Therapeutic Use of Auto-Induced Cognitive Trance in a Chronic Pain Setting: A Case Study Using Mixed Methodology

Abstract

Auto-induced cognitive trance (AICT) is a method for voluntarily entering modified state of consciousness. The therapeutic implications of AICT are still unknown. Since complementary approaches based on modified states of consciousness are recognized to be beneficial for patients suffering from chronic pain (e.g., hypnosis, meditation), we here present the first case report of a 68-year-old man with a long history of chronic pain linked to an open Spina Bifida L4-L5, who used AICT to improve his health condition. Standardized questionnaires were collected before and after four days of AICT training. In addition, testimonies of AICT practice were recorded in his diary for 2 months post-training. Data were analyzed through a mixed methodology using textual statistical analyses, thematic content analysis, and a narrative approach based on clinical psychology. The results showed that, after AICT training, pain intensity, anxiety, and depression slightly decreased; most of the attitudes and beliefs evolved positively; the mental component of quality of life was improved, while the physical component decreased, and the patient considered that his global condition of health had worsened. Narratives allowed deeper comprehension of the patient’s experience of AICT and its effect on his health. Qualitative analysis using textual statistical analysis revealed four classes related to 1. corporality and trance characteristics; 2. location of pain, AICT action, vocalization, and daily life; 3. questioning, difficulties in the practice of AICT, AICT characteristics and the tension felt and expressed during AICT; and 4. medical and somatic elements. Finally, five themes were identified using thematic content analysis, i.e., 1. AICT; 2. medical history; 3. pain, falls, and motor difficulties; 4. professional activity and private life; 5. thoughts and reflections. Altogether, these qualitative reports allow for the characterization of the subjective experience of the patient regarding his health condition and his way of dealing with pain.