Talk pediatric patients through their asthma
Studies show hypnosis helps reduce incidents
A child is sitting on the examining table in the emergency department (ED) wheezing, coughing, wild-eyed, and terrified. His mother stands beside him, ineffectually patting his back and looking around for a nurse, equally wild-eyed.
"A child having an asthma attack is a frightening thing for everyone," says Marc Oster, PsyD, a clinical psychologist in Arlington Heights, IL, who is also a private practitioner of hypnosis. "But there are ways to calm him down and keep the attack from getting worse. There are even ways to keep the attack from happening."
Researchers at the University of California-Davis recently compiled a review of studies on hypnosis and asthma for the Journal of Asthma1 that shows considerable benefits of hypnosis on patients with asthma, and particularly good results with children.
Eric Gershwin, MD, of the UC-Davis Division of Rheumatology, Allergy, and Immunology wrote that "relatively little attention has been given recently to the use of clinical hypnosis as a standard treatment for asthma" since there is considerable interest in finding nonpharmacological treatments for the disease.
"Such nonpharmacological approaches are expected to reduce the burden of asthma on the patient as well as on the health care system," the researchers wrote. "Importantly, alternative treatment modalities are needed which give patients greater control over their asthma, thereby improving the patients’ well-being and quality of life."
Relaxation-oriented, self-administered, hypnotic-style therapy seems to have positive effects on children with asthma, Gershwin’s group wrote.
Some studies show this approach reduces the severity of symptoms and the number of ED visits.
While Gershwin wrote that it’s premature to conclude that hypnosis is unequivocally effective against asthma, the team found some compelling evidence:
• A large number of studies have shown that between 5% to 10% of the population is very responsive to hypnotic suggestion and between 25% to 30% are minimally responsive.
• Peak hypnotizability is achieved between the ages of 9 and 12.
• As early as 40 years ago, researchers found patients did best with a prolonged course of six months of hypnosis, self-hypnosis skill-building, and careful record keeping of symptoms. After that time period, incidence of wheezing decreased by 50% and the use of bronchodilators decreased fourfold, from an average of 89 times a month to 22 times a month.
• In a year-long British study, women showed greater improvement than men and asthma was "much better" in 59% of the subjects in the hypnosis group compared to 43% of the control group that received instruction in simple relaxation techniques.
• In a study of patients with asthma that could not be adequately controlled with drugs, after a year of hypnotherapy, hospital admissions declined by 64%.
• A one-year study of children ages 3 to 20 showed that hypnosis and self-hypnosis practiced at home showed 70% of the subjects with either a complete resolution of their asthma or greater than 50% reduction in symptoms with correspondingly fewer school absences and ED or doctor’s office visits.
• Two studies of hypnosis used during acute attacks showed significant improvement without drug intervention. One study shows 80% of the patients needed no medication after hypnosis, "suggesting that use of hypnosis during an acute attack is safe."
"Hypnosis is a powerful technique," Gershwin’s team wrote.
Oster and his colleagues agree. "With hypnosis, you can teach the child to begin recognizing the symptoms at the onset of an attack before it gets to the panic stage and it is much more difficult to bring under control," says Oster.
Returning to the ED scenario with the child having an acute attack, Oster says panic usually sets in with the child, the parent, and perhaps even the staff. "The child’s body goes into the fight or flight syndrome," he says. "But we can give a suggestion and prevent the panic from coming."
Oster asks his subjects to practice different — nonpanic — responses to the attack, over and over again. "If the child doesn’t panic, the adults don’t panic and it breaks the cycle. Then he can shorten the episode or even prevent it." Oster finds it is helpful to work with the child and with the parents — sometimes together, sometimes individually — so all can recognize warning signals and rehearse a successful process.
Tad James, MS, PhD, Honolulu-based chancellor of American Pacific University and director of the American Institute of Hypnotherapy, looks to a patient’s past to find keys to his current disease manifestation.
He’s found particular success in treating asthmatic children with hypnosis, neuro-linguistic programming (NLP), and a specific brand of hypnotherapy he devised 15 years ago, Time Line Therapy.
"This therapy allows a person to go back to emotion-laden events in the past and see the emotions related to it — anger, sadness, fear, and guilt. Then we show them they can release those emotions connected with the past," he says.
In treating a disease such as asthma, says James, hypnosis can help the practitioner find the root cause and help the patient release it. "The symptomology of asthma can be psychosomatic, and hypnosis is a powerful way of addressing psychosomatic illnesses of all sorts."
He tells the story of a young girl who was brought to him with severe asthma, apparently connected to an allergy to dog hair. The child wanted a dog, says James, so he helped her go back in time to an incident when she was two years old and was bitten by a dog.
"During the 2½ hour session, we communicated with the child’s unconscious mind and got it to let go of the asthma, which was based on her fear lingering from the old incident," says James. "It took one session, and now she has no more asthma, and she has two dogs."
James says he and other practitioners of NLP and Time Line Therapy prefer to treat patients on referral from physicians.
[For more information, call (800) 800-MIND or (808) 941-TIME for the name of a local practitioner.]
Reference
1. Hackman R. Hypnosis and asthma: A critical review. J Asthma 2000; 37:1-15.
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