International Handbook of Clinical Hypnosis - E-Lib FK UWKS

14 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
The seriously burned patient needs psychiatric help from the time of injury to
full recovery Chapter 19). Opioids are the treatment of choice for pain relief, even
though relief is seldom complete. Hypnosis can be a helpful adjunct, and should
not be withheld even in patients who test low in hypnotizability.
In the ®rst 2 to 4 hours postburn, hypnosis diminishes the in¯ammatory response.
Later, it is helpful for resting pain, and especially effective for control of pain in
those patients with the most excruciating procedural pain. Infection is minimized,
suppressed appetite can be restored, and body image and active participation in
rehabilitation are enhanced. A burned patient who has accepted the suggestion that
his wounded area is `cool and comfortable' is easy to treat, optimistic, and heals
rapidly.
Commonly, the patient who enters the dentist's room is at some level of trance
and the dentist has the opportunity to manipulate this hypnotic state to enhance
patient comfort in the dental situation. The hypnotic interaction has begun before
the ®rst word is uttered.
Another area in which hypnotic strategies are utilized, but the concepts of
hypnosis are not mentioned, is in the 3-minute smoking cessation interaction. This
can take place at the conclusion of the oral examination and cancer screening, if
there is an indication by the patient that there is a desire to `quit.'
With the advent of stereophonic headphones, the dentist can offer positive
hypnotic suggestions while taking care of the mouth. When preparing the patient
tapes, it is recommended that the form of speech be primarily in the passive voice
and the text be devoid of personal pronouns. For the listener, hearing just the ideas
and suggestions is empowering. Note that Dr Glazer, in Chapter 20, in this way is
using Ericksonian injunctive communication, as recommended by Dr Zeig. It
should be noted that the words pain, hurt and discomfort are never introduced.
Because the brain does not easily compute `no' in the hypnotic state, it is more
effective to offer positive suggestions.
The tape is used to teach patients not only to relax but to manage muscle tension
headaches and to abort bruxism.
Fear of dentists is commonly listed in the top ®ve commonly held fears and is
among the ten most frequent intense fears. There are strong indications that a
signi®cant portion of the dental phobic population is hypnotizable and that the
same high hypnotizability that allows them to develop a phobia is also a useful tool
to help them overcome the phobia.
Implicit in these ®ndings is a caution for dentists that they should be aware that a
signi®cant portion of the population is highly responsive to suggestion. Attention
should therefore be given not to deliver suggestions to patients that may be
counter-productive to treatment. Otherwise treatment dif®culties and enduring
problems may be created inadvertently.
During the 1970s research began to report both the clinical ef®cacy and
psychophysiologic changes associated with self-hypnosis in children. At the same
time the bene®ts of hypnosis training were recognized for children with chronic