A SPECIALIST in radiology once told me that he was hesitant to use waking hypnosis in preparing patients for barium enemas. Though he considered the barium enema to be radiology's most unpleasant procedure, he felt that the approach I suggested amounted to deceiving the patients.
He usually told them, "I have to put you through a procedure that isn't very comfortable, but I'll make it as easy for you as I can."
I contended that he was telling patients a lie, since the procedure doesn't have to be uncomfortable. If I were the radiologist, I said, I would approach patients in this manner: "You're fortunate that you're here today. The doctor who referred you tells me that you've been having a lot of distress lately. I need some x-rays, and in order to get them, I'm going to coat the lining of your stomach with the most soothing medication ever devised."
The radiologist refused to tell patients anything so "absurd" until one day he had to work on a man who was already in terrible discomfort. Out of desperation, he tried my approach. The patient was relieved, and, in fact, actually enjoyed the barium enema. The radiologist now uses this approach consistently. The only problem he has encountered is that some patients so thoroughly enjoy the "soothing medication" that they retain the barium and refuse to let it go. He solves this by telling them it will feel as beneficial leaving as it did entering.
Another doctor learned a variation of this technique for doing internal examinations on tense women patients. A gynecologist taught him to tell such a patient that a new preparation had just arrived from Vienna—an anesthetic especially designed for such examinations. He would then swab her externally with a bit of medical jelly (squeezed out beforehand and left in a jar or on a spatula). After waiting a couple of minutes for the placebo to "take effect," the examination could proceed without further trouble.
A urologist recommends a similar approach for such procedures as cystoscopy. The doctor touches the tip of the canal with a lubricant. Then he puts the lubricant on his instruments. But he tells the patient this lubricant is an anesthetic, and that nothing will be felt during or after the procedure.
A proctologist said, "I never thought there was such a thing as painless proctology until I began using waking hypnosis."
All of the above instances are examples of applications for waking hypnosis. Recently, one doctor told me that the only problem he encounters with the technique, now that he's learned its proper applications, involves nurses rather than patients. In biopsies and the like, it frightens the nurses a little when the doctor doesn't pick up the novocain —just starts cutting. My answer to this is that nurses and assistants should be taught what to expect in cases where hypnosis is used, and how to act properly in the presence of hypnotized patients.
One application of waking hypnosis combined with the trance is especially affective in getting children over the fear of the needle. And as the following classroom recording proves, it can also be used with an adult:
Elman: Is there anybody in this room who would like to have an area on his body anesthetized to a degree where, from now on, you will never feel an injection again? You will never even know that you're getting an injection while it's being done. Anyone who dreads an injection terribly, and would like to have a Magic Spot on his body?... Come on up ... Those of you who won't come up are going to be awfully sorry because this is a chance to get something which is fantastically good. This Magic Spot is amazing . . .
[to subject] Can you raise your sleeve a little bit? Now here's the greatest device for children. As far as that goes, it works on adults just as well as children, because I have an adult right here. Now, watch this ... I want you to open your eyes wide, please. I'm going to pull your eyes shut. All you have to do is to pretend that you can't open your eyes and keep on pretending you can't open your eyes— so much so that when you try to open your eyes they just won't open . . . Now let me see you try to open them while you're pretending . . . That's right . . . Now stay like that and keep on pretending you can't open your eyes, and the most amazing thing is going to happen. You're going to have a Magic Spot put on your arm. Once this Magic Spot is put on you, never again will you have to feel an injection. You'll know that the doctor is working there, but nothing will disturb, nothing will bother you. You'll never have any discomfort from an injection, either before, during or afterwards . . . Now, who is in the habit of giving a lot of injections, because I want this injection given in the usual way, once I've given her the Magic Spot. . . Now, watch, I take this area and I paint a Magic Spot with alcohol, like that. Now, whenever an injection is given in that area—she'll be able to point it out to the doctor—nothing will be felt at all except that she'll know you're working there . . . She'll feel absolutely nothing . . . Now, doctor . . . you'll see she won't even feel when you're doing it. [Injection is given with a number twenty needle.] Now, isn't that beautiful? . . . [to patient] You've already had your injection and you know you didn't feel a thing. From now on you will always be able to have injections this easily. After a while, that Magic Spot I painted on your arm will no longer be visible to you or anyone else—except for one important thing—you will know exactly where it is so that any time you must receive an injection, you will be able to point out the exact area to your doctor. If you wish, you will be able to watch him giving you the injection, and it won't bother you a bit. . . All right, open your eyes . . . What did you feel?
