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The promise of medical hypnosis

Network - Fall 2012

By Mary Brolley

The patient was claustrophobic.

Scheduled for an MRI to screen for cancer, she was afraid to have the procedure. But because she’d already had three primary cancers and was experiencing new symptoms, she needed it.

Patients who can’t tolerate closed spaces aren’t unusual, according to Ian Lipski, M.D., clinical associate professor in the Department of Anesthesiology and Perioperative Medicine.

“When we’re called to sedate patients, it’s usually for claustrophobia, anxiety and/or pain,” he says.

But this patient had come in alone and had no one to drive her home. Giving her drugs was out of the question.

Luckily, Lipski had another tool at his disposal. He asked the woman if she’d consider participating in medical hypnosis to relax her enough to get through the MRI. She agreed.

Lipski read the patient a short, standard script that asked for her cooperation and participation in a relaxation exercise, then guided her into it.

Forty-five minutes later, she emerged from the procedure. “She was fine. She said she fell asleep,” he says.

New option gives patients more control

Medical hypnosis is the use of hypnosis within the medical setting to help reduce anxiety, fear or pain, or help manage other symptoms.

It’s gaining attention and racking up success stories as its use grows. Lipski was trained in the technique in 2010 at a three-day conference in Boston sponsored by the Society for Clinical and Experimental Hypnosis.

Elvira Lang, M.D., an interventional radiologist who developed her own techniques in her practice, trained him and others. Lipski was hooked.

Back at MD Anderson, he enlisted the support of Kenneth Sapire, M.D., professor, and Thomas Rahlfs, M.D., professor and chair of the department. Soon Lang was invited to the institution to train more than a dozen interested staff from anesthesiology, internal medicine, interventional radiology, proton therapy, thoracic surgery and pediatrics.

Since then, several anesthetic procedures have been performed at MD Anderson with medical hypnosis, either alone or as a complement to medication.

Crucial to its success, Lipski says, is establishing an instant rapport with patients. “We mirror body language. We tune in to preferences. For example, a patient might say, ‘I can’t see myself getting through this.’

“This can mean he’s a visual learner, so we help him visualize a peaceful or relaxing scene.”

It’s important for practitioners to avoid negative suggestions, such as “This may hurt or cause discomfort.” Instead, the script emphasizes breathing exercises and progressive relaxation. These serve to focus attention on something pleasant, and the actual environment moves to the periphery.

What medical hypnosis isn’t

It’s not magic, trickery or mind control. It’s an altered mental state, a state of focused attention, that’s entered willingly. It distracts a patient from pain or discomfort. It’s a complement to — not a substitute for — traditional anesthesia, Lipski says. And it may reduce the amount of medication necessary to complete a procedure.

“And procedures with less medication may be shorter,” Lipski adds.

Hypnosis has also been used to reduce side effects like pain, anxiety, hot flashes and depression. It requires no prescription and has no side effects.

“Of course, I’m not a trained psychotherapist,” Lipski says. “I’m interested in using this technique for procedural purposes in a rapid, fast-paced environment.”

He sees great promise in the use of medical hypnosis at MD Anderson. He plans to work closely with Lorenzo Cohen, Ph.D., and Richard T. Lee, M.D., professor and assistant professor, respectively, in the Department of General Oncology and co-directors of the Integrative Medicine Program.

“We’ll collaborate to develop a strategy to work medical hypnosis into our perioperative standards,” he says. 

“We want to deliver more compassionate care to patients while empowering them to participate,” he adds.

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