Placebo-Enhanced Hypnotic Intervention (PEHI)™

A Case Study: Chronic Arthritis Foot Pain

An 80-year-old client from New York City has suffered for years with severe arthritis in both feet, with additional mallet toe deformity in his right foot. The pain, sharp and stabbing from the base of his toes to his ankles, had recently escalated beyond what compression sleeves or cushioning pads could manage. His podiatrist had recommended MLS laser therapy to reduce inflammation, but he faced a two-week wait before treatment could begin.

"I've had a really bad couple of days of arthritic pain in my foot and it is driving me absolutely crazy," he wrote. "I need a quick fix."

My Approach

I used Placebo-Enhanced Hypnotic Intervention™, which combines neuroscience education with hypnotic visualization. The approach works in two steps:

Understanding the mechanism: I explained how the brain can activate its own pain control systems, releasing endogenous opioids (natural painkillers chemically similar to morphine) when expectation is properly engaged. Research shows these aren't imaginary effects, they're measurable neurobiological responses.

Targeted visualization: Using hypnosis, I guided him through detailed visualization of the laser therapy he would eventually receive. I had him imagine the laser's therapeutic warmth penetrating deep into his inflamed joints, triggering his body's natural anti-inflammatory response and flooding the area with his own natural painkillers. We followed actual pain pathways from his foot through his spinal cord to the brain regions that process and modulate pain. By leveraging his knowledge of the laser treatment, we created a powerful expectation anchor and credible framework his brain could translate into physiological changes.

The Results

After the first session focusing on his left foot, his response was immediate: "You helped my foot pain unbelievably. This is like something out of the movies!"

One week later, he requested a second session for his right foot, reporting his left foot relief had sustained. After a third session targeting both feet, he reported: "It has been about four weeks since I had a session with you and I have not felt pain in my foot since. Amazing!"

Most significantly, he added: "Based on these results, my doctor is holding off on any kind of treatment for the arthritis." This represents objective, third-party validation that the intervention produced meaningful results.

By the fourth session, eight weeks after our initial contact, he was walking comfortably without pain. He was also taught self-activation techniques (simple visualization), that will allow him to maintain relief independently.

What This Means

This case demonstrates the power of open-label placebos. The client understood he was using visualization and expectation, yet this didn't diminish effectiveness. The pre-talk explaining placebo science actually enhanced results by providing a scientifically credible framework. At 80 years old with degenerative arthritis, he achieved relief through his own neurobiological resources without pharmaceuticals, medical procedures, or side effects.

The combination of placebo education, anatomically-informed visualization, and self-activation training created outcomes substantial enough that medical intervention became unnecessary (the decision to postpone medical treatment was made by his physician based on observed outcomes). Results were replicated across multiple sessions targeting different areas (left foot, right foot, bilateral), demonstrating a learnable, sustainable pain management system rather than a one-time placebo response.