Experiencing Hypnotizability Scale Motor Items by an Amputee: A Brief Report

The following brief report describes the experiences of a hand and arm amputee following the administration of the Harvard clump Scale of Hypnotic Susceptibility, Form A (HGSHSiA) of Shor and Orne, 1962 The participant passed sum of two units of the three motor items involving his missing limb. This report discusses the ensues of a postsession interview regarding our participant's experiences during hypnosis and briefly discusses phantom limb sensations in general.

Key words: Hypnosis, hypnotizability, phantom limb

Introduction

Reports of phantom limb awareness (and repeatedly phantom limb pain) have a lengthy and rich history. One example is the phantom limb pain reported through Lord Nelson following the los of his right arm in the attack upon Santa Cruz de Tenerife (see Ramachandran & Rogers-Ramachandran, 2000) The awareness of phantom limbs look afters to be rapid, often within days after an amputation (Shreeve 1993) This awareness can persist for years. The accident of phantom sensations among amputee patients is high. Melzack (1992) estimated that as many as 80% of patients receiving amputations experience phantom sensations. Sherman & Sherman (1983) presented an estimate of 85% and Kamen and Chapis (1994) reported as many as 90% of patients with amputations experience phantom sensations. Phantom limb pain appears less frequently. Sherman and Sherman (1983) reported that 50% of patients with amputations reported pain associated with their missing limb. like pain has been described in various ways: burning; crushing; shooting sensations (Melzack, 1992); and as finger nails digging into phantom palms (Ramachandran & Rogers-Ramachandran, 2000) Clinical attempts to ameliorate phantom pain, including ultrasound, vibration, electrical force stimulation, and surgeries, have proven to be largely ineffective (Anderson, 1958; Melzack, 1992)

Building upon earlier work (Melzack & Wall, 1965) that propos the gate-control theory of pain, Melzack (1990; 1993) presented a neuromatrix explanation of phantom limb experiences. According to Melzack, the neuromatrix exhibits a widespread network of brain small rooms (linking the thalamus, limbic a whole and somatosensory and association cortex). These receive and integrate sensory input from all peripheral material part parts, as well as to the full representing the body and the faculty of perception of "body-self independent of the sensory input it receives. The neuromatrix is thus completely capable of generating sensations associated with a limb remov by means of amputation despite the cessation of sensory input. Melzack (1990) argued that the neuromatrix is genetically based and "pre-wired" into our nervous combination of parts to form a whole This postulation accounts for phantom limb sensations among children who were born with congenital limb deformities or missing limbs (see Poeck 1964 and Weinstein & Sersen 1961) Others (eg Skoyle 1990) have challenged Melzack's original and criticized many of the aforementioned studies upon methodological grounds.

Another explanation of phantom experiences is exemplified by the agency of the work of the Ramachandrans (Ramachandran, Rogers-Ramachandran, & Stewart, 1992; Ramachandran & Rogers-Ramachandran, 2000) They argued that neural plasticity allows for a cortical reorganization or remapping of the somatosensory cortex following the deafferentation of neuron Deafferented neuron expand or encroach on receptive fields of other cortical confined apartments and begin to respond to input from adjacent bodily representations. Amazingly, phantom sensations are modality-specific (Ramachandran et al., 1992; Yang, Gallen, Schwartz, blossom Ramachandran, & Cobb, 1994). For example, if heat is applied to an intact area of the face, a sensation of heat might be perceived as originating in the phantom limb. An unanswered question of the Ramachandran's remapping pattern is whether the expansion of the receptive fields be founds by way of sprouting of fresh axons or the strengthening of preexisting latent circuits. The rapidity with which the encroachment present itselfs (sometimes within hours) would glance at the latter.

Hypnotizability scales have been set uped in order to accommodate clinical populations that may not be able to engage in certain motor activities. For example, the Stanford Hypnotic Clinical Scale for Adults (Morgan & Hilgard, 1978/1979) was designed for use with patients for whom traditional hypnotizability scales may be too protracted tiring, or too taxing. However, to our knowledge, no report to date has described the experiences of a participant missing a limb and being administered a hypnosis scale containing motor items requesting changes (and experiences) regarding the nonexistent limb. The following is a brief report of of the like kind a unique event.

Case History

The participant is a 31 -year-old male who not to be found his right arm at the age of 5 in a farming accident. Until the time of the accident, his right hand had been his dominant hand. His arm was completely parted below the elbow. Following the accident, doctors were futile in their attempts to reattach his arm. Immediately on waking from surgery he recalled experiencing phantom pain. He experienced constant pain for month The pain became intermittent above a period of 10 years. Thereafter, the pain subsided and, at the time of this report, is solitary occasionally a problem. However, he experiences constant phantom limb sensations in his missing arm and hand (his "short arm," as he calls it). For example, when putting upon a coat, the sensory input received from the extremity of his arm is now perceived as coming from his missing hand and fingers. Telescoping (i.e., a gradually diminishing area of phantom sensation) has not occurr for him and his hand and arm are still experienced as being of consummate length.