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

Introduction

Reports of phantom limb awareness (and often phantom limb pain) have a long and rich history. One example is the phantom limb pain reported by Lord Nelson following the loss of his right arm in the attack on Santa Cruz de Tenerife (see Ramachandran & Rogers-Ramachandran, 2000). The awareness of phantom limbs tends to be rapid, often within days after an amputation (Shreeve, 1993). This awareness can persist for years. The occurrence 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) offered an estimate of 85% and Kamen and Chapis (1994) reported as many as 90% of patients with amputations experience phantom sensations. Phantom limb pain occurs less frequently. Sherman and Sherman (1983) reported that 50% of patients with amputations reported pain associated with their missing limb. Such 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 nerve stimulation, and surgeries, have proven to be largely ineffective (Anderson, 1958; Melzack, 1992).

Building on earlier work (Melzack & Wall, 1965) that proposed the gate-control theory of pain, Melzack (1990; 1993) offered a neuromatrix explanation of phantom limb experiences. According to Melzack, the neuromatrix represents a widespread network of brain cells (linking the thalamus, limbic system, and somatosensory and association cortex). These receive and integrate sensory input from all peripheral body parts, as well as fully representing the body and the sense of "body-self independent of the sensory input it receives. The neuromatrix is thus completely capable of generating sensations associated with a limb removed by amputation despite the cessation of sensory input. Melzack (1990) argued that the neuromatrix is genetically based and "pre-wired" into our nervous system. 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 (e.g., Skoyles, 1990) have challenged Melzack's model and criticized many of the aforementioned studies on methodological grounds.

Published in American Journal of Clinical Hypnosis, July 2005 by Page, Roger A. and Green, Joseph P.