HYPNOTERAPl - Dansk Selskab for Klinisk Hypnose

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states. Thus, as I give information about the anticipated anesthetic in language which patients
can understand, I consider it of major importance to "choose words wisely": avoiding
language which might convey negative connotations, replacing it with positive ones. (This
never means misrepresentation or deception!)
Example: addressing post-operative pain before the operation:
With the intent of giving accurate information a surgeon told a patient:
"you will hurt like hell when you wake up in the recovery room. But we can give you shots
for that".
Instead one might use a verbalization such as this:
"...as you begin to wake up after your operation and become aware of the pressure
underneath those bandages, it lets you know that your operation is already completed and
that you are safe. So you can just settle back and relax because those feelings underneath the
bandages let you know that healing has already begun. And if, at any time, you need to be any
more comfortable, alI you need to do is let the nurses know. There are so many ways in which
we can help you be more comfortable. You might even be surprised how much more
comfortable you can feel when you let all your muscles go limp and relaxed".
(After the operation one can observe a striking difference as to the level of comfort and
demeanor of patients who have been exposed to the former verbalizations vs the latter.)
To introduce the concept that the patient has options, I offer him choices, some of which seem
minuscule, yet get the point across: whether or not he will take a sleeping pill in the evening,
a sedative in the morning; what anesthetic approach, what method of postopera-tive pain
control he prefers; when and how pain medications will be given etc.
A brief trance session can follow, if the patient wishes and if time permits. As an
anesthesiologist I do not have the luxury of time and I must achieve what this patient needs
usually in only a few minutes.
Technique: An induction and 3 fractionations can be accomplished in 5 to 10 minutes.
Using time progression, the operation and recove-ry up to discharge from the hospital and
beyond can be rehearsed in another 5-10 minutes. Suggestions for comfort, freedom from
com-mon side effects, rapid healing, return of physiologic functions postoperatively etc are
included.
Griefwork regarding the organ to be lost can be attended to in this stage, and is most
effectively done in trance. It must be individualized and can include symbolic appreciation of
that organ's meaning and function, leave taking, and for some patients symbolic burial. Once
that has been accomplished, patients experience a profound sense of relief, may lose sensation
and awareness not only of discomfort, but even at times, of that organ's presence.
DAY OF SURGERY
For those patients who had a pre-operative trance experience, trance is re-induced with one
breath or shoulder pressure while they are being wheeled into the operating room. For others
a seemingly simple chat about their favorite place can easily lead to dissociation and trance.
During induction of anesthesia, intra-operatively, and during emergence suggestions are
continued. Particularly important to cancer patients are suggestions to disregard conversations
and comments overheard in the operating room - whether while awake or anesthe-tized. For,
unfortunately, discussions regarding possibly poor prognoses are common between the
surgical team and pathologist and there is now irrefutable evidence that awareness can occur
even during general anesthesia. If I had been unable to avert such com-ments or make it
impossible for the patient to hear them, I will address the patient by name and give corrective
suggestions. I do this with greater assurance today than 20 years ago in view of substantial