Hypnosis and Control of Bleeding and Haemophilia


There are numerous accounts of the human ability to affect blood flow using mind-body techniques. Stories such as Milton Erickson, MDʼs well known account of using hypnosis to control severe bleeding in his hemophiliac son after an accident, to Martin Rossman, MDʼs less well known but equally dramatic story of using hypnosis in the Emergency Room with a woman to stop her haemorrhaging. However, the widespread use of techniques such as Guided Imagery and Hypnosis for blood control will not be embraced by the medical community without hard science to back up the contentions.

Fortunately, several published studies present corroborating evidence. Biofeedback training, of course, has a long and well-documented history of being able to affect perfusion.

A recent study showed that biofeedback-assisted relaxation training was 87.5% effective in increasing peripheral perfusion (and, thereby, healing) in patients with foot ulcers. The field of hypnosis also has many studies related to pain management in surgery, and studies showing hypnosisʼ ability to affect blood flow are beginning to show up in the literature. Studies with burn patients have shown that hypnosis can significantly improve wound healing by increasing blood flow to the affected area. Subjects were able to achieve significant increases in hand warming using hypnotically-induced vasodilation. Haemo-dynamic measurements of systolic blood pressure, arterial blood flow, and resistance all changed appropriately when hypnotised subjects believed they were donating blood.

As an indication that these so-called autonomic functions can be patient controlled during surgery, one matched, controlled study of maxillofacial surgery patients receiving pre-, post- and/or peri-operative hypnotic suggestion had up to a 30% reduction in blood loss. The health benefits to the patient and savings to hospitals with these kinds of blood loss reductions are considerable. A further study showed that intra-operative and post-op capillary bleeding can be reduced using hypnosis, even in haemophiliac dental patients.

A most impressive study is one in which 121 patients used hypnosedation during endocrine surgical procedures. It has become an expectation from patients who use mind-body modalities for these patients needed significantly less pain medication. Of even greater implication, however, is the fact that all surgeons in these 121 procedures reported better operating conditions (estimated by the visual analog scale), and the researchers attributed this to reduced bleeding in the operative field. Furthermore, no patients were required to convert to general anesthesia during any of the procedures.

These and other factors — high patient satisfaction, better surgical convalescence, turn beds faster, lower use of resources, fewer demands on personnel, fewer follow-up visits by physicians — reduce the socio-economic impact of patient treatment, especially in the area of in- patient surgery.

References

Rice B, Kalker AJ, Schindler JV, Dixon RM. “Effect of biofeedback-assisted relaxation training on foot ulcer healing.” J Am Podiatr Med Assoc 2001 Mar;91(3):132-41.
Moore L and Kaplan J. Hypnotically Accelerated Burn Wound Healing. Am J Clin Hypn 1983 Jul;26(1):16-9.

Moore LE, Wiesner SL. Hypnotically-induced vasodilation in the treatment of repetitive strain injuries. Am J Clin Hypn 1996 Oct;39(2):97-104. Casiglia E, Mazza A, Ginocchio G, Onesto C, Pessina AC, Rossi A, Cavatton G, Marotti A. “Hemodynamics following real and hypnosis- simulated phlebotomy.” Am J Clin Hypn 1997 Jul;40(1):368-75.

Enqvist B, von Konow L, Bystedt H. “Pre- and perioperative suggestion in maxillofacial surgery: effects on blood loss and recovery.” Int J Clin Exp Hypn 1995 Jul;43(3):284-94.
Lucas ON. “The use of hypnosis in hemophilia dental care.” Ann N Y Acad Sci 1975 Jan 20;240:263-6.
Meurisse M. Faymonville ME, Joris J, Nguyen Dang D, Defechereux T, Hamoir E. “Service de Chirurgie des Glandes Endocrines et Transplantation, Centre

Hospitalier Universitaire de Liege, Belgique.” Ann Endocrinol (Paris) 1996;57(6):494-501.

Haemophilia

Study 1: Suggestions Reduce Blood Loss in Surgery
Preoperative Instructions for Decreased Bleeding During Spine Surgery
http://journals.lww.com/anesthesiology/Citation/1986/09001/Preoperative_Instructions_for_Decreased_Bleeding.244.aspx

Results: Those who were given preoperative suggestions for the blood to move away during surgery – so the body could conserve blood – lost significantly less blood than those in both the control and relaxation groups.

