of mechanical stress that results in an imbalance of enzymes released from the cartilage cells or from the lining of the joint. When normally balanced, these enzymes allow for the natural breakdown and regeneration of cartilage. However, too much of the enzymes can cause the joint cartilage to break down faster than it can be rebuilt. The exact cause of this enzyme imbalance remains unclear.

The body goes to work repairing the damage, but when the repairs are inadequate, the result is also inadequate. Instead of true repair there is growth of new bone along the sides of the existing bone. This produces prominent lumps, most noticeable on hands and feet. Each of the steps in this attempted repair process produces pain. The pain and tenderness over the bony lumps may be most marked in the early stages of the disease. It becomes less evident later on in the diseases progress.

As previously noted, there is no known cure as damage to the joint is unlikely to be reversible. The usual procedures are the application of various medications, and in extreme conditions, surgery.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease which is characterised by inflammation of the lining, or synovium, of the joints. This disease can lead to long-term joint damage, the result being chronic pain, loss of function and the possibility of complete disability. Rheumatoid Arthritis (RA) progresses in three distinct stages. The first stage of the disease is the swelling of the synovial lining. This swelling causes pain, warmth, stiffness, and redness and swelling around the joint. The second stage is the rapid division and growth of cells, or pannus, which causes the synovium to thicken. In the third stage, the inflamed cells release enzymes that can digest bone and cartilage. When this happens it can cause the joint concerned to lose its shape and alignment. This leads to more pain coupled with a loss of movement.

The exact cause of rheumatoid arthritis is unknown. It is believed, however, that there is no one exact cause for this disease. Researchers now are debating whether RA is one disease or several different diseases that share common features.  It is known that the body’s immune system plays an important role in rheumatoid arthritis. In fact, RA is referred to as a disease of the immune disease because people with RA do have an abnormal immune system response. In the normal healthy immune system, white blood cells produce antibodies that protect the body against foreign substances. People who have RA have an immune system that mistakes the body’s healthy tissue for a foreign invader and attacks it.

Rheumatoid arthritis presents itself on many different fronts, and in many different ways. This means that medical treatment needs to be tailored to the individual. To do this it becomes necessary to take into account the severity of the arthritis, other medical conditions that may be present, and lifestyle. Current treatment methods focus on relieving pain, reducing inflammation, stopping or slowing joint damage and improving the body’s ability to function correctly thus helping to develop and maintain a sense of well-being.

Arthritis has more than 100 forms and is a very common cause of physical disability.  There is no cure for arthritis, but there are available treatments that can relieve pain and help the sufferer to remain active. Furthermore the way in which a person copes with arthritis can depend very much upon behaviour and attitude. If real efforts are made to actively manage arthritis, then it is possible to gain some measure of control over the pain.

Hypnotherapy and Arthritis

There have been studies carried out involving hypnotherapy and arthritis. In one instance [Biochemical Correlates of Hypnoanalgesia in Arthritic Pain Patients. Domangue BB; Margolis CG; Lieberman D; Kaji H - J Clin Psychiatry Jun 1985, 46 (6) p235-8,], reported levels of pain, anxiety, and depression, and plasma levels of beta-endorphin, epinephrine, norepinephrine, dopamine, and serotonin were measured in 19 arthritic pain patients before and after hypnosis. Correlations were found between levels of pain, anxiety, and depression and following hypnotherapy, there were clinically and statistically significant decreases in pain, anxiety, and depression and increases in beta-endorphin-like immunoreactive material. This reveals that hypnotherapy can play an important role in conquering the painful symptoms associated with arthritis.

One dramatic case was reported in the Journal of the American Medical Association of a 10 year old girl diagnosed as having juvenile rheumatoid arthritis which had responded minimally to large doses of aspirin and physical therapy over a period of 7 weeks. The doctors decided to try hypnotherapy and 4 hours after her second session, the girl was able to ride her bicycle and was free from pain. Two further reinforcing sessions were given and the girl remained well for the three years to the time of the report.

Research carried out by Gay, Philippot and Luminet [Differential effectiveness of psychological interventions for reducing osteoarthritis pain: a comparison of Erickson hypnosis and Jacobson relaxation.] showed that hypnotherapy was effective for the treatment of pain caused by osteoarthritis. The study showed that hypnosis is effective as it reduced more than 50% of osteoarthritic pain after only four weeks of treatment. This reduction was maintained up to the 6 month follow-up. Relaxation resulted in a lower level of subjective pain. The overall result of the study showed that hypnotherapy was more effective than Jacobson Relaxation. This is a technique in which the subject learns to benefit from tensing and relaxing various muscle groups of the body.

The treatment of arthritis using hypnotherapy requires that the client also has a basic understanding of the arthritic condition in order to aid visualisation while undergoing hypnosis. It is useful to prepare diagrams of a joint so that before induction the client can imprint the workings of a joint on his or her mind. This will increase the effectiveness of the script.

