The Energy of Words
Lee Raven, RN, CIIG
What
would you do if you could utter a few sentences to a pre-op spinal surgery
patient, and by doing so, reduce her blood loss by an average of almost 50
percent, and perhaps prevent the risk of a blood transfusion?
In
a landmark study reported in the September issue of Anesthesiology in 1986,
Henry L. Bennett, PhD., did just that. A pioneer in the field of behavioral
anesthesia, Dr. Bennett divided 94 patients into three groups: a control group,
a group taught muscle relaxation, and a group that received 15 minutes of
attention from a psychologist. During the 15 minutes, the third group was
introduced to the idea of becoming active participants in their own surgical
procedure and recovery. It was explained that they weren’t expected to do
anything consciously, but that their bodies would naturally take over on a
non-conscious level, much as it does in the case of blushing. Then they were
told the following: "To make sure you will have very little blood loss
in your surgery, it is important that the blood move away from the area of the
spine and out to other parts of your body during the operation. Therefore, the
blood will move away from your back during the operation. Then, after the
operation, it will return to that area to bring nutrients to heal your body
quickly and completely."
The study was conducted at the University
of California (Davis) Medical Center, where the average expected blood loss for
these spinal operations was 900cc. But this third group, who received
instructions about blood movement, lost an average of only 500 cc of blood,
about half of that lost by both other groups.
* * *
It was shown more than 40
years ago that patients don’t even need to be conscious to follow instructions. In a famous
1960 study by Wolfe and Millet, 50% of surgical patients followed suggestions
during surgery to such an extent that they required no postoperative medication
for pain relief at all.
Following up on that study, Dr. Bennett demonstrated that patients don’t require
conscious memory of the surgery. In the mid-1980’s, he played a three minute
message during surgery, in which he instructed patients to touch their ear
during their postoperative interview, which was to happen a week later. The
interviewers did not know which patients had been told to touch their ears.
Eighty-two percent of those told to did touch their ears, and the average time
spent “ear–touching” was 15 times as long in this group as in the control
group. These patients did not remember the instruction being given, but they
did follow it. In the same way, patients may not remember their surgeon’s
negative suggestions during surgery, but they do follow them.
For those of you who, like me, have either worked in or been a patient
in a surgical suite, think of the number of times we’ve heard surgeons saying
or suggesting negative outcomes. What is happening inside the minds and bodies
of unconscious patients when they hear, “Oh, no,” “It’s worse than I thought,” or even, “All right. That’s it.
There’s nothing more that we can do”?
* * *
In the April 2000 Lancet, the prestigious British medical
journal, Dr. Evira Lang, associate professor at Harvard Medical School,
published a remarkable U.S. study. 241 patients divided into three groups
underwent invasive procedures that normally require sedation and pain
medication, similar to the one British Prime Minister Tony Blair went through
recently. She demonstrated that Guided Imagery, in the form of helping patients
to envision a comfortable, safe, beautiful place of their own choosing, significantly reduced pain,
anxiety, drug use, procedure time, and complications. That is enormously
important—read that list again. A simple intervention of well-placed words and
questions during a procedure made it decidedly more comfortable, safer for
the patient, and saved the hospital both time and money.
There is another point in Lang’s study
that deserves our attention: patients in the Guided Imagery group were not
allowed to hear anything negative about their procedure—before, during or
after. Because their attention was focused on positive images, undistracted by
negative expectations or communications, half of the patients in the Guided
Imagery group needed no sedation or pain medication at all. Those that did
choose medication used only half the amount used by the control group. But
here’s the real kicker: in the Guided Imagery group, hemodynamic instability (a
sudden precipitous change in heart rhythm, heart rate, or blood pressure) was reduced
by twelve-fold.
* * *
Are surgeons and hospitals leaping to buy
the audiotapes Henry Bennett has made, or to
incorporate Guided Imagery and a moratorium on negative language in the
hospital? No, they are not. As Bennett says
“Viewing the patient as anything other than a warm set of organs raises the
anxiety of the healthcare profession.” But the evidence is persistent, and the
word is spreading nonetheless. Bennett has tapes available, Peggy Huddleston,
Belleruth Naparstek, Dr. Martin Rossman, and others have CDs and/or books out
on positive imagery for surgery and enhancing healing potential. Through the
work of Bennett, Lang, Andrew Weil, Jeanne Acterberg, Christiane Northrup, and
so many others, patients and doctors are sitting up and taking notice. In 2001,
even the insurance industry got in on the act: Blue Shield distributed 50,000
guided imagery surgery tapes to their Kaiser patients in California because
they were convinced it would save them money. And let’s not forget the most
important resource of all: the army of dedicated holistic practice nurses who
are resolutely educating their patients and clients.