Elm an: Now gentlemen, I want you to see how this works the next time the patient requires an injection. So we're going to pretend this same patient has come to your office for another visit. You tell the patient that you must give her another injection, and that as she already knows, it won't bother her at all. You ask her to show you where her Magic Spot is.
Patient: Right there, doctor.
Elman: All right, doctor. Here's another needle. Go ahead and give the patient an injection in the usual manner. You merely cleanse the area with alcohol as usual, and go ahead with your injection . . . Young lady, I want you to watch the doctor while he is giving you this second injection . . . [Doctor gives injection.] What did you feel?
Elman: And doctor, when you dismiss your patient, just make the statement that all is well, and that next time she needs an injection, it will again be just as easy ... [to patient] That bleeding will stop now. It's bled enough and now it will stop.
Patient: Did it stop?
Elman: Sure it stopped.
Patient: I'm going to remember that spot. It's going to come in handy.
Doctor: The trouble I have with these kids is that they won't listen to you to start with.
Elman: If they won't listen to you, then you've got to give the injection the hard way. If I can promise a child, "Look, if I give you a Magic Spot so that you never have to feel an injection again, wouldn't you like that?"—then I have no trouble with them. But you must get their attention long enough to get this point across. Our pediatricians who are working with a tremendous number of children—that's all they do all day long—they tell us that the Magic Spot is one of the most valuable things they know. The mothers and fathers of these children come in later and ask for Magic Spots for themselves. When the child comes back for the next visit he usually says, "Right there, doctor. There's my Magic Spot."
Is this waking hypnosis?
This is a combination of the trance state and waking hypnosis, developed by Doctor Earl Farrell of Cincinnati, a pediatrician . . . You use eye-closure to start with—then give the injection. The next time the child may watch the injection. And they'll be able to watch and won't feel a thing. They lose all their fear of an injection.
That's the next visit you let them watch?
Yes. However, suppose you have a patient who requires injections in several different places. Give him a Magic Spot in each place. Give the first injection with the eyes closed. Then have him open his eyes and watch you give the other injections. Sometimes when you've given the first injection with the eyes closed, the child will say, "You didn't give me the injection." The doctor says "Yes, I did. There's where I gave it to you."
How about an external abdominal examination? Can we use waking hypnosis for that?
Yes. You'll find that when you use this "relaxing-agent" approach, they just automatically relax. They have no control over it at all. Their critical faculty is bypassed completely . . . You'll find that you've already got the anesthesia ... If you want to make an external examination instead of an internal examination and you want the stomach muscles to be relaxed, this is a good technique. If you find, by any chance, a muscle or two is not as completely relaxed as you want it to be, just say, "In about ten seconds the relaxing agent will reach that area and even those muscles will relax."
I would like to know a few phrases I can say in using hypnosis . . . For instance, we know the one, "Want it to happen and it will happen."
No, you wouldn't use that in waking hypnosis.
What do you say then?
You do what we did here.
You would still say to the stranger, "Now I'm going to anesthetize this area so that you won't feel a thing—and this gadget that I have to put down your throat—you just won't mind it at all once we get this anesthesia in there.
And you can do that with headaches, too?
I wouldn't try to remove a headache by waking hypnosis. Use the trance state for removing headaches. You'll get better results. I would use Waking Hypnosis the way I've indicated, and then widen your use of it as you go along as you learn to use it more and more. But don't try to use waking hypnosis to the detriment of the trance state. In other Words, don't use it as an "instead-of" measure. It's just one more tool . . .
How much anesthesia can you achieve with a child?
In waking hypnosis?
No, in the trance—in the pretend game.
Elman: You get a perfect anesthesia—the equal of any chemical anesthesia, just as you do with an adult in somnambulism. You've got to give the suggestion, "Now you won't feel anything. I'll be working there, but it won't bother you a bit." Those things you must get over.
Doctor: With patients with acute back strains or cancer of the back or the sacro-iliac joints, could I have used some suggestions to relieve the muscle spasms?
