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Thursday, May 16, 2013

Thursday's Trivia Answer: How Psychotherapy, Relaxation, Hypnosis Can Help Save Lives

Photo from 'I Love Colors' *

Thought for the Day:  Those of you who have been following my blog know that there is nothing trivial about these posts. Today's post may save lives.  A new client, who was petrified about the prospect of surgery, inspired me to write Last Tuesday's Psychotherapy Trivia Question which was:
                True or False: Psychotherapy can improve the outcome of 
            high risk surgery.
      What was your guess? Since I posted it on Tuesday, I have met with the client, let's call her Judy, for a second time & will be meeting again today to help her begin to prepare for surgery. I know from my clinical experience that there are a variety of things I can do to help improve her prognosis. I will describe what I am doing with Judy, but first I will share some research supporting these kinds of therapeutic interventions.
     As a clinician, I have worked with many clients prior to & after surgery. I do not need a literature review to know that psychotherapy can help a client face & recover with greater ease. Since I take an eclectic approach to therapy, I have developed a "tool box" of techniques to draw from when my clients are preparing for operations. Since no one technique fits all clients, I can offer options. According to Herbert Benson, MD & Miriam Z. Klipper, authors of The Relaxation Response, any form of relaxation can improve the prognosis of patients with coronary heart disease. Therefore, I can offer either simple relaxation training or hypnosis depending on the client's preferences. I prefer to teach people how to use self hypnosis, since it is quicker & easier to use, but if a client prefers other approaches, I will teach them simple relaxation techniques. Another reason I prefer hypnosis is that it can be used not only for the reduction of anxiety, but also for enhancement of healing & reduction of pain. 
      Yesterday, I explained hypnosis to Judy. I answered her questions about the process. Today, I will be teaching her how to use hypnosis for relaxation & to reduce anxiety. Once she learns, she will be able to practice this form of simple hypnosis daily on her own until the operation in early June. In the interim, I will teach her to use hypnosis to enhance healing & reduce pain following the operation. 
        With Judy, if she is willing & there is time, I will help her process some of the trauma & grief over her mother's death when the Judy was a young child. This will help reduce Judy's fatalistic views about her medical condition. Instead of expecting to be the one in twenty to have a negative outcome, I hope to help Judy expect to be one of the nineteen who have positive outcomes. Her doctors have told her that her odds are actually much better, but she has not been able to hear them. Her unresolved issues from the past make her expect the worst. The fact that a parent dies at a young age, does not necessarily predispose their children to die young. Actually, Judy has already outlived her mother by twenty years. Perhaps because of her mother's early demise, Judy has adopted a healthy life style & gone for frequent check ups, so that Judy's medical problems were discovered early. Judy's life choices make her prognosis better from the get go. However, her unresolved grief has led to Judy's fatalistic expectations, increased anxiety & fears. In the next couple of weeks, psychotherapy will help prepare her for & more hopeful about the outcome of surgery. Judy knows that her request for help inspired this trivia question & answer, I asked her permission to let you know about her progress.
If you or someone you love is preparing for an operation, please let them know there are things they can do that will help them be better prepared & improve their prognosis. If you have learned hypnosis, meditation or yoga & used it to prepare for an operation, feel free to share your experiences here, they my help save a life.
If you would like to read more on the topic:
      I did a quick google search to find the most recent studies supporting the benefits of psychotherapeutic techniques to improve the prognosis & outcome of surgery. I chose to share findings from a review (Depression and anxiety and outcomes of coronary artery bypass surgery Virginie Pignay-Demaria, MDa,c, François Lespérance, MDa,e, Roland G. Demaria, MD, PhDb,d, Nancy Frasure-Smith, PhDa,f, Louis P. Perrault, MD, PhDb* ) of research connected to cardiac surgery. There are studies of other types of surgery, but to keep things simple, I'm only reporting the ones about cardiac surgery. The review found that:
      "A small prospective study in 32 patients admitted for CABG evaluated the potential benefits of self-hypnosis–based relaxation taught before surgery. Subjects in the self-hypnosis group were more relaxed and required smaller analgesic doses postoperatively compared with the control group [71]. These findings expand those of earlier studies [72, 73], in which psychological interventions significantly reduced pain, mean hospital length of stay, and post-surgical morbidity. These data support the possibility that pre- and postoperative psychological support may improve quality of life in cardiac surgical patients....
      "...clinical experience suggests that routine evaluation and effective treatment of preoperative psychological distress in patients scheduled for coronary revascularization may facilitate postoperative recovery, which may translate into a better cardiovascular prognosis [18, 73]."
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'I love colors' http-/

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