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58
ERIC
P.
SIMON
AND
MONIQUE
M. CANONICO
LeBaron, 1982),and self-reportedpain (Ellenberget al., 1980;Katz et al.,
1987;Pinnell
&
Covino, 2000;Wall
&
Womack, 1989;Zeltzer
&
LeBaron,
1982)during bone marrow aspirations
(BMA)
in pediatric patients. Fur-
thermore, hypnosis appears to be
an
effective treatment for reducing
self-reported distress (Kellermanet al., 1983;Zeltzer
&
LeBaron, 1982)
and decreasing self-reported pain (Wall
&
Womack, 1989; Zeltzer
&
LeBaron, 1982)during
LPs
in pediatric patients.
Thisliteraturebase provides a variety of hypnotic techniquesused for
the pediatric
LP
patient. These techniques certainlycould be applied to
an adult needle-phobic patient, who may otherwise be especially sus-
ceptible to a very uncomfortable experience and lack the resources to
cooperatesufficientlywithmedical procedures that arevital tohis or her
ongoing medical care. For instance, Katz et al. (1987)suggest using the
followingduringhypnoticpreparation for a difficultmedical procedure:
discussion of the child’s medical history, rapport development, active
imagination targeted to the child’s specific interests, muscle relaxation,
hypnotic induction using eye fixation, and hypnotic suggestions. The
hypnotic suggestions incorporated distraction, developing a sense of
self-efficacyand mastery over affectiveand sensory experiences, refram-
ing
of sensory experiences, pairing medical procedures with positive
affect, and posthypnotic suggestions for resuminghypnosis quickly and
deeply during the medical procedure. Other hypnotic techniques that
have been suggested include: using a pain switch (Kuttner et al., 1988);
interweaving an imaginary story line with coping suggestions and pro-
cedural information (Kuttner et al., 1988); glove anesthesia (Ellenberg
et al, 1980);mind/body dissociation(Ellenberget al., 1980;Kuttneret al.,
1988);and time distortion (Ellenberget al., 1980; Kuttner et al., 1988).
THENEEDLE-PHOBIA
LITERATURE
Turning to the literature on using hypnosis to treat needle phobias,
several authors (Channon, 1983;Daniels, 1976;Heap, 1984;Kraft, 1984)
have suggested using hypnosis as
an
adjunct to systematicdesensitiza-
tion for the treatment of needle phobias.However,in thepresent case the
medical urgency did not provide the luxury of time necessary to take a
longitudinal history or to establish
and
work through the more usual
hierarchy of fears (Wolpe
&
Lazarus, 1966) over extended visits
(Tumage
&
Logan, 1974).Cautela (1966)recommends using direct
sug-
gestions and scene visualization for the hypnotic treatment of phobias.
Along these lines, Dash (1981)recommends using safe space imagery, a
technique alsoshown tobe effectivefor adultsundergoing other uncom-
fortable medical procedures (Simon, 1999). Finally, in a review of the
hypnotic treatment of phobias,McGuinness(1984)suggests that, in part,
“the success of behavioral hypnotherapy can be attributed to enhanced
abiiity to relax
and
produce vivid imagery as well as
to
the demand
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