Elman: Yes, but for this type of difficulty too, our doctors get better results with the trance state. We think we only have control over certain muscles and certain organs of our bodies, but as a matter of fact, we have control over much more of our bodies than we think, It was possible for example, for me to say to that lady who received the injection, "It will stop bleeding," and it did. Because I knew if she didn't look at it, it would stop bleeding. She didn't look at it and it stopped bleeding... Now to get back to the muscle spasm the doctor asked about, first I would have used the trance state to let the patient feel the relaxation because the patient can feel it better when he lets himself go into deep somnambulism. Once in deep somnambulism, I would have swabbed the area with some type of lubricant and said, "I'm going to make sure that this area, particularly where the muscle spasm has occurred —that this area is relaxed. Now, you won't have to do a thing about this, but when I swab it, just stay relaxed and the relaxing agent will do the rest," and you would have locked his mind around the idea that the muscle was going to relax. And the inner control which we exercise—as she exercises inner control over bleeding, but doesn't know it—the inner control which we exercise over those interior muscles, would have manifested itself, and the muscle spasm would have been relieved . . .
Much as we think we know about the human body from our anatomy studies, we still can't look inside the human mind to see how it works. I've had doctors who've said that they believe that some illness is caused by emotion. Others say most illness is caused by emotion. I don't think most doctors would accept this hypothesis and I'm sure that I wouldn't... but all neurotic conditions are caused by emotions, and perhaps some physical ones. Certainly it explains why we have control over bleeding. Our dentists say to their patients after an extraction, "That bleeding will stop when it reaches the top of the socket," and the bleeding stops as suggested. Physicians also have given their patients suggestions to control bleeding when indicated . . . We have much more control than we think we have, and that's what makes it possible for doctors to use suggestion in the manner indicated . . . Remember this, that with hypnosis you will never mask a symptom. You can alleviate a symptom but you can never mask a symptom. And if there is any pathology revealed by that symptom, it will be alleviated and eased, but it will not disappear.
Doctor: In other words, a ruptured disc would not be masked?
Elman: Of course it wouldn't. You couldn't mask a symptom. The patient would say, "My back feels a lot better, but it still hurts in there, doctor." And then before long it would be hurting as much as ever. So, you can alleviate it but not mask it . . . Here's a doctor who's already used hypnosis on four cancer patients. He can't mask a cancer. They know they have pain, but he has certainly given these patients a lot of relief. Isn't that right, doctor?
Doctor: Yes. They're not even taking aspirin.
Despite the fact that waking hypnosis can be used in every branch of medicine, I think its greatest value is in deep surgery, in alleviating the distress and worry of the patient before the operation. There are very few patients who face an operation without anxiety. Every one of these patients is wide open to waking hypnosis and to waking suggestion. Make your suggestions in such a confident, assured manner that you can. see visible evidence of the disappearance of the unpleasant anxiety signs. Keep it up until you know the patient is ready to face the operation in the proper spirit. Lock the patient's mind around the idea that recovery will be swift and sure—that the operation is not an extraordinary one, but that it is done every day of the year in countless hospitals and that patients always recover from it fast. And then use waking hypnosis to remove postoperative discomfort.
I often advise doctors to get the patient into the hypnotic trance for presurgical visits or for preanesthesia visits. However, when pressed for time, you can do without the trance. I am not saying you should forego the trance. But I am saying that if there is any doubt of success in your mind, or if you don't have time enough to go for the trance state, use the waking hypnotic state and lock the mind of the patient around the idea that recovery will be swift and sure, and that patients always recover from such surgery fast. Lock the patient's mind around the idea that there will be no postoperative discomfort. You can counteract all the things that are worrying the patient.
If by any chance the patient indicates that he has the thought that he will not recover from the operation, cancel the surgery, or cancel your part of it at any rate, if possible. This case history will show you how important the preoperative attitude is:
Some years ago, a surgeon came to class and said: "I think I saved a life with waking hypnosis this past week. I was called in to do a prostatectomy on a man about seventy-six years of age. I was told that he was a cardiac case and that he couldn't take much anesthesia, if any. I've been in the habit of making preoperative visits, and I thought I should see that he was in the right mental state before I proceeded to do the operation with as little anesthesia as possible. I went up to see him and introduced myself as the man who would be in charge of the surgery. I started locking his mind around the idea that recovery would be swift and sure, and all that sort of thing.
"Suddenly he looked up at me and said, 'You know, doctor, I'm seventy-six years old. I'm an old man and I've lived a long time. I'm a cardiac case. So tomorrow I'll die on the table.'
"I told him that, as of that moment, the operation was cancelled. I said I would never operate on anybody in the world who thought he was going to die on the operating table, that I'd never had that happen, and certainly wasn't going to start with him. He looked relieved, but he kept repeating that he was a cardiac patient and couldn't live through the operation.
