Hypnosis and Cognitive Behavioral Therapy can work

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UroToday Int J. 2011 Aug;4(4):art46. doi:10.3834/uij.1944-5784.2011.08.02.

Feasibility Trial of Medical Hypnosis and Cognitive Behavioral Therapy for Men With Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Rodney U Anderson1, Thomas F Nagy2, Elaine K Orenberg1, Angie Morey1, Patricia Glowe1
1)Department of Urology, School of Medicine, Stanford University School of Medicine Stanford CA USA.
2)Department of Psychiatry, School of Medicine, Stanford University School of Medicine Stanford CA USA.
Publication Date June 22, 2011

ABSTRACT

OBJECTIVE: To determine the feasibility and effectiveness of medical hypnosis and cognitive behavioral therapy (CBT) for relief of pain, improvement of psychological status, and quality of life in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

METHODS: Men with refractory chronic pelvic pain who were symptomatic for >3 months were assessed for hypnotic susceptibility after medical, mental health, and social history were obtained. Psychological data from healthy men with no evidence of pain disorders or genitourinary symptoms were used as a comparator group. In 7 weekly sessions, the psychologist/hypnotherapist utilized CBT to challenge and balance negative cognitions associated with symptoms, performed guided imagery and hypnotic intervention, and provided patient training in self-hypnosis for symptom management. Changes in symptom indices, psychometrics, and compliance with home exercises using audiotapes of hypnosis sessions and CBT workbooks were assessed after 3 and 6 months.

RESULTS: Sixteen men with median pain duration of 7 years and high symptomatic pain scores participated. All had moderate to high hypnotic ability. At 6 months after training, the median NIH-CPSI total score decreased 10.5 points (-7 to -27) relative to pretreatment in 57% of patients; McGill pain scores decreased a median of 6.5 points (-2 to -28). Both NIH-CPSI pain and quality of life domain scores significantly improved (P ≤ .02). Most (88%) patients reported continued self-hypnosis effective for symptomatic relief and improved coping.

CONCLUSION: CBT and self-hypnosis training for patients with CP/CPPS was feasible, resulted in decreased symptoms, and provided patient self-directed methods to improve sense of control, ability to cope, and dissociation from pain symptoms. Longer-term follow-up is required to determine the impact of these therapeutic approaches for selected men with this disorder.

ABBREVIATIONS AND ACRONYMS: BSI, Brief Symptom Inventory; CAM, complementary and alternative medical; CBT, cognitive behavioral therapy; CNS, central nervous system; CP, chronic prostatitis; CPPS, chronic pelvic pain syndrome; CPSI, Chronic Prostatitis Symptom Index; DSM, Diagnostic and Statistical Manual; GRA, global response assessment; NIH, National Institutes of Health; PPSS, Pelvic Pain Symptom Scale