Hypnotherapy: A Useful Adjunctive Therapeutic Modality in Hansen's Disease
A 22-year-old male suffering from Hansen's disease-borderline tuberculoid presented with type 1 reaction. His main symptom was severe neuritic pain of right lower limb and the skin lesions present over the right leg and trunk. The pain was increasing steadily day by day and after a few days, the patient was screaming with pain (visual analog scale [VAS][] rating showed the worst pain-10). This man was a very active karate black belt holder. After knowing the diagnosis, he thought that his nerves are completely damaged by the disease and there was no more hope in future. This thought lead him to severe depression (hospital anxiety and depression scale.\nThe patient was on high dose of systemic steroid (inj. dexamethasone. 2cc once daily for 2 weeks initially and then twice daily for 4 weeks), aspirin (325 mg thrice daily for 2 months), clofazimine (100 mg, initial 1 week, 200 mg next 2 weeks and 100 mg thrice daily for next 5 weeks), and diclofenac sodium (50 mg thrice daily for 2 weeks) daily. As he was not improving, we subjected the patient to hypnotherapy after informed consent. During hypnosis, the patient was asked to visualize his skin, brain, and peripheral nerves according to his mental concept and to imagine that the skin and the nervous system has completely recovered to the pre-diseased state and he is leading a healthy life. After the first session, the patient had a subjective decrease of pain around 70% (VAS scale-3). Two more sessions were given at 3 days interval. The pain markedly decreased after third sitting (VAS-scale-1) and showed excellent improvement psychologically (HADS-4, DLQI-4) and we reduced the drugs very quickly (inj. dexamethasone 2 cc- 1 week, 1 cc- 1 week, tab. Prednisolone 20 mg- 1 week, 15 mg- 1 week, 10 mg 1 week, 5 mg 1 week and stopped. Aspirin 375 mg twice daily-1 week, once daily- 10 days and stopped. Clofazimine 200 mg daily- 2 weeks, 100 mg daily- 2 weeks and stopped and diclofenac sodium was completely stopped) and continued MDT up to 6 months. We followed the patient for 2 years and he had no features of reaction or neuralgia thereafter.