Alleviate Pain and Anxiety by Avoiding Negative Suggestions

Ever noticed that your back starts to ache when you’ve been sitting in one position for too long? Or does the thought of giving a presentation to your boss fill you with worry?

Chances are, these feelings of discomfort or anxiety might not have crossed your mind until this very moment. It’s fascinating how language has the power to shape our experiences.

In the context of healthcare, there is something called Negative Suggestions. These are statements that predict an undesirable experience, such as “this is going to hurt” and “this will sting”. Our research has shown that when patients are exposed to such negative suggestions, or qualifiers like “little” or “not much”, their levels of pain and anxiety increase. Even well-intentioned follow-up comments like “that wasn’t so bad?” can make one feel uneasy.

How can we handle these situations differently? One approach is to use a more neutral tone and stick to factual statements. Instead of saying, “This might hurt a bit,” you could say, “I’m going to place your IV now.” And if you’re administering local anesthetics, consider throwing in a positive suggestion like, “I will give you some numbing medicine”.

“Providing options” is another effective strategy, especially when incorporating a slightly confusing element in your sentences. For example, before injecting something, you could say, “you might experience a sensation of warmth or coolness, and some individuals even describe it as a delicious tingling feeling”.

Lastly, you can use indirect language. Instead of “you WILL experience”, replace it with “you MAY OR MIGHT experience.” This avoids making promises regarding something you have no control over, while still acknowledging that patients have the right to their own experiences.

 

Now, let’s do a little exercise.

Which statement below do you think will produce the LEAST amount of discomfort when placing an IV?

A. It will only be a little prick and a burn.

B. Let me know when it hurts.

C. You may feel some coolness from the alcohol swab.

D. You are not afraid of needles, are you?

 

Correct answer is C.

 

Reference:

Lang EV, Hatsiopoulou O, Koch T, Berbaum K, Lutgendorf S, Kettenmann E, Logan H, Kaptchuk TJ. Can words hurt? Patient-provider interactions during invasive procedures. Pain. 2005 Mar;114(1-2):303-9. doi: 10.1016/j.pain.2004.12.028. Epub 2005 Jan 26. PMID: 15733657.

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