Silje Endresen Reme heads a project that offers breast cancer patients pre-operative hypnosis to help strengthen them mentally. “We have a hypothesis that what the patient brings into the operation affects the prognosis. Having a lot of anxiety and stress or being in a difficult life situation with little social support can affect the outcome of surgery and the path forward," she says.

Researchers use hypnosis to help breast cancer patients cope better with surgery

One in ten women develops breast cancer during their lives. But how they cope with the disease mentally varies dramatically. Now, researchers may have found a method that can help patients recover better following surgery.

In a new doctoral dissertation from Lund University in Sweden, researcher Katarina Velickovic has investigated psychological resilience.

Psychological resilience refers to our ability to meet problems and adversity in life. You can read more about resilience here.

To some extent, this ability is something we inherit through our personality. But psychologists believe it can also be influenced.

In a supportive environment, we can strengthen our tolerance for adversity.

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    Breast cancer patients tested

    A lot of us will receive a cancer diagnosis during our lives. And many women will experience both psychological and somatic aftereffects for months and years following treatment.

    A number of studies have shown that optimism has a protective effect for cancer patients, both mentally and physically.

    Velickovic has used a tool to measure psychological resistance in 780 breast cancer patients in Sweden.

    They were first tested right after they were told they had cancer. Then they were tested again after treatment.

    Velickovic found that patients with strong psychological resilience had good mental health throughout the course of treatment.

    Patients who scored low on resilience generally fared worse.

    Three important factors

    The researcher found that three factors in particular proved to be especially important for patients in maintaining good mental health through their illness and treatment.

    The three important aspects relevant for resilience were:

    • patients’ experience of having agency regarding their own treatment.
    • the support patients received from friends and people around them.
    • how the patients thought about breast cancer.

    Patients who scored high on psychological resilience had the ability to look at the cancer as a completed chapter in their life. After surgery, they thought of it as being behind them, not something that continued to hang over them and threaten them anymore.

    Existential crisis for some patients

    Silje Endresen Reme is a professor in the Department of Psychology at the University of Oslo. She headed a recently completed study on psychological aftereffects among Norwegian breast cancer patients. The results have not yet been published.

    Reme says that their experience has been the same as what the Swedish researcher describes, in terms of how differently people cope psychologically with a breast cancer diagnosis.

    Although breast cancer is a disease that now has high survival rates, many people experience the illness as an existential crisis.

    “For others patients, their illness is a trivial matter in life, something they just have to get through,” says Reme.

    If you have a lot of anxiety and stress and are in a difficult life situation with limited social support, this can affect the outcome of the surgery and the path forward.

    Silje Endresen Reme

    Using hypnosis

    The Norwegian research group was trying to strengthen the psychological resilience of patients before surgery in this study.

    “We have a hypothesis that what the patient brings into the operation determines the prognosis. If you have a lot of anxiety and stress and are in a difficult life situation with little social support, this can affect the outcome of the surgery and the path forward.”

    The researchers randomly distributed the 200 women participants into two groups.

    One group received hypnosis for 20 minutes before surgery and a digital follow -up afterwards.

    The other group, the control group, received a mindfulness audio file to reassure them before surgery.

    The researchers wanted to ease patients’ stress, concerns and unrest. They also wanted to increase patients’ expectations for mastering what they were going through.

    Breast cancer patients struggle a lot with pain and fatigue and were therefore selected for this study.

    No hocus pocus

    Many people probably associate hypnosis with something mysterious and out of the treatment mainstream. But hypnosis is used today in modern medicine.

    “It's not about losing control or not being able to remember anything afterwards,” Reme says. She explains, “You have control all the time under hypnosis, but it can help you get into a very focused state where the body is completely relaxed. Then the brain becomes particularly receptive to messages.”

    It has been well documented through research that hypnosis before surgery can reduce pain, she says.

    “We are also trying to influence psychological resilience. If you tell the brain that everything will go well during surgery, it can be a kind of "antidote" against catastrophic thoughts.”

    Looks promising

    If you tell the brain that everything will go well during surgery, it can be a kind of "antidote" against catastrophic thoughts.

    Silje Endresen Reme

    The researchers wanted to investigate whether the treatment has an effect on job function, the need for drugs and whether it affects biomarkers for stress.

    The results have not yet been published, but Reme can reveal that the findings look promising.

    Reme believes the results could be significant for how patients fare after surgery.

    This is the first time that the use of hypnosis in connection with surgery has been studied in Norway.

    Several studies from other countries have shown very positive effects of hypnosis on breast cancer and that many patients benefit from it.

    The women in those studies had significantly less pain, fatigue and nausea after surgery, according to Reme.

    Also affects survival

    Reme says that to some extent, psychological resilience is an ability that we inherit through our personality.

    “We know that optimism is a stable structure in human personality and that it’s largely genetic.”

    But it can also be influenced, she says.

    “I have research colleagues in the Netherlands who have given participants specific tasks in studies where they have been asked to recall good memories. This turns out to make this group of participants more optimistic than other groups who are assigned more neutral tasks. The optimism also seemed to relieve pain directly when the participants were subjected to painful stimuli.”

    A large study shows that optimism predicts longer survival in general, Reme says.

    There is thus a certain degree of influence and opportunity for change here, which she believes is important to apply in cancer treatment.

    “The strong connection between the mental and the physical is under-communicated,” she says.


    Katarina Velickovic: Recovery from Breast Cancer: Investigating the Role of Resilience in Breast Cancer Survivorship. Doctoral dissertation at Lund University in Sweden, 2022.


    Read the Norwegian version of this article at

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