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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Prior studies of psychological preparation for surgery have focused on reassurance given to patients preoperatively and informing them of what to expect postoperatively, including suggestions of relaxation and confidence, breathing techniques and music, as well as verbal rehearsal of routine procedures undergone by surgical patients (Lamarche et al., 1998; Linden, 2000).

Our psychological findings concerning reduced depression and anxiety with CABS patients are supported by the results of several studies (Ashton et al., 1997; Blankfield, Zyzanski, Flocke, Alemagno & Scheurman, 1995; Robb, Nichols, Rutan, Bishop & Parker, 1992;Trzcieniecka-Green&Steptoe 1994). Ashton et al. (1997) evaluated the effects of self-hypnosis and its role in surgery and found that patients who received self-hypnosis training experienced a significant reduction in postoperative tension, compared to patients in the control group. Decreasing tension and anxiety led to shortterm and long-term psychological benefits. Both standardized and individualized audiotaped hypnotherapeutic inductions and suggestions have also been shown to be beneficial for anxious surgical patients (Blankfield et al., 1995). Trzcieniecka-Green and Steptoe (1994) also found significantly reduced depression, negative mood states, and enhanced psychological well-being, following relaxation-based stress management, utilizing autogenic training and visual metaphors. Robb et al. (1995) showed the benefits and effectiveness of music assisted relaxation interventions to manage stress and anxiety of surgical patients. We were encouraged by the above findings, as results of our own study seem to support these conclusions.

Greenleaf et al. (1992) studied 32 CABS patients to examine the effect of hypnosis on recovery from surgery. The patients were assessed for hypnotizability with the Hypnotic Induction Profile (HIP) and randomly assigned to experimental groups to equate for differences in hypnotizability, age, and severity of illness. Scores on the HIP were significant predictors of recovery, independent of experimental treatment with formal hypnosis. Patients who scored midrange stabilized more quickly in the intensive care unit (ICU), than those who scored high or low. Results indicated that measured hypnotizability was associated with the recovery sequence from surgery. TrzcienieckaGreen & Steptoe (1994) also found that behavioral modification improves mobility, functional status, social activity, restlessness, trembling, shortness of breath, fatigue, and loss of appetite. Although physiological anxiety reduction responses have not been monitored in our study, patients' qualitative responses (De Klerk, 2003) revealed similar patterns of physiological and behavioural benefits as found by Greenleaf et al. (1992) and Trzcieniecka-Green & Steptoe (1994). Although not testing for hypnotizability, our findings are supported by the above investigations, in view of comparable experimental designs and concurring emphasis on anxiety reduction, by means of hypnosis with surgical patients. However, well-controlled studies are required to provide further support for the development of psychological interventions to assist patients during major surgical interventions.