the surgical procedure, freedom from post-operative complications, and
the patient's early return to maximum functionality. Much of this can be
accomplished without hypnosis. However, employing hypnotic trance and
suggestion as tools achieves these desired results more efficiently and
The best time to deal with
physical and psychological post-operative complications is
preoperatively. Good psychological preparation for surgery clarifies
misunderstandings, explains what is to come, protects the patient from
harmful conversations in the operating room, and promotes the
expectation of a rapid and a comfortable recovery. In an ideal world, a
good pre-operative preparation for the surgery in the waking state would
be given by all of the physicians that matter to the patient: the
referring physician, the anesthesiologist, and the surgeon.
also be ideal if each important physician were trained to employ
hypnosis. Ideally, the key physicians and nurses should confer and be
aware of each otherís preoperative visits with the patient. If one
doctor has taught the patient a self-hypnosis exercise, it would be
great if the other clinicians involved in the case reinforced and
validated its employment by the patient. Unfortunately, this is seldom
the case. This is where a clinical/medical psychologist like myself
trained in hypnosis and psychotherapy, and well versed in medical
hospital protocol, comes into the picture.
In preparing patients for
surgery, my approach is first to learn everything that I can about the
patient's physical/medical condition and the procedure that is to be
performed. Then, I endeavor to learn as much as is relevant about the
patient's personality and life circumstances. My goal is to impress upon
the patient the importance of maintaining a healthy, optimistic outlook
about the upcoming procedure and how it is going to help the patient get
better. I then assess any obstacles that the patient faces that stand in
the way of maintaining a positive outlook and address them. My goal is
to teach the patient how to deal with negative thoughts, and how to
dismiss them, but at the same time, maintaining a realistic perspective
so that realistic concerns are addressed.
Negative thinking by the
patient is to be avoided as much as possible and the patient is taught
techniques for maintaining a healthy, positive outlook. The patient is
also supported and coached in establishing healthy communication with
his or her doctors and the surgeon. Any issues that need to be resolved
or clarified are addressed both objectively in the waking state and on a
feeling/emotional level under hypnosis.
I teach the pre-surgical
patient how to use self hypnosis for relaxation, positive thinking and
positive self-affirmation, positive goal-directed visualization, and for
obtaining restorative sleep. I also teach the patient how to use self
hypnosis to alleviate anxiety or depression. Anxiety and depressive
symptoms are addressed both in the waking state using reality based
counseling and cognitive-behavioral therapy as well as in hypnotic
trance so as to address the subconscious issues that need to be dealt
I typically make a personal
hypnosis audio CD for the patient that contains on it an individualized
self hypnosis/self relaxation exercise along with protective suggestions
that I want the patient to thoroughly internalize. Some examples of
protective suggestions that have been repeatedly found to be helpful
1. You will have an
easy day during the surgery.
2. The night before the
procedure you should let yourself feel safe and comfortable, sleeping
soundly, accepting the fact that you are turning this over to your
3. You can help your
body heal best by having an attitude that nothing will bother you.
Nothing will bother you.
4. In the morning, you
wonít want to eat or drink anything, so that all of your body functions
will be at rest.
5. When you receive
your pre-op injection in your room, you should empty your bladder and
let the sedative take effect while you relax and go to your "laughing
place" (I have already helped the patient find his/her "laughing
6. From the time you
leave your room until you return from the recovery room, you should
simply enjoy your laughing place and completely ignore anything that
people say unless you are spoken to directly by name. [Repeat].
Completely ignore anything that people say unless you are spoken to
directly by name.
7. When your anesthesia is
started, all pain sensation is blocked. Some people hear sounds during
their operation, and if you do, you will ignore it because you will be
feeling no pain and enjoying your laughing place.
8. You will get a
constant supply of oxygen through a small tube in the back of your
9. When the surgery is
completed, you will be moved to a stretcher and taken to the recovery
room. You will gradually awaken just as you do from natural sleep,
relaxed and refreshed.
10. You will wake up
remarkably comfortable, with a good appetite, and your normal bladder
and bowel functions will resume quickly.
11. You will be up
walking later in the day [if appropriate].
12. Whatever you need
for comfort will be supplied, and your tissues will heal rapidly.
13. Now, I want you in
your imagination just to picture all that I have just told you taking
place, and then project ahead in time to when you feel healed and well
and ready to leave the hospital. And when you do that, signal by raising
your right index finger, and a date or the number of days will come into
your mind so that you can tell me when it is.
The patient is encouraged to
practice using self hypnosis to go to his "laughing place" in his
imagination so that he can enjoy himself, totally free of
responsibility, and just goof off, worry-free. The intent is for the
patient to do this at the time of the surgical procedure and to leave
the rest to his doctors.
In sum, my work in preparing
patients for surgery is devoted to alleviating all of the negative
factors that can work against the patient's having an as comfortable as
possible experience and a positive and successful surgery outcome.
Research shows that positive expectations promote positive outcomes.
Bruce N. Eimer, Ph.D.,
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