Psychology as Medical Therapy

I learned about the importance of hypnosis as part of my practice of pediatric pulmonology when I recognized that oftentimes psychology played a major role in causing and relieving my patients’ symptoms. 

For example, my patients with asthma were more likely to complain of shortness of breath when they were stressed by academic pressures. Patients were more likely to present with habitual cough when their social lives had been disrupted. On the other hand, on holidays patients rarely reported physical symptoms as they were preoccupied with the festivities rather than their health issues.  

I found that self-hypnosis could have a profound effect on many of my patients’ symptoms after 10 minutes of instruction about how to use it. Other patients improved after several sessions of hypnosis therapy. 

As I am a pediatrician as well as a pulmonologist, over the years I expanded my use of hypnosis to children, adolescents, and young adults with any medical condition. I have come to understand that nearly everyone with chronic symptoms can benefit from learning about its application. In the majority of cases patients with significant discomforts develop psychological issues because of their symptoms: 

• A patient with asthma might develop anxiety because he is afraid of being unable to breathe. Such anxiety could lead to worsening shortness of breath with an asthma flare-up.  
• A patient with irritable bowel syndrome might be afraid of travelling because she would not have easy access to a restroom. Such fear can cause abdominal pain to occur. 

• A patient with chronic pain might develop depression when his life is derailed by his illnesses. Such depression can cause his perceived pain to become more intense.  

In a minority of patients, psychological problems are the main cause of their symptoms. In these cases, the symptoms often solve a problem for the patients. 

• A patient might develop vocal cord dysfunction that prevents her from speaking when she is afraid of disclosing uncomfortable information.  
• A child who is bullied at school might develop stomachaches that serve the purpose of having an excuse from attending school. 
• A patient may develop chronic headaches because she has not dealt adequately with grief over the loss of a beloved friend. 

These patients can all benefit from learning how to calm their emotions with an associated improvement in their symptoms. Patients can recover completely in cases wherein the psychological problems, which are the main cause of their symptoms, are addressed adequately. 

Because psychological factors are nearly always involved in patients with chronic symptoms, I believe that healthcare providers should address these factors early in the course of medical therapy, rather than once all of the standard medical therapies fail.  For example, consider how all of the following patients would have benefitted from an early psychological intervention during their medical therapy. 

• A patient with vocal cord dysfunction (in which the vocal cords close during inhalation, which makes it difficult to breathe) was treated with medications for asthma, allergies, and gastroesophageal reflux. When she did not respond she underwent a tonsillectomy. When she failed to improve it was recommended that she undergo injection of Botox® into her vocal cords. Finally, her symptom resolved after one session of hypnosis therapy. Had she been taught hypnosis at the start she would not have required any additional medical therapy. 
• A 12-year-old patient with asthma was treated with intensive asthma medications for 10 years including oral steroids, which caused her to develop obesity and stunted her growth. Each time her oral steroids were discontinued she ended up in an intensive care unit with a severe asthma flare-up. At 12 she learned how to use hypnosis and thereafter her asthma control improved greatly, as her symptoms turned out to be mostly related to her anxiety. Had she been taught hypnosis to calm herself early in life (which can be done with young children) she would likely not have required as much intensive medical therapy. 
• A 16-year-old with a 13-year history of irritable bowel syndrome underwent numerous medical investigations, and treatment with multiple medication regimens. Nonetheless, he remained severely affected by his symptoms in that he could not get to school until mid-morning and could not participate in after school activities because he was in so much pain.  Three weeks after learning to use self-hypnosis his symptoms had largely resolved. Had he been taught hypnosis earlier in life he would have been spared a lot of trauma. 

Takeaway 

Patients who deal with chronic symptoms should ensure that any associated psychological issues are addressed early in the course of a medical evaluation and treatment planning, especially if the symptoms fail to improve sufficiently with initial medical therapy. 

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Author

Ran D. Anbar, MD Ran D. Anbar, MD, FAAP, is board certified in both pediatric pulmonology and general pediatrics, offering hypnosis and counseling services at Center Point Medicine in La Jolla, California, and Syracuse, New York. Dr. Anbar is also a fellow and approved consultant of the American Society of Clinical Hypnosis. Dr. Anbar is a leader in clinical hypnosis, and his 20 years of experience have allowed him to successfully treat over 5,000 children. He also served as a professor of pediatrics and medicine and the director of pediatric pulmonology at SUNY Upstate Medical University in Syracuse, New York, for 21 years.