April 28, 2000 - "Robert" had undergone more medical procedures than he could count on both hands, and that was just in
the last two years.
He has liver disease and has a plastic tube inserted in his bile duct. The tube regularly gets clogged, meaning more trips to the
hospital, where the tube is cleaned out or replaced. It's a painful procedure, made more painful because of Robert's anxiety.
But before one of these procedures, his doctor asked him if he wanted to try something new: self-hypnosis. It just might
lessen the pain, she told him.
She told him to lean back, breathe, and focus on floating away to someplace safe and comfortable. She kept repeating these
directions while she and her assistants worked to replace the plastic tube. She kept repeating them while the
anesthesiologist monitored Robert's vital signs and asked if he was feeling any pain.
When it was over, Robert (not his real name) was a convert. Never again , he said, would he undergo a procedure without
using self-hypnosis. He was so impressed with the process that he asked the doctor for a copy of the script she used for the
self-hypnosis, so he could take it home and use it with his wife when they argue. "He says they will use it to calm down,"
says one of his doctors, Elvira Lang, M.D., an associate professor of radiology and medicine at Harvard Medical School.
At Beth Israel Deaconess Medical Center in Boston, where Lang is director of cardiovascular interventional radiology, patients
are regularly offered the option of using self-hypnosis as a booster to traditional painkillers and sedatives during some
types of operations. In a study of the technique, published in the medical journal Lancet, she and colleagues
found that hypnosis had a positive effect.
In the study, Lang compared patients who used self-hypnosis or a similar method called structured attention technique, along
with the painkilling drugs, to patients who received drugs alone. The patients who underwent self-hypnosis experienced less
pain and anxiety. Importantly, doctors spent less time completing the procedures in these patients, and less time meant less
cost, about $100.00 a patient less.
Lang and her colleagues divided the nearly 250 patients they studied into three groups: Some got standard care, some used
structured attention techniques, and others did self-hypnosis. all the patients were having operations to open blocked arteries
or ducts.
"Self-hypnotic relaxation saved 17 minutes of (operating room) time, despite the time invested in the hypnotic induction
compared with standard care," she writes. The structured attention technique shaved and average of 11 minutes off the time it
took for the procedures.
Lang tells WebMD that "it only takes about five minutes to induce the relaxed or self-hypnotic state in the patients." The
standard script she uses asks patients to "close their eyes, breathe, and then concentrate on the sensation of floating. While
focusing on the sensation of floating, I tell them to transport themselves to someplace safe and comfortable." She says
that it can be a familiar place -- "one woman goes to her kitchen and cans vegetables" -- or it may be an exotic setting
that the patient has only read about.
In the structured attention method, patients are told to focus on a specific sensation where the painful part of the
procedure is about to begin. "The patient is directed to focus on the sensation of numbness or warmth, for example," Lang
says. At the same time, the patient is coaxed and assured by phrases such as "What are you feeling?" or "Tell us when
we can do something for you."
Helmut Cascorbi, M.D., PhD, tells WebMD that many anesthesiologists are already using the self-hypnosis approach.
"The bottom line is that hypnosis and self-hypnosis can be extremely helpful in some patients. In fact, in a few minutes
I will be going to radiology to use it myself in helping an anxious patient," he says. Cascorbi is a professor of
anesthesia and psychiatry at Case Western Reserve University School of Medicine in Cleveland.
But Cascorbi says that hypnosis and self-hypnosis are not for every patient: "The personality profile is extremely important,
because there are a significant number of personalities that don't allow for hypnosis or self-hypnosis.
"Among the North American population, there is data that suggests that between 15% to 20% of the population can be hypnotized
deeply, to the point where one might consider doing a painful procedure with hypnosis alone. But there is a large percentage
-- how large is unknown -- who are completely resistant," he says.