Can hypnotherapy help me get through a painful doctor's visit?

July 29, 2009 7:56 AM

Can hypnotherapy help me get through a painful trip to the doctor?

I have primary vaginismus, and have had therapy for it. I've made good progress over the years, which has been beneficial in lots of other ways.

However, I haven't had a proper Pap smear yet. My GP is wonderfully patient and encouraging, and has been giving me "manual" exams (i.e. no speculum, just hands) as part of a desensitisation process. Until recently she's been very happy with my progress.

But at my last examination several months ago, something went wrong and I found it much more traumatic than usual. I'm terrified of having to go back and continue with these examinations (irrational, yes, I know). This has had a knock-on effect to my sex life, where I've regressed to a state I thought I'd beaten years ago. It's very disheartening. It's also increased my general levels of anxiety.

I'm very concerned that I'm in my thirties and have never had a proper Pap smear. At the rate I'm going, I may never get one, and cancer does run in my family. Unsurprisingly, this adds to my anxiety and is undoing all my hard work at getting over this. I'm sick and tired of dealing with it, and worried that I'm compromising my health on something that should be easy to rule out. I resent using all of my "working on the problem" energy on a routine doctor's visit instead of on my sex life.

I could go back to CBT therapy, but honestly, I've had a lot of that and there's not much left that I don't know about my condition and what I need to do to fix it. It's about practice, practice, practice now.

I'm considering trying hypnotherapy to get me through the Pap smear. My theory is that I'd use it to manage the anxiety, to become just relaxed enough that I can get through the exam with the bare minimum of freaking out. I'm not trying to wake up saying "Yay! It's Pap smear day! I can't wait, it'll be awesome!" (I'm reliably informed that no-one enjoys it that much). I don't really expect or want help with the sex side of things, as I'm making good progress on that when I'm not caught up in doctor-stuff.

There's also the hope that some small success will give me enough of a confidence boost that I can get better at it and move on. That's happened for me with previous stages of this problem. It's just been a long time since I've had a win.

Can hypnotherapy help with this? I'm told that it's good for habit-driven and anxiety issues, which are definitely a contributing factor for me. I'm not expecting miracles, just assistance with a difficult goal so I can move on to the (sigh) next difficult goal. I figure since the problem isn't physical, then a mind-game might do the trick.

Data or anecdotes about hypnotherapy (or getting over Pap smear anxiety) would be most welcome; detailed horror stories about doctor's offices tend to make me worse, so I'll pass on those.

posted by anonymous to health & fitness (11 comments total)

I'll probably be the minority voice on this, but this sort of thing is what Xanax is for. Call your doctor, say you have anxiety and ask them to call in a script for you. Take one an hour before you go.

I'm personally all for character development and meeting one's fears head on and all that, but it sounds like you are working on your issues and this particular thing is just a big fat not worth it. You need a pap smear for your physical health, not your mental health.

My personal trial is dental work. I've been through dental hell, and after a good year of recreational root canals, I decided -- fuck this. There are better ways for me to spend my energy than thinking somebody's going to give me a medal for sucking it up during a trip to the dentist, and frankly sucking it up for a year really did me no good at all. I still hated it, I still felt shitty and terrified before going (this isn't because of the root canals themselves, it's because I was afraid of what else they would find was wrong while they were in there.) and I just decided I wouldn't do it that way any more.
posted by A Terrible Llama at 8:06 AM on July 29 [8 favorites]

Have you talked to your GP about anti-anxiety meds?

I think it's a better option then hypnotherapy. It's always a possibility that you are not able to go under hypnosis.

Not everyone can be hypnotized.
posted by royalsong at 8:12 AM on July 29

If you do go on anti-anxiety meds (like Xanax) - be aware that they will knock you on your butt. So make sure you're not operating motor vehicles while under the influence. (I.E. Don't drive to the doctor's office!)
posted by royalsong at 8:14 AM on July 29

I agree about the anti-anxiety meds. I have developed terrible anxiety before dental visits. Now, I take one Ativan about an hour before the appointment, and I feel much better about it.

I don't know anyone who has done hypnotherapy for anything. But, anti-anxiety medications are effective, safe (when used appropriately, sparingly and under a doctor's supervision) and useful. Frankly, knowing your history and the anxiety-pain cycle associated with your condition, I'd be surprised if your gynecologist hasn't already suggested an anti-anxiety medication.

