“Keep your eyes on something,” Roeland says in a French accent. “Now close your eyes and get more relaxed and comfortable.” Fresquez closes his eyes. “Now you’re on his November day,” Roelants continues. “It’s Thanksgiving dinner at home. Look at your friends and your husband. The lights are dim, and a small candle flickers in the window.”
While Roelant speaks, Fresquez stands completely still and closes his eyes. The surgeon inserted a long needle into her neck to numb only the area near her parathyroid glands, then drilled a 1-inch hole in her throat area to insert two needles, each about the size of a grain of rice. Remove the gland.
When the surgery was finished, Fresquez said, “I felt relieved and happy that the hypnosis worked and that I was able to undergo the surgery without general anesthesia.” . . . It felt like I had run a marathon and won. (As a friend, she let me watch the surgery on video.) She was initially nervous about relying solely on local anesthesia, but Dr. Roelants made sure she was comfortable at all times during the procedure. Fresquez was relieved when the doctor assured him that he would be able to undergo anesthesia.
And she says: “I would definitely do it again.”
Hypnotherapy (also called clinical hypnosis or hypnosurgery) has been used for decades in Europe for minimally invasive surgeries such as hernia repairs, lumpectomies, biopsies, and mastectomies for some breast cancers. . However, hospitals and doctors in the United States are shying away from this treatment.
Girish Joshi, an anesthesiologist at the University of Texas Southwestern Medical Center in Dallas, is working with colleagues in Europe to use virtual reality for hypnosis. takes longer to implement, has slower response rates, and the U.S. payment system does not accommodate alternative medicine.
But some U.S. hospitals are now offering hypnosis to patients to reduce preoperative anxiety, manage postoperative pain, and even as an alternative to general anesthesia for partial breast cancer resections. (Hypnosis has been used for years to help people quit smoking, lose weight, sleep, and control stress.)
For example, about two years ago, MD Anderson Cancer Center in Houston began using hypnotherapy to supplement partial mastectomies and sentinel lymph node biopsies (in which doctors identify and remove cancerous lymph nodes in the armpit or breast). He says he has started using . Staff anesthesiologist Elizabeth Rebello is also an associate professor of anesthesiology at the University of Texas MD Anderson Cancer Center.
The results of the hospital’s ongoing randomized controlled study comparing surgical patients receiving general anesthesia or hypnosis versus local anesthesia have not yet been published, but 60 people who were hypnotized in the ongoing study Patient feedback and results have been positive, Rebelo said.
Before surgery, patients undergo a 15-20 minute practice session with a hypnotherapist. During the breast surgery itself, patients are awake, and EEG monitoring of electrical impulses in the brain shows that many patients respond to hypnotherapy as if they were under sedation. When she asks her patients if they would use hypnotherapy again, she said, “The answer is a resounding yes.”
Treatment is not magic
Guy Montgomery, a clinical psychologist at the Icahn School of Medicine at Mount Sinai in New York who studies hypnosis for cancer treatment, said the technique is “not magic” but could make pain more manageable. He says he can do it. “I’m not saying it’s going to be pain-free, which it might be for some people, but let’s see if we can turn the pain dial down,” he says.
To be clear, this is not a parlor game where hypnotized people take off their clothes and jump like chickens. The American Psychological Association defines hypnosis as “a state of consciousness characterized by focused attention, decreased peripheral awareness, and an increased ability to respond to suggestions.” Experts say it’s like being so focused on work that you don’t notice what’s going on around you.
Proponents point out that patients are always in control and can never be persuaded to do something they don’t want to do. And no medical professional suggests using hypnotherapy for major invasive surgery.
Montgomery says patients should definitely keep a few caveats in mind before choosing hypnotherapy. Anyone can claim to be a hypnotherapist, so be sure to see a licensed medical professional. For people with certain mental health issues, such as dissociative disorders, hypnosis can cause unexpected reactions, such as paranoia. “When you’re trying to control your pain, big psychological issues can come to the fore,” Montgomery says. Medical professionals are probably prepared for such a situation.
Daniel Cole, vice president of the Anesthesia Patient Safety Foundation and professor of clinical anesthesiology at the David Geffen School of Medicine at the University of California, Los Angeles, said hypnotherapy is a “very interesting alternative” for some patients. ing.
If the definition were simply “intensive attention that allows patients to have greater control over their mind and body,” it could be effective for minor surgeries, he says. It could also be an option for older patients who are more prone to delirium after general anesthesia, he added.
Patients should also be able to expect pain control through a combination of local anesthesia and hypnosis. “The last thing you want to do is compromise the surgery because the patient is suffering and in pain,” he says.
Management of pain and limitations
Psychiatrists and some anesthesiologists say it’s no surprise that hypnotherapy has been shown to be effective in managing pain. David Spiegel, associate professor of psychiatry and behavioral sciences at Stanford University, said pain perception originates in the brain and can vary from person to person. Hypnosis can actually change the degree of pain a person feels, he says. Stanford University offers self-hypnosis classes for patients to deal with a variety of medical problems, including pain, stress-related neurological problems, phobias, treatment side effects such as nausea and vomiting, and cancer. ing.
Martha’s Vineyard-based entrepreneur Debbie Phillips, 63, turned to hypnosis 10 years ago when she needed a biopsy for a thyroid tumor. She had several preparatory sessions with Elvira Lang, then the director of interventional radiology at Beth Israel Deaconess Medical Center. Later, Ms. Lang accompanied Ms. Phillips during her needle biopsy, making her imagine a serene beach scene as a long needle was inserted into her neck without local anesthesia. She wasn’t completely pain-free, but Lang sensed it, “and took me deeper,” Phillips said.
Lang, who calls his method “drugless patient sedation, or ‘comfort talk,'” has spent the past 25 years as a radiologist treating patients who require “minimally invasive” procedures that do not involve excision. He says he has developed a system that handles this. They used X-rays to guide doctors to widen blocked arteries and treat gallstones.
“Patients wake up and look at you with big scary eyes,” she says. She understood that drugs have limited effectiveness, but if someone loses consciousness, she can’t help with the procedure.
When Phillips’ biopsy revealed she had thyroid cancer and needed surgery, she continued to use hypnosis for her anxiety. This time, Lang performed hypnosis over the phone. Phillips said she was so relaxed that she told her husband, “She’s going to have major surgery, but she’s going to be fine.” Her husband replied, “You are technically hypnotized.”
The surgery required general anesthesia, but she said she was so relaxed that she refused to take anxiety medication before the surgery.
MD Anderson also uses hypnotherapy instead of sedatives and painkillers, Rebello said, and some breast cancer surgeries rely on opioids for symptom relief during and after surgery. He pointed out that this means that the degree of
“Hypnotherapy cannot completely replace general anesthesia,” Rebelo says. However, if the standard of care is general anesthesia, hypnotherapy may be a better plan. “In these cases, we owe it to our patients to consider this option.”
