Hypnoanalgesia and Psychо-Emotional Techniques in Pain Management A Collection of 10 Clinical Cases from the BAHH Course (Plovdiv, 2025–2026)

Abstract Background: Non-pharmacological approaches to pain management, particularly those based on clinical hypnosis and psychо-emotional techniques, have gained increasing recognition for their ability to reduce pain perception, anxiety, and catastrophizing without the side effects associated with opioids or other analgesics. Despite a growing body of experimental evidence, detailed real-world clinical case series documenting rapid, single-session effects in naturalistic settings remain relatively scarce. This collection presents ten consecutively documented, fully anonymized clinical cases conducted between December 2025 and February 2026 in Plovdiv, Bulgaria, illustrating the practical efficacy of brief hypnoanalgesic and dissociation-based interventions across a wide range of pain conditions. Methods: The cases involved eight adult patients (aged 36–84 years) and two children (aged 6 and 7 years) presenting with: acute musculoskeletal injuries (ankle sprain, elbow strain, chest contusion), chronic or recurrent joint pain (shoulder), residual post-viral throat pain, cardiac-related chest/abdominal distress, and procedural dental pain/anxiety. Interventions were performed by course participants using short sessions (typically 15–40 minutes). Core techniques included indirect suggestions, sensory dissociation, visualization of protective metaphors (“Matryoshka”, “Balloon in the hand”, “Magic balloon”, “Energy ball”, “Observer from above”), redirection of attention, and tailored post-hypnotic suggestions. Formal trance terminology was frequently avoided to enhance patient acceptance. Four sessions were conducted at home or remotely via telephone due to immobility or acute distress. All patients provided verbal consent for anonymized case reporting. Results: Remarkable analgesic effects were observed in the majority of cases after a single intervention. Nine out of ten patients reported clinically meaningful pain reduction (frequently from severe/intolerable to mild or absent), often within 20–30 minutes. Specific highlights include: complete analgesia during caries excavation without local anesthesia in an anxious adult patient; painless administration of local anesthesia in a highly fearful 7-year-old child; rapid resolution of severe post-traumatic chest pain via telephone-based dissociation in an immobilized patient; near-elimination of movement-provoked shoulder pain flares in a case of chronic overuse; substantial relief of nocturnal cardiac-related distress and air hunger in an 84-year-old man with advanced heart failure. Even in the case with more gradual improvement (ankle sprain follow-up), protective behaviors and guarding markedly decreased, enabling earlier functional recovery. Anxiety, anticipatory fear, and pain catastrophizing were consistently reduced across all participants, including both pediatric cases. No adverse events, symptom substitution, or rebound phenomena were reported. Conclusions: This case series provides strong naturalistic evidence of the high clinical effectiveness and rapidity of brief hypnoanalgesic and psychо-emotional interventions in managing diverse acute, procedural, residual, and chronic pain conditions. The techniques proved safe, opioid-sparing, adaptable to home/remote settings, suitable for pediatric and geriatric populations, and capable of producing substantial relief in a single session in most instances. These observations strongly support the integration of hypnosis-based methods into routine pain management pathways in both medical and dental practice. The findings also highlight the value of flexible, rapport-centered delivery and indirect suggestion strategies. Larger prospective studies, including standardized outcome measures and longer follow-up, are warranted to quantify effect sizes and identify optimal patient selection criteria. Acknowledgements This collection was prepared under the leadership of Yuri Sinenko, who authored and delivered the BAHH Course on Hypnotic Analgesia (Plovdiv, December 2025 – February 2026) as its lead trainer and International Secretary of the Bulgarian Association for Hypnosis and Hypnotherapy (BAHH), and who also served as the editor and coordinator of the present publication. Deep gratitude is extended to co-trainer Rumyana Raynovska for her essential contributions to the course implementation and participant supervision. The authors also thank the Bulgarian Association for Hypnosis and Hypnotherapy (BAHH) for organizing this specialized training program, which created the structured environment for the practical application and documentation of these clinical cases. The openness and dedication of the course participants in sharing their anonymized reports made this open-access resource possible Keywords: hypnoanalgesia, clinical hypnosis, pain management, acute pain, chronic pain, procedural anxiety, dental hypnosis, pediatric dentistry, non-pharmacological analgesia, dissociation techniques, Matryoshka technique, balloon visualization, remote hypnosis, Bulgaria