To determine whether hypnosis is more effective than conventional interviewing to find traumatic life events in patients with fibromyalgia, we carried out a within-subject experimental design with complete intragroup counterbalancing. Thirty-two women under care in a public primary care center gave 2 identical interviews, with an interval of 3 months, in which the occurrence of traumatic life events was explored, once in a state of wakefulness and once in a state of hypnosis. The state of consciousness was evaluated using 3 measures: bispectral index, skin conductance level, and pain intensity. In the hypnotic state, the patients expressed 9.8 times more traumatic life events than in the waking state, a statistically significant difference with a large effect size.
Fibromyalgia is a disorder characterized by chronic generalized pain, including allodynia and hyperalgesia, and is usually accompanied by fatigue, sleep disturbances, stiffness in the joints, and mild cognitive impairment, along with other symptoms. Its diagnosis is clinical, and is based on the self-reporting of the severity of pain and the associated symptoms. 1,2 A key factor in the pathophysiology of fibromyalgia is central sensitization, which is a state of neuronal hyperexcitability.The origin of central sensitization can be complex and attributed to multiple causes, with predisposing factors and organic, environmental, and psychosocial triggers, including chronic stress, whether it be in the form of trauma, stressful life events, or even daily hassles that can occur over the course of a lifetime. 3 The term potentially traumatic life event (PTLE) 4 is used to refer to Abstract Aim: In common clinical practice, potentially traumatic life events and the possible attribution of such events to fibromyalgia often go undetected. Having demonstrated in a previous study that hypnosis facilitates the exploration of such events, we now aim to explore and classify the content of these events and to determine whether there is an association between the type of event, the state of consciousness in which the patient verbalized it, and possible causal attributions of the disorder.Method: Thirty-two women (age 52 ± 7 years) suffering from fibromyalgia and receiving care in a primary healthcare center participated in the same semi-structured interview twice: once in a wakeful state and once under hypnosis. They answered two questions: what other events in your life coincided with the onset of fibromyalgia? Are those events related to your fibromyalgia in any way? To counteract biases related to order or recall, the order of the two interviews was randomized with a 3month period in between. Results:The patients verbalized 23 different types of events, which we classified into eight categories, mostly psychosocial events. Although the relationship between the three variables was not statistically significant, two of the bivariate associations predicted (type of event and state of consciousness; and state of consciousness and causal attribution) were confirmed (χ 2 , P values of .01 and <.001 respectively). Conclusion:Potentially traumatic life events could remain undetected in primary healthcare consultations and hypnosis could prove a useful tool for their detection. K E Y W O R D Scausal attributions, fibromyalgia, hypnosis, life events, primary health care
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