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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Despite the positive outcome of our study, there were some limitations in its design. First, only two 60-minute preoperative HES sessions were conducted because of time constraints associated with hospitalization procedures. We believe that patients would have benefited more from HES had they not been hospitalized only a day prior to surgery. Although quality of life is often aggravated for several months post surgery, regrettably no further intervention occurred between discharge and 6-week follow-up, as patients hailed from afar. Had such interventions been possible, effects may have been enhanced. Similarly more repetitions of ego strengthening might have produced better outcomes.

Second, we only focussed on changes in mood states in CABS patients and did not investigate the effects of HES in its totality. However, physiological benefits and surgical outcomes might have rendered other substantial findings.

Third, it would have been worthwhile to test hypnotizability beforehand to determine whether the positive outcomes were produced by the treatment context or by participants' hypnotic capabilities (Sapp, 1997). Regrettably, it was not feasible to assess hypnotizability independently in our study, in view of patient and time constraints, particularly their degree of preoperative stress and postoperative discomfort and fatigue.

Finally, omission of an attention/placebo group could arguably be perceived as a further limitation, especially coupled to the use of self-report inventories only. With only self-report responses and no attention/placebo group, it is uncertain how much of the results were due to non-specific effects associated with being offered an intervention which might relieve suffering, in contrast to the control group.

Conclusion

The findings of the study elucidated the efficacy of hypnotherapeutic ego strengthening. HES techniques have the potential to augment the impact of psychotherapeutic intervention during CABS. Its increased leverage can facilitate more rapid relief of disabling anxiety and depression. Elimination of these symptoms may facilitate inherent healing capacities in the body and enhance psychological well-being. Hypnotherapy may enable patients to explore their adaptive resources while controlling concomitant stressful symptoms, thus gaining understanding and acceptance of their surgical trauma. Thus, the significance of brief HES interventions in the preoperative preparation and postoperative well-being of patients to manage the traumatic experience of CABS was demonstrated, as well as the viability of service delivery within a compact inpatient format.

Minimal HES inputs and assessments due to time and patient constraints, necessitate further quantitative and qualitative studies featuring HES applications in other hospital settings, to advance well-being through biopsychosocial patient care.

References

Andrew, M.J., Baker, R.A., Kneebone, A.C., & Knight, J.L. (2000). Mood state as a predictor of neuropsychological deficits following cardiac surgery. Journal of Psychosomatic Research, 48(6), 537-546.