Dispositional factors affecting the analgesic response to imagery and mindfulness suggestions during hypnosis

Medical hypnosis combined with mindfulness suggestions may improve pain management, but individual benefits are difficult to predict. This study compared the effects of hypnotic induction suggestions and different hypnotic suggestions for analgesia on acute experimental pain, considering hypnotic susceptibility (SHSS:A) and five mindfulness facets (FFMQ). Thirty-four healthy participants were administered phasic electrical stimulations during a Baseline condition, a Hypnotic induction alone condition, and experimental hypnosis conditions involving Imagery and Mindfulness-like suggestions of analgesia. Results showed significant pain reduction to all three hypnotic conditions compared to Baseline (EMMs = 18.98 to 23.76; p < 0.0001) and highlighted the moderating role of dispositional factors. Imagery suggestions were more effective than Hypnotic induction (EMMs = 3.14, p < 0.001) and Mindfulness (EMMs = 4.78, p < 0.0001) but Mindfulness suggestions did not provide benefits over Hypnotic induction (EMMs = 1.64, p = 0.25). Individuals with higher hypnotic susceptibility (SHSS:A) and lower scores on the FFMQ's non-reactivity subscale reported significantly more analgesia (p's < 0.01). FFMQ's Non-judgement score positively predicted hypoanalgesia in Hypnotic induction suggestions (p < 0.01), FFMQ's Description score positively moderated Hypnotic induction and Mindfulness suggestions effects (p's < 0.01) and FFMQ's Awareness score was a negative moderator of mindfulness's hypoalgesia suggestions (p < 0.001). These findings confirm that mindfulness-like suggestions can be integrated to hypnotic interventions but indicate that they may not provide additional effect on acute pain responses, beyond standard hypnotic induction techniques. Importantly, different mindfulness dispositional characteristics may sustain or reduce the potential benefits of hypnosis interventions.