Evans F J
UMDNJ-Robert Wood Johnson Medical School, Piscataway.
Clin J Pain. 1989 Jun;5(2):169-76. doi: 10.1097/00002508-198906000-00007.
Some of the theoretical and technical problems associated with the use of hypnosis for chronic pain are discussed in the context of two similar case studies, one of which had an unsuccessful outcome. Different hypnotic strategies are discussed which depend on a careful, direct evaluation of the role of secondary gain and depression in maintaining the pain in the two patients. Specific hypnotic interventions are described, based on dissociation, imagery and the non-specific components of the hypnotic relationship. Self-hypnotic procedures are described stressing the development of mastery and self-control over pain. Differences in the kinds of hypnotic intervention that are appropriate when secondary gain or depression are central to the pain problem, compared to the more direct techniques available when they are not, are discussed.
本文结合两个相似的案例研究，探讨了与使用催眠治疗慢性疼痛相关的一些理论和技术问题，其中一个案例治疗结果不理想。文中讨论了不同的催眠策略，这些策略取决于对次要获益和抑郁在维持两位患者疼痛中所起作用的仔细、直接评估。基于解离、意象和催眠关系的非特异性成分，描述了具体的催眠干预措施。还介绍了自我催眠程序，强调培养对疼痛的掌控和自我控制能力。文中讨论了在次要获益或抑郁是疼痛问题的核心时，与次要获益或抑郁并非核心问题时可采用的更直接技术相比，适用的催眠干预类型的差异。
