Hypnotherapeutic Ego Strengthening with Male South African Coronary Artery Bypass Patients

American Journal of Clinical Hypnosis,  Oct 2004  by de Klerk, Jacoba E,  Plessis, Wynand F du,  Steyn, Hendrik S,  Botha, Mike

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Subsequent to extensive conceptual evolution, hypnotherapy has become accepted as a means of enhancing an individual's perception of control, participation in, and mastery of difficult circumstances. Currently, a resurgence in the use of hypnotherapy and increased acceptance of hypnotherapy as a treatment modality in surgery is evident (Blankfield, 1991; Evans & Stanley, 1990, 1991; Fredericks, 2000, 2001; Kessler & Dane, 1996; Olness & Kohen, 1996; Pinnell & Covino, 2000; Sunnen, 2000; Varga & Dioszeghy, 2003). Hypnotherapeutic interventions have been used with hospitalized patients undergoing orthopedic, plastic, pediatric, obstetrical, gynecological, oncological, and general surgery (Fredericks, 2001; Manusov, 1990; Olness & Kohen, 1996). More specifically, hypnotherapy has been utilized effectively with cardiac surgical patients (Greenleaf, Fisher, Miaskowski, & DuHamel, 1992).

However, most recommendations for the utilization of hypnotherapy as an adjunct to medical treatment were based on anecdotal reports and isolated case studies. Researchers and clinicians alike lamented the paucity of outcome studies utilizing clinical hypnosis and noted the need for well-designed clinical research. Empirical support for the utility of hypnotherapeutic interventions would promote their wider acceptance in medicine (Pinnell & Covino, 2000).

In a recent study, Lang, Joyce, Spiegel, Hamilton, and Lee (1996) investigated the effects of hypnotic relaxation on intravenous drug use for anxiolysis and analgesia during radiologic interventional procedures. Thirty surgical patients were randomized to a self-hypnosis relaxation or a control group. The findings of this study provided support for the effectiveness of self-hypnotic relaxation in reducing the requirement for analgesic and anxiolytic intravenous medication. In another study, Lambert (1996) investigated the effects of hypnosis and guided imagery on the postoperative course of pediatric surgical patients. Fifty-two pediatric patients were randomly assigned to either a hypnosis or a control group. The patients in the hypnosis group had significantly lower postoperative pain ratings and shorter hospital stays than those in the control group. The results of this study pointed out the benefits of hypnosis in addition to standard preparation for children having elective surgical procedures. However, its potential for preoperative patient preparation has been grossly underutilized in surgery contexts.

Since surgical patients experience heightened emotional stress, they tend to be highly responsive to hypnotherapeutic suggestions. When hospitalized for major surgery they spontaneously enter into states of altered awareness (Fredericks, 2000, 2001; Sunnen, 2000). The hypnotic state allows increased access to imagery, fantasy, emotion and memories in this context of decreased defensiveness and increased receptivity (Frederick & McNeal, 1999). This offers unique opportunities to tailor communication to higher suggestibility levels of patients (Varga & Dioszeghy, 2003). As their capacity to cope with psychological distress associated with CABS will depend on their inner strengths (Frederick & McNeal, 1999), mobilization of ego strength is perceived as the key coping mechanism in patients undergoing surgery (Gahlaut et al., 1993).