Juliet Auer shows us how we nurses might
use these principles in hospital wards. For example, form her own experience
during rounds; a doctor said in front of a patient, “I don’t like the look of
the AF on this ECG. No MI on enzymes, but long-standing malignant hypertension.
Pyrexial too, uh-huh (significant look). Have we looked for vegetation? Do you
think we’re missing SBE? Perhaps we ought to. Hm (knowing nod).” Auer says, “As
they move to the next bed, I try to mop up the worst of the psychological
damage.” She explains to the patient that in this case “malignant” has nothing
to do with cancer, vegetation just means germs, and they’re planning to check
why the person still has a temperature. She then reframes the situation so that
the person feels in charge of their treatment and in control of reaching their
own health objectives.
Does this make any difference? Dr. K.
Thomas, a British physician, studied 200 patients who were experiencing general
ill-health but without a specific diagnosis. He told half of them that they had
a definite complaint, and that they would get better. He told he other half
that he was unsure what was wrong, and to return if they did not improve. Two
weeks later, 64% of the first group had improved, compared to only 39% of the
second group. What is your doctor telling you?
* * *
Once we as holistic health practitioners
understand the power of our words, we will change what we say. We will begin to
talk of successful outcomes and how much is possible in terms of healing body,
mind and spirit. We will remind clients of their innate capacity to heal. We
will help focus their attention and intention on their own internal power to
orchestrate their healing process.
Not only will our patients feel better
and heal faster, but also we will experience our own thoughts and words as
powerful healing agents. We will be rewarded in our constant refinement of the
words and tones that have the most powerful therapeutic effect. And we will be
reminded that every time we speak to someone else about his or her own healing
potential, our constellation of body, mind and spirit is listening. That, after
all, is why we were drawn to the holistic health field in the first place:
because we want to make a genuine contribution to humanity and the earth that
empowers us all to heal wholly.
References
Bennett, H. L., Bensen, D. R., and Kuiken, D.A., “Preoperative
Instruction for decreased bleeding during spine surgery” in Anesthesiology,
No. 65, 1986
Bennett, H. L., and Disbrow, E. A., “Preparing
for Surgery and Medical Procedures”, Goleman, D. and Gurin, J. ed. Mind-Body
Medicine, Consumer Reports Books, Yonkers, New York, 1993
Bennett, H. L., and Davis, H. S., “Non-verbal
response to intraoperative conversation.” in Anesthesia and Analgesia.
No. 63, 1984
Lang,
Elvira et al, “Adjunctive Non-pharmacological Analgesia for Invasive Medical
Procedures: A Randomised Trial”, Lancet, 29 April 2000.
Siegel, B. S. Love Medicine and Miracles. Arrow, London, 1988
Egbert,
L. D., Battit, G. E. et al, “Reduction of postoperative pain by encouragement
and instruction of patients” in New England Journal of Medicine, No. 270
pp. 825-827, 1964
Dreher,
H. “Mind-body interventions for surgery: evidence and exigency” in Advances
In Mind-Body Medicine, Volume 14, No. 3, pp. 207-222, 1998
Thomas,
K., “General practice consultations: is there any point in being positive?” in British
Medical Journal Vol. 294, pp. 1200-1202, 1987
Thomas, K.B., “The placebo in general practice”, Lancet, Vol. 344
(8929), 1994
Wolfe, L. and Millet, J. “Control of post-operative pain by suggestion under
general anesthesia” in American Journal of Clinical Hypnosis No 3, pp.
109-112
Lee Raven, RN
CIIG, has over a
decade of experience in Critical Care and Interventional Nephrology. Now is
private practice, her clients include cancer and surgery patients, those with
other health challenges, and expecting couples. She also regularly works with
teens and children on health, self-esteem and creativity.
Lee
blends Interactive Imagerysm with a number of other complementary
therapies, including Advanced Reiki, TFT (Thought Field Therapy), EFT
(Emotional Freedom Technique), Transpersonal Healing, HypnoBirthing®. She incorporates Tarot, energy work,
and intracultural archetypal symbols in her private practice, seminars and
workshops. She is the President of Imagery International, a member of AHNA, and
an adjunct faculty member of Beyond Ordinary Nursing. You can visit her website
at www.ImageryForHealth.com .