Phobias

Paediatr Anaesth. 2007 Aug;17(8):800-4.

Brief hypnosis for severe needle phobia using switch-wire imagery in a 5-year old.

Cyna AM, Tomkins D, Maddock T, Barker D.

Department of Paediatric Anaesthesia, Women's and Children's Hospital, Adelaide, SA, Australia. allan.cyna@cywhs.sa.gov.au

We present a case of severe needle phobia in a 5-year-old boy who learned to utilize a self-hypnosis technique to facilitate intravenous (i.v.) cannula placement. He was diagnosed with Bruton's disease at 5 months of age and required monthly intravenous infusions. The boy had received inhalational general anesthesia for i.v. cannulation on 58 occasions. Initially, this was because of difficult venous access but more recently because of severe distress and agitation when approached with a cannula. Oral premedication with midazolam or ketamine proved unsatisfactory and hypnotherapy was therefore considered. Following a 10-min conversational hypnotic induction, he was able to use switch--wire imagery to dissociate sensation and movement in all four limbs in turn. Two days later the boy experienced painless venepuncture without the use of topical local anesthetic cream. There was no movement in the 'switched-off' arm during i.v. cannula placement. This report adds to the increasing body of evidence that hypnosis represents a useful, additional tool that anesthetists may find valuable in everyday practice.

Mil Med. 1999 Jan;164(1):71-2.

Hypnosis using a communication device to increase magnetic resonance imaging tolerance with a claustrophobic patient.

Simon EP.

Clinical Psychology Department, Tripler Army Medical Center, Honolulu, HI 96859, USA.

This is a case report of a patient who prematurely terminated two previous magnetic resonance imaging procedures because of his highly claustrophobic condition. The patient was induced into a hypnotic trance twice before his third magnetic resonance imaging examination and he was given posthypnotic suggestions for decreased anxiety and increased physiologic control. Using a communication device with headphones on the patient, he was induced into a trance as he entered the magnet. This patient was successfully able to cope with this procedure and reported great satisfaction with treatment.

J Dev Behav Pediatr. 1996 Oct;17(5):335-41.

Hypnobehavioral approaches for school-age children with dysphagia and food aversion: a case series.

Culbert TP, Kajander RL, Kohen DP, Reaney JB.

Alexander Center for Child Development and Behavior, Park Nicollet Clinic HealthSystem Minnesota, Bloomington 55437, USA.

The purpose of this article is to describe hypnobehavioral treatment of five school-age children with maladaptive eating behaviors, including functional dysphagia, food aversion, globus hystericus, and conditioned fear of eating (phagophobia). The unique treatment approach described emphasizes the successful use of self-management techniques, particularly hypnosis, by all five children. Common etiological factors, treatment strategies, and proposed mechanisms of change are discussed. To the authors' knowledge, this is the first such case series in the mainstream pediatric literature describing the use of a hypnobehavioral approach for children with these maladaptive eating problems.

Am J Clin Hypn. 1990 Oct;33(2):80-4.

Magnetic resonance imaging: improved patient tolerance utilizing medical hypnosis.

Friday PJ, Kubal WS.

Shadyside Hospital, Pittsburgh, PA 15232.

Magnetic Resonance Imaging (MRI) is a medical diagnostic procedure which requires a patient to be placed supine into the cylindrical bore of a powerful magnet for approximately one hour. The patient's arms are usually against the sides of the magnet bore with a 3" to 10" space between the patient's face and the top of the magnet bore. This enclosure induces panic and claustrophobic responses in 1% to 10% of the patients undergoing the MRI procedure. There have been many failed diagnostic studies due to patient intolerance, and there are reports of procedure-induced claustrophobia. We describe the hypnotic procedure utilized to reduce anxiety and panic for successful completion of MRI scans. Medical hypnosis has been an effective intervention in ten patients, permitting completion of their diagnostic procedure.

Dent Clin North Am. 1988 Oct;32(4):745-61.

Hypnosis in the treatment of dental fear and phobia.

Forgione AG.

Gelb Craniomandibular Pain Center, Tufts University School of Dental Medicine, Boston, Massachusetts.

The term hypnosis is currently used to define an area of research and treatment that employs suggestion. Within this area, suggestion refers to the induction of expectancies by implicit or explicit means, usually involving concentration and the expectancy that the suggested results are possible. This use of suggestion differs from the common use of the term suggestion, which is a logical offering for a change in behavior or thought. The long history of hypnosis is testimony to its effectiveness, although there has been controversy as to why it works. Patient selection is important. Further, fear must be distinguished from phobia. Combined with other treatment techniques, such as systematic desensitization, it is a powerful behavior modification method. To prevent accidental delivery of suggestions that may be counterproductive to treatment, the study of hypnosis is important even to those health care professionals who have no intention of employing it in their practice.