"I told him, 'You're seventy-six years old. I've done this operation on men in their eighties, and they're now in their nineties and just as healthy as they could possibly be. You're only seventy-six and you're thinking of dying because of a simple operation like a prostatectomy. You think you can't have anesthesia. That's what I came up here to show you. Since you don't have surgery scheduled for the morning any more I'll show you what you missed. I'm going to show you the anesthesia I would have used.'
"And then I got him into the trance state and anesthetized his entire body. He took the suggestion like a drowning man clutching at a straw and he had complete anesthesia. Then I had him open his eyes, and I made tests over his entire body. He couldn't feel anything. Then I had him close his eyes again, brought him out of the state and he looked up at me and said, 'You know doctor, with you for my surgeon, I believe I could get well.'
"After firmly locking his mind around the idea of easy recovery, I went ahead with the surgery. He has made a perfectly magnificent recovery, and I believe I saved a life. I had encountered the will to die and that man would have died on the operating table if not for waking hypnosis."
A physician once told me about a simple operation he had arranged to perform on a young man. The patient was taken into the operating room prepared for surgery. Suddenly, the anesthetist—who hadn't yet done anything to the patient—looked up and exclaimed, "My God, he's dead!" Every type of investigation was made, including an autopsy, and they could find no cause of death. Yet the man was dead.
He had occupied a semi-private room and the investigation revealed that just before he was taken down to the operating room he had turned to the patient in the other bed and said, "I'm never coming out of that operating room alive." What had caused his death was the will to die.
Doctors should beware of even casual remarks made by patients. Sometimes these seemingly casual remarks may be fatal. We have heard doctors report that they've been able to change the will to die to the will to live with waking hypnosis. They were alert enough to realize that suggestion was needed. Others have failed to do what was needed and have lost patients as a result. Here is a case history that illustrates both possibilities in surgery:
A student of mine, attached to a Catholic hospital, encountered the will to die when he was called in to do surgery on one of the nuns working at the institution. He made a preoperative visit, and during the conversation, she said, "You know, doctor, ever since I was a little girl, I've had the notion that some day I would die on the operating table, and I suppose this is it."
The doctor immediately began a program of waking hypnosis, locking her mind around the idea that recovery would be swift and sure, that as long as she'd been in the hospital she had never known of a mortality for this particular type of operation. Finally she said to him, "You know, doctor, I just know I'm going to recover with you for my surgeon. You can go ahead with the surgery." He performed the operation, and she recovered in a minimum of time.
About six months later, the patient had to have minor surgery done. The doctor didn't know the operation was scheduled. It was done at a different hospital by a different physician in another city. There was nothing dangerous, or even serious, about the surgery. She died in the operating room.
We are born with the will to live. The law of self-preservation is the primary law of our lives. It is fundamental. Yet, there are two types of people who do not possess the instinct of self-preservation at normal level. They are the suicidal depressive and the manic depressive. But even with people suffering from these two kinds of depression, the will to die appears to be a mere warp in the straight line of self-preservation. It is sometimes possible to straight en this warp with the means put at our disposal by psychotherapy and hypnosis. Every doctor who knows how to use hypnosis is capable of changing the will to die into the will to live in normal patients. Psychiatrists report it is worth a try even with psychotic depressives; with nonpsychotics, then, the chances of success are overwhelming.
One more aspect of waking hypnosis deserves mention here. I spoke earlier of superstition, which is a manifestation of unintentional hypnosis—a form of waking hypnosis. There are other such manifestations. In one of my classes, a doctor told me this story:
During World War II, he worked as an anesthetist in a station where casualties were brought in after battle. He was working with nitrous oxide and the day had been a very busy and trying one. He noticed that the nitrous oxide tank was getting low but later, in the excitement, he failed to notice that it was completely used up. When he finally realized this, he drew the surgeon aside and said, "My God, that nitrous oxide tank must have been empty for the past hour or so. What are we going to do?"
The surgeon answered, "There is nothing we can do now. We will have to keep on working just as we have been. These men have been getting perfect anesthesia. They think they are anesthetized, and consequently they are. Keep on doing what you're doing and don't say a word." And they completed their work in this manner. I would say this was a combination of unintentional hypnosis, waking hypnosis in its usual sense and somnambulism gained in the waking state, without the use of the trance.
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