Once the client has been induced and satisfactorily deepened, a script based upon the following example may be used. The script below is a script for osteoarthritis. A specific script for rheumatoid arthritis may be developed along the same lines. Emphasis in the script can be modified to suit the particular client and their condition.

“Now you are relaxed and you are continuing to relax … and as you are feeling calm and comfortable … you can safely think about the osteoarthritis that is troubling your joints.

The pain you experience with arthritis is mostly due to cartilage and calcium debris in the synovial fluid between the bones. You also known that your emotional state can influence your body’s defence system and its natural healing and rebuilding ability.

This natural healing …this natural cleansing … and the ability to rebuild is influenced by your subconscious mind … so as you continue to relax … deeper and deeper … here are some suggestions for your subconscious mind to work with.

Now these suggestions are perfectly reasonable … they are positive … beneficial … and they are in your very best interest. These suggestions will cause your subconscious mind to positively influence all your thoughts about your arthritis.

As you know it is the subconscious mind that directs your body movements … it directs your fingers … your wrists … your elbows … your shoulders …your hips … your knees … your ankles … your toes … and all the joints in your body. It is your subconscious mind that can influence the natural lubricating fluids of your body … those lubricating fluids that ease the movement of your joints.

Now let yourself visualise your subconscious mind in full control … in perfect control of all the joints in your entire body … visualise in your mind the natural fluids of your body lubricating your bone joints … visualise the oily substance penetrating around and between your bones .. easing movement and reducing pain. Wherever there are debris and deposits in your joints this lubricating oil causes them to be dissolved .. it causes them to dissolve away … the bones and joints of your body begin to feel and move more easily and freely … the bones and joints of your body begin to feel and move more easily and freely

[This section may be included on a CD for daily listening: These deposits between the joints take time to dissolve … and so from today you make the time just to relax… each day you make time to relax … and each day you visualise your bones and the joints between the bones becoming more and more comfortable … each day and every day your body moves and feels more and more comfortable.  You begin to notice improvements as each day passes … and your body feels more and more comfortable … more calm … and you find that you are able to do everything in more relaxed manner.]

Now I want you to imagine your body bathed in a warm healing glow … I want you to imagine this healing glow … I want you to experience this healing glow on all the parts of your body where the arthritis is centred … on all those joints that have arthritis. Feel the warmth of the healing glow as your body’s natural lubricating fluid .. your body’s natural oil … sets to work on those calcium deposits … and you feel the discomfort ease … more and more you feel the discomfort ease … the healing process of your body is working for you right now … your subconscious mind is managing this for you right now.. and this will continue long after this hypnotherapy session … it will continue long after you turn your attention to other things. Once started it works silently all day and every day … all day and every day the healing process continues. Each day you notice an improvement … maybe it seems slight at first … but your discomfort eases and you experience less and less restriction in the joints that have been troubling you … you are pleased with the progress and you are proud of the manner in which you have taken control of your body.

Each time you think of your arthritis you consider it to be something you are getting the better of. You take pleasure and pride in supplementing … aiding … reinforcing … the healing glow you have activated in your body. By working on your arthritis with your subconscious mind and by keeping to a suitable diet you come to terms with it … you overcome its unwanted effects on your life … and you ultimately experience less and less discomfort … less and less pain.

As you know … these suggestions are perfectly reasonable … these suggestions are positive … and in your very best interest. They cause your subconscious mind to influence in a very positive way your thoughts about arthritis … your feelings about arthritis … your behaviour towards arthritis. You are confident that your body is being healed and with each passing day you begin to feel better and more agile … more agile and more happy in every way.”

This is of only one possible line of attack. In addition to endorphin production, pain can also be decreased if the sufferer perceive it from a different location in the body. By redirecting sensitivity away from hips, knees, and vertebrae to a less critical part of the anatomy such as a finger tip, the intensity of pain may be decreased.

The same approach could be used to create and assign a different quality to the pain sensation. A sharp pain could then be modified to be perceived as a dull pressure. Other senses may be mobilised as a way of managing the symptoms of arthritis. While the client is in a deepened state, it can be suggested that the client imagine a colour to represent pain and then a different colour to represent the desired relief, for example red for the pain slowly moving towards a cooling blue. This enables the client to see and feel the difference.

In a similar manner, attaching a number value to pain creates the option of change. Asking the client to imagine a ruler or gauge, numbered from nought to ten, during hypnosis. The client can pick the number on the gauge that indicates the level of pain experienced. Once this is done the suggestion of cleansing breaths can allow them feel their pain lessening as they watch the numbers decreasing on the gauge. This technique is analogous to the Standard Unit of Discomfort (SUD) used in Meridian Psychotherapy.

With the aid of hypnotherapy, the client can gain a distinct advantage in managing, and in some cases even reversing, the limitations of arthritis. Treatment should include the application of self-hypnosis. A few sessions with a hypnotherapist gets the treatment started, and with the aid of recordings on an audio CD or tape, the client can begin to effect healthy and really positive changes in his or her life.