Background: Knowing that patient expectations play a crucial role in the experience and management of pain is also of great importance for clinical practice. Expectations not only influence the experience of pain but also hypnotic analgesia (Baker & Kirsch, Citation1993). Interestingly, in this study, pain reduction was mediated by expectations, measured as expected pain before each trial in all groups. Changing expectations could be a significantly positive way to improve the effectiveness of treatments.

Methods: In a series of studies, Vase and colleagues (Vase, Riley, & Price, Citation2002; Vase, Robinson, Verne, & Price, Citation2003) further explored the role of expectations and desire for pain relief. The results showed that different instructions inducing different levels of expectation led to a significant reduction in opioid intake, despite the same time course of pain in all groups studied. Hypnotic suggestibility is part of the broader psychological trait of direct verbal suggestibility. For clinical practice, these results are of great importance for both patients and doctors. The findings suggest that one of the therapist's tasks may be to evaluate and potentially modify patients' expectations. In summary, expectations appear to play a significant role in the experience of pain and related disability, but also in predicting treatment success, assessing (and potentially modifying) patients' expectations could be a key mechanism to consider. Effective communication skills are essential to optimally manage chronic pain and opioids. This sequential, mixed-methods exploratory study tested the effect of a new framework designed to improve pain-related communication and outcomes. (Henry SG, et all: Development and testing of a communication intervention to improve chronic pain management in primary care: a pilot randomized clinical trial. Clin J Pain. October 2022) This study developed a new framework and intervention to teach doctors about pain-related issues communication skills. Although the intervention has shown promise, more intensive or multicomponent interventions may be needed to significantly impact clinicians' pain-related communication and pain outcomes.

Results: Studies have demonstrated broad analgesic effects of hypnotic communication in a range of acute and chronic pain conditions. Scaglione M, et all: Hypnotic communication for periprocedural analgesia during catheter ablation of atrial fibrillation. Int J Cardiol Heart Vasc. July 2019 Hypnotic communication during AF ablation was related to a significant reduction in intraprocedural anxiety, perceived pain, procedural analgesic medication dosage, and perceived procedural duration without affecting total RF delivery time and safety procedural. Hypnotic communication has been added for analgosedation in the implantation of a subcutaneous implantable cardioverter defibrillator. The results demonstrated a significant reduction in perceived pain, anxiety, procedural time and use of analgesic medications in patients who responded to hypnosis. These results reinforce the beneficial effects of the hypnotic technique in patients undergoing S-ICD implantation.

Conclusions: Training healthcare workers in the use of hypnotic communication techniques could guarantee better adherence to the therapeutic path.