Management of asthma can be complicated by both medical and