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The
Power of Suggestion |
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The
Power of Suggestion |
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By Mary
Ann Hellinghausen Imagine having a lump the size of an orange carved out of your breast without anesthesia or feeling no pain as the surgeon drives a pin into the bone marrow of your fractured leg without a chemical pain reliever. Hypnosis, when used by properly trained healthcare professionals, can refocus patients’ minds and alleviate their pain. Dorothy Larkin, MA, RN, clinical specialist and a faculty member in the graduate program in holistic nursing at the College of New Rochelle in New York state and a medical hypnosis teacher, began using hypnotherapy while treating burn patients in the late 1970s. "I found that while inflicting pain [through physical treatments] on burn patients, I could talk to them in a soothing way and divert their attention from the pain,’’ she said. Larkin also used hypnotherapy to help a woman who could not tolerate anesthesia while undergoing a lumpectomy. Patients under hypnosis may still feel pressure or pulling, but healthcare professionals can use hypnosis to suggest that those sensations are good. A patient who has been chemically anesthetized feels nothing. Usually, hypnotic techniques are used during surgery only as a last resort or in conjunction with chemical anesthesia. But hypnosis can be effective in the preparation for or recovery from surgery and in all areas of pain management. An effective treatment Many healthcare professionals already use hypnotic techniques without being aware of it, said David Pederson, CRNA, a nurse anesthetist in Carroll, Iowa, and a spokesperson for the American Association of Nurse Anesthetists, which recognizes the technique as a valid form of analgesia. It is often natural for anesthetists and nurses to murmur to patients coming out of anesthesia that "everything is fine" to put them in a comfort zone, a form of hypnosis, he said. In fact, studies have shown that patients undergoing hypnosis before, during, or after surgery need less pain medication and heal more quickly. Hypnosis has also been shown to be an effective way to find causes for insomnia, anxiety, and pain, said Daniel L. Handel, MD, president and medical director of the Center for Pain Management in Fort Worth. It also is used in obstetrics and for dental work. Insurance reimbursement for hypnosis varies greatly from state to state, said Rodger Kessler, PhD, clinical psychologist at Central Vermont Medical Center in Berlin. He believes that insurance companies should look at the cost savings, which can be significant. Studies have shown that when hypnosis was used in surgical preparation, patients left the hospital two days sooner than normal at a savings of $6,500 per surgery, he said. Medicare pays for hypnosis if it is used by a physician, but not by nurses (including certified nurse-midwives, certified registered nurse anesthestists, and nurse practitioners), a situation that the American Society of Clinical Hypnosis (ASCH) is working to change, said Edward Frischholz, PhD, editor of the American Journal of Clinical Hypnosis. Turning off the logical mind "It’s like Br’er Rabbit says, ‘Everybody’s got a laughing place,’ " said Dabney Ewin, MD, a New Orleans surgeon who has used and taught medical hypnosis for more than 30 years. "You’re turning off the logical mind and using the ‘daydream’ part of the mind, which is perfectly willing to take your thoughts and feelings off to Hawaii and leave your [physical body] with me." Helen L. Erickson, PhD, RN, FAAN, who recently retired from her position as a professor of holistic medicine at the University of Texas at Austin School of Nursing, believes all bachelor’s-prepared nurses should have advanced training in hypnotic techniques. "Nurses are too focused on the medical model, the mentality that ‘I’ll do it, I’ll give them more morphine,’ instead of ‘they’ll do it.’ To use hypnosis, you have to be focused on the client," she said. It is difficult to tell how often hypnosis is used in surgical situations because there’s no general reporting of it, said an ASCH spokesperson. Said Kessler, "It’s used in such highly specialized areas that I’d say it’s used quite rarely. But more than before, with pressure coming from the cost of surgery. The cost [in using hypnosis to prepare for surgery] is inexpensive compared with the cost savings of the outcomes." Hypnosis techniques probably are not used more often as a sole analgesic during surgery because of the preparation time involved, healthcare professionals say. "I would want to see a client at least two or three times before surgery to be sure they’re in a good state of suggestibility," said Pederson, who has limited training in the techniques. "That’s reasonably labor intensive." Ewin agreed. "We have excellent chemical anesthesia that is highly predictable," he said. "But hypnosis is nice to have in your bag of tricks." |
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