The entire thrust of whatever therapeutic approaches are cited and reviewed in this series of blogs has been to demonstrate credible and viable ways of reinforcing patients’ ability to cope. Yet again, “Rome was not built in a day”. Nevertheless, it was built and by adopting – and where necessary adapting – simple but readily available methods and strategies, as outlined in these pages, you can and you will not only cope but continue to grow in confidence and inner strength.

Hypnotherapy has been and can be widely employed to manage anxiety state, reactive depressive episodes, phobic responses and pain. However, nowhere is the above point better and at times, more dramatically made and demonstrated than in the successful application – self or otherwise – of hypnotherapy, using what has become known as the “ego- strengthening” routine. Once the patient/subject has settled ‘into his/her ‘work’ and is comfortably sensitized and thus increasingly responsive, ego-strengthening can begin. In reality, it amounts to the delivery of a sequence of simple suggestions for the relief of tension, apprehension, and feelings of unease and vulnerability. My erstwhile mentor referred to in the previous blog used to refer to it as “strengthening the ‘inner man’”. “Ego-strengthening” also makes liberal use of what is sometimes referred to as post-hypnotic suggestion: i.e. not just· “you’re thinking is becoming comfortably paced and in that sense measured and pleasantly achieved”; “you are becoming increasingly relaxed and at peace with the world” etc., etc. but “your thinking will continue to be comfortably paced and measured…”“you will continue to feel relaxed and at peace with the world…” “You will…” “You will…” “You are going to…” (if you see what I mean).

This ability to shape, manage and control one’s thoughts and feelings by means of future projections concerning our on-board resources in this way is surely one of the most fascinating, exciting and rejuvenating experiences that anyone can undergo. Moreover, it becomes increasingly self-evident that such achievements are indeed the product of one’s own resource, since it is now – let us say – the day after therapy and the clinician/therapist who helped to plant them in the first place, has long gone. Yet you are continuing to experience such projected feelings of greater control (an example of post-hypnotic suggestion at work). Now let me use the remainder of this blog to draw together all and any loose ‘edges’ contained in the last four blogs and this I intend to do in the form of three fairly typical case histories of applied hypnotherapy.

One evening I was walking out through the main doors of the Beatson Oncology Centre, Glasgow, when one of the unit’s ward sisters – still on duty at around 10pm – called me from the stairway above. She had a young man in his early twenties on her ward with advanced testicular cancer. Earlier that day he had received radiotherapy and during the course of the evening had been given quite powerful analgesics (pain killers) together with a tranquillising drug but seemingly, all to little or no effect. Apparently he had been anxious and restless all-day but now, as night fell and was ‘bearing in’ on him, matters were building up to a crescendo of fear, frustration and distress. His girlfriend, who had been with him for part of the evening, was now sitting in sister’s office in ‘floods of tears’, having been ‘ordered out’ of his room by him earlier.

More often than not, a problem i.e. through surprise and of alarm, can actually be further created, where one is introduced to such a patient so late in the evening. Consequently, I decided and agreed with sister to keep my raincoat on with briefcase in hand, whilst just happening to look in through his window on my way down the central corridor of the ward. As I did so, there he was, in a kind of semi-lotus position on the bed, head in hands. I gently tapped then opened the door saying, “I was just on my way out when I noticed you through the window. Are you all right fella?” At that moment I discovered that I had seen him at another hospital way back when times were better and seemingly we had got on rather well. Fortunately he recognised me, murmuring softly through his distress, “I really need help”. Placing my coat and bag on the chair presumably vacated by his girlfriend, I sat down on the side of the bed. He told me that he “ached all over” and was still experiencing a “pressure and throbbing” pain in his lower abdomen. Again and again he said to me, “I’m scared”, and inquired through his distress, “what’s happening to me?”

After about 15 minutes, he calmed somewhat and I managed to persuade him to lie back in a more rested position. Gently diverting his attention to his rhythm of breathing, I began to describe an area known to both of us from “fishing days” in the Clyde Valley. Once calmed in this way, I took his right hand in mine, explaining as I did so that I was going to exert gentle then gradually increasing pressure on his right hand. I further suggested that to save him from having to speak, he might, with the movement of the first finger on his left hand·, indicate to me when the sensation of pressure on his right hand approximated to the sensation (I carefully avoided the word pain) of pressure in his lower abdomen. (Incidentally, if you try this yourself, i.e. with one hand on the other, you will find that you are able to bear considerably more pressure than ever you might, were that pressure being exerted by another and over whom you had not the same degree of control. In this very simple manner, you will be able to demonstrate to yourself how loss of control and its associated fear can markedly change your threshold for pain via its anxiety component). I didn’t of course go into all that detail with my patient on the night in question, simply assuring him that at the first sign of movement of the second finger on his left hand· indicating that he wished to discontinue, I would instantly release my grip.

Gently but firmly – and increasingly – I applied pressure to his right hand and after just a few minutes, the first finger of the other hand twitched. I continued to talk softly, repeatedly ‘suggesting’ to him that as I slowly released the pressure on his hand, so the feeling of pressure in his lower abdomen would also begin to remit. I repeatedly referred to the likelihood that he would begin to feel pleasantly tired and would that night experience comfortable and relaxing sleep. I also included certain elements of “ego strengthening” and took a few extra moments to show him how, by making a fist and relaxing it, he could begin to gain control over his pain.

Before I left, his girlfriend – now calm and composed – was by his side as he gently drifted into restful sleep. I learned the following day that he had in fact slept until around 5:30am (once again, note the possible influence of post-hypnotic suggestion) and to cut the rest of the story short, his newfound skills – not mine but his – stood him in good stead for days yet to come. (C) (SB)

*Read italicized words on this page only, in a slow and measured way, repeating then if you wish. Fill the gaps if you want to with what is appropriate, e.g. “you will feel increasingly at ease within”. “you are going to remain calm and inwardly controlled” if you get the idea.

• First finger movement of left hand indicated equilibrium; second finger movement meant, I wish to discontinue.