Notes: Ninety-two patients who were scheduled for spinal surgery were randomly divided into three groups. One served as the control, the second were given suggestions for relaxation, while the third were given preoperative suggestions that the blood would leave the area where the surgery was to take place at the start of the operation and then remain away until it was complete. This third group was also given suggestions about the importance of blood conservation. The authors note that generally blood loss during surgical procedures can vary wildly between different patients and is unpredictable. For certain types of surgeries, this blood loss often requires transfusions. Giving preoperative suggestions about decreased bleeding could help with these issues.

Anaesthesiology, Sept. 1986, Vol.65 A246
By: H. L. Bennett, Ph.D., D. R. Benson, D. A. Kuiken, Dept. of Anesthesiology and Orthopedic Surgery, UC Davis Medical Center, Sacramento California

Study 2: Case Study – Hypnosis to Treat Gastrointestinal Bleeding
Hypnotic Control of Upper Gastrointestinal Hemorrhage: A Case Report
http://www.tandfonline.com/doi/abs/10.1080/00029157.1984.10402584?journalCode=ujhy20

Results: After treatment with hypnosis, the patient (who was suffering from upper gastrointestinal tract bleeding) was discharged from the hospital without the need for surgical intervention.

Notes: This paper presents the successful treatment with hypnosis of a patient with upper gastrointestinal tract bleeding. After treatment, the patient was discharged from the hospital without the need for surgical intervention.

American Journal of Clinical Hypnosis, Volume 27, Issue 1, 1984
By: Emil G. Bishay M.D.a, Grant Stevensa and Chingmuh Lee, UCLA School of Medicine

Hemophilia Disorder Disease Word in Blood Stream in Red Cells

Study 3: Hypnosis Helps Hemophiliacs Avoid Transfusions, Decreases Risk of Other Health Problems, and Increases Quality of Life
The Use of Hypnosis with Hemophilia
http://www.ncbi.nlm.nih.gov/pubmed/1289965

Results: The hemophiliacs using hypnosis realized a reduction in the need for transfusions, which results in a decrease in the development of inhibitors, less potential exposure to dangers such as the AIDS virus and a lower incidence of liver and kidney damage. A decrease in the frequency and severity of bleeding episodes results in less morbidity and better coping in the face of HIV infection. Self-hypnosis has provided many bleeders with increased feelings of control and confidence and improved the quality of their lives.

Notes: The Colorado Health Sciences Center’s program to treat hemophiliacs using hypnosis is described.

Psychiatr Med. 1992;10(4):89-98
By: W. LaBaw, University of Colorado Health Sciences Center, Denver

Study 4: Hypnosis for Hemophilia Dental Care to Decrease Bleeding
The Use of Hypnosis in Hemophilia Dental Care
http://onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.1975.tb53358.x/abstract

Results: This paper discusses how hypnosis can decrease bleeding during dental care and lower the anxiety of hemophiliacs about dental procedures.

Notes: The author describes the experiences of a dental clinic that uses hypnosis for hemophiliacs undergoing dental surgical procedures.

Ann N Y Acad Sci,1975 , 240;263-6, Volume 240
By: Oscar N. Lucas, University of Oregon Dental School

Hypnotic blood flow control

Study 5: Hypnosis to Reduce Blood Loss in Maxillofacial (Neck, Head, Jaw, etc.) Surgery
Pre and perioperative suggestion in maxillofacial surgery: Effects on blood loss and recovery
http://www.ncbi.nlm.nih.gov/pubmed/7635580

Results: The patients who received hypnotic suggestions were compared to a group of matched control patients. The patients who received preoperative hypnotic suggestions exhibited a 30% reduction in blood loss. A 26% reduction in blood loss was shown in the group of patients receiving pre- and perioperative suggestions, and the group of patients receiving perioperative suggestions only showed a 9% reduction in blood loss.

Notes: The basic assumption underlying the present study was that emotional factors may influence not only recovery but also blood loss and blood pressure in maxillofacial surgery patients, where the surgery was performed under general anesthesia. Eighteen patients (group 1) were administered a hypnosis tape containing preoperative therapeutic suggestions, 18 patients (group 2) were administered hypnosis tapes containing pre- and perioperative (note “perioperative” generally means the time of hospitalization until discharge) suggestions, and 24 patients (group 3) were administered a hypnosis tape containing perioperative suggestions only. Groups 1 and 2 listened to the audiotape 1-2 times daily for the two weeks before surgery. The audiotapes provided therapeutic suggestions for improved healing, less bleeding, lower blood pressure, and faster recovery. The audiotape was 17 minutes in length. During surgery, group 2 also heard an audiotape, which contained similar positive therapeutic suggestions.

Int J Clin Exp Hypn. 1995 Jul;43(3):284-94
By: B. Enqvist, L. von Konow, H. Bystedt, Eastman Institute, Stockholm, Sweden

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