This session addresses potential pitfalls in application or interpretation of the Comfort Talk® encounter and how to avoid them.
When Hypnosis is Not Appropriate
Although Comfort Talk ®, including guided self-hypnosis, is helpful and safe for most patients, it is inappropriate in some circumstances.
Legal cases. Do not use imagery or formal hypnosis with victims of violence or those who may need to go to court and identify the perpetrators. Many states throw out testimony tainted by hypnosis. It is most important that you do ABSOLUTELY NO REGRESSION TO ANY PRIOR TIME OR HELP PATIENTS TO RE-EXPERIENCE WHAT HAPPENED. You can, instead, use breathing and relaxing techniques to help these patients.
Multiple Personalities and Psychotics. Multiple personality patients have a tough time keeping all the elements of their personality together under normal conditions; you don’t want to introduce another dissociative element. Schizophrenics are usually not hypnotizable, so there is not too much of a risk. In general, one should leave patients with florid mental disorders to the experts. Organic brain syndrome and Alzheimer’s are not contraindicated since elderly patients also benefit from Comfort Talk® as our research had shown.
How to Handle Quietude
After you have read the script, the work is basically complete. Some professionals structuring procedure hypnosis get startled when they run out of things to say. It is okay to be quiet. Just an occasional “hmmm” or “that’s right” will be all that is needed. The “that’s right” works also when things don’t go that well technically (e.g. when having a tough time to hit a vein in a screaming kid). It is very reassuring for all involved to hear that phrase of confidence.
Resist to “overwork.” The research data shows that just a short setting of expectations and reframing of thought at the beginning of the encounter or procedure are all that is needed to keep a patient comfortable.
No Need to Discard the Effects
In past trainings we found that sometimes when a patient does particularly well, personnel may conclude and express that this patient would have done well regardless. Not necessarily so. This attitude that Comfort Talk ® made no difference also undermines confidence. One has to be able to trust the patients to want to be their very best and that your guidance to help them help themselves can make a big difference.
No Room for Guilt
When a patient doesn’t indicate zero pain and zero anxiety it is not a signal to feel guilty or think you may have “failed.” Our research clearly shows that patients are still doing better than if you hadn’t offered guided self-hypnosis. Even if at the time it may not seem so, the data can give you reassurance that what you did mattered.
Best Practice
Waiting until you have a “tough” case before applying your Comfort Talk ® skill is ill advised. Waiting for the “ideal case” can also backfire and undermine confidence. It is much better to build up confidence by practicing with many patients who “seem easy.” Just because someone looks externally relaxed doesn’t mean he or she is relaxed internally and won’t benefit from support. Recall the time dependence of distress. In the end you will save so much more time by investing a little support upfront rather than waiting until a crisis develops—that will be more difficult to manage, take more time, and have greater potential to disrupt your day.
Leaving Psychotherapy to the Psychotherapists
This training does not qualify you to practice psychotherapy. The Comfort Talk ® techniques are intended for limited use of healthcare professionals to help patients help themselves. Trainees are not encouraged nor does this training qualify them to attempt any other application nor to expand any of these techniques. Under no circumstance should these techniques be applied to solve patients’ psychological problems.
In general, always avoid inviting imagery of what may seem like a great time in the patient’s past—that experience may have been shaded by a traumatic incident. Therefore, it is also essential that one always anchors a patient in a safe place when using imagery and never attempts age regression.
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