International Handbook of Clinical Hypnosis - E-Lib FK UWKS

278 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
doctor: [after obtaining ideomotor
signal] Now let your inner mind lock
in on that sensation of being cool and
comfortable and you can keep it that
way during your entire stay in the
hospital. You can enjoy going to your
laughing place as often as you like,
and you'll be able to ignore all of the
bothersome things we may have to do
and anything negative that is said.
I then leave the patient in trance, go
ahead with his initial care, and get him
moved to the Burn Unit. Often, he will
drop off to sleep.
doctor: Go to your laughing place. On subsequent days, this is all the signal
the patient usually needs to drop into a
hypnoidal state and tolerate bedside procedures,
physical therapy, and so on.
With burns covering less than 20% of the body surface, the single initial trance
generally suf®ces, while in more extensive burns, repeated suggestion helps control
pain, anorexia, and uncooperativeness Crasilneck et al., l955; Ewin, l973; Schafer,
l975; Wakeman & Kaplan l978; Knudson-Cooper, l98l; Patterson, Everett, Burns
& Marvin, 1992). In more extensive burns requiring multiple surgeries, the patient's
outcome may be in¯uenced by subconscious hearing of pessimistic conversation
while under general anesthesia Ewin, 1986a,b).
GUILT AND ANGER
Since a thought can produce a `burn' see above), continued feelings of guilt or
anger can prevent healing, and should be dealt with during emotional countershock
Mattson, l975) a day or two after admission. If the patient caused it and is feeling
guilty, I stress the fact that the injury was unintentional, he has been punished
enough and has learned a lesson he will never forget or repeat. If someone else is at
fault and he is angry, I point out that our ®rst priority is healing. Getting well does
not interfere with his legal rights, and they come later. If it was an accident, I ask
my patient to forgive the person of evil intent, even though planning to pursue legal
redress. There is no place for anger at his laughing place, and he is instructed to
postpone that feeling until healing has occurred.
PAINÐRESTING AND PROCEDURAL
During hospitalization, burned patients endure two quite different pain experiences.
Resting, or background, pain is ever present and of low to moderate intensity.