Best of luck to you.
posted by FergieBelle at 8:19 AM on July 29

I also have nothing useful to say about hypnotherapy, but I agree with everyone else that this is a job for your friendly neighborhood benzodiazepines. I have dental anxiety, and some Ativan allows me to not freak out while sitting in the chair. I would recommend not driving yourself because it will probably make you drowsy.
posted by crankylex at 8:28 AM on July 29

I have used anti-anxiety meds in my life, and have pretty much only good things to say about them. As others have said, it could be a good option to explore with your doctor.

That said, I also uses hypnosis to help manage pain during labor and delivery, and to prepare me for a stretch of time when I had to give myself a daily injection in the abdomen for several months. In both cases--perhaps especially the injections--the hypnosis did help. It took some time to learn the really deep relaxation for labor and delivery; I practiced daily for a few months. For the injections, one session with the hypnotherapist, in which I talked about what I wanted for the injections (basically I wanted them to be as minor a part of my day as brushing my teeth, and they were) and then she relaxed me and we sort of visualized while I was in that state.

I can't say for sure whether it would help with your situation, but the deep relaxation from learning and practicing self-hypnosis probably wouldn't do any harm, either. I found it very pleasant even apart from any other benefits I hoped to get from it.
posted by not that girl at 8:44 AM on July 29

Hypnosis is a skill that you have to practice - so seeing a hynotherapist may outweight the cost of the visit to the obgyn in the first place. Because you've been through other trauma, it might also trigger memory issues, etc. - or actually solve the problem.

I would say: at least try it, if it's affordable to you. Otherwise, I'd second that xanax suggestion.
posted by medea42 at 9:07 AM on July 29 [1 favorite]

If you do decide to try hypnotherapy, I would very strongly recommend going to someone who is a hypnotherapist AND a licensed/registered mental health provider (psychologist, MFT, LCSW, whatever other varieties exist in your state). There are some hypnotherapists who do NOT have a professional counseling/therapy background, and some people may experience a resurgence of strong emotions related to past traumas, etc. and a therapist/counselor will be able to handle that much more helpfully with you than a hypnotherapist without counseling/therapy skills and experience.
posted by so_gracefully at 9:19 AM on July 29

Nthing benzos. Like A Terrible Llama, I used to struggle with dental visits. Even cleanings sent me into a panic, and I'd cry all the way through them. It didn't bother my old-school dentist of 20 years, but when he retired his replacement endured about two minutes of my crying and then sent me home with a prescription for Ativan. Now I almost look forward to dental visits - they're an excuse to take some Ativan!
posted by elsietheeel at 9:28 AM on July 29

I'll second so_gracefully to suggest finding a hypnotherapist who's also a qualified mental health expert. Hypnotism can be a tremendously powerful way to control anxiety and get rid of phobias. Some people use it for pain management, although this seems to be more about managing their reaction to the pain ("This hurts but I'm not giving it all my attention") rather than actually dulling the pain in the way an anasthetic would.

Hypnotherapy can help you with two things here. First it can help you to break the automatic link between thoughts about a Pap smear and thoughts of anxiety, replacing it with a more pleasant association (similar to NLP's "anchoring"). Secondly, you can learn to control your mood better, so when you start to feel anxous you can feel it coming and use various techniques to get back to a calm state.

However, if the anxiety is severe you'll probably find that these require some practice. Possibly less practice than CBT, but you're learning new skills and trying to instill a new thought pattern so it won't be an instant and permanent affect.
posted by metaBugs at 9:57 AM on July 29

I also have vaginismus, and my ob/gyn informed me that if I couldn't go through with an annual exam, there was also the option of having an exam under sedation. So general anesthesia might be another idea, perhaps at a hospital or larger clinic.

And, like the other suggestions here, I've also heard it's possible to get a one-time dose of Valium or Xanax or Ativan and just take it before your appointment so you're really chilled out. Call your doctor in advance and explain your problem & concerns; she'll probably give this to you. I personally have taken a half dose of some old-school sleeping drug (Benadryl, essentially), which also mellows you out, although not as much as the prescription stuff. I don't know much about hynotherapy, but it seems like that's an acquired skill that needs some practice, and if you want to know your cervical health status ASAP, a one-time pill is probably quicker, cheaper, and easier.

Also, not to presume what you have or have not tried, but pelvic floor physical therapy really is a wonderful thing. I'm in it right now and making great progress after a few years of trying to unsuccessfully fix this myself.
posted by castlebravo at 11:28 AM on July 29