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Hypnosis in a Case of Long-Standing Idiopathic Itch

From the Psychiatry Research Unit, Hospital for Sick Children (J.J.R.), and Department of Psychology, Toronto Hospital (D.S.), Toronto, Ontario, Canada.

Address reprint requests to: Dr. Julia Rucklidge, Psychiatry Research Unit, Elm Wing 4th Floor, 555 University Ave., Hospital for Sick Children, Toronto, Ontario, M5G-1X8. Email: julia.rucklidge{at}utoronto.ca

OBJECTIVE: This article presents the results of a brief hypnosis treatment of a woman with chronic, idiopathic vaginal and anal itch.

METHODS: The patient was referred after 3 years of unsuccessful outcomes with standard topical and oral treatments prescribed by her family physician and three dermatologists. Treatment consisted of five sessions of self-hypnosis training in techniques of relaxation, deepening, and imagery, and home practice with an individualized instructional tape.

RESULTS: After treatment, the patient reported substantial tissue healing, confirmed by her treating physician, that coincided with significant reductions in her scores of itch intensity, itch-related sleep disruption, and distress from pre- to posttreatment. These improvements continued at 4 months of follow-up, and the patient reported complete resolution of physical symptoms.

CONCLUSIONS: The fact that these changes coincided with only minor improvements in general anxiety scores suggests that the resolution of the patient’s itch condition was treatment-specific rather than the result of methodological artifact, participant reporting bias, or a general sense of feeling better. These findings suggest that hypnosis is a cost-effective treatment for idiopathic itch conditions, especially those that are unresponsive to standard medical treatments.

Key Words: idiopathic itch • hypnosis • dermatology • case study

Abbreviations: SCL-90-R = Symptom Checklist-90-Revised; STAI =State-Trait Anxiety Inventory; SHCS = Stanford Hypnotic ClinicalScale; IRS = itch rating scale; GSI = General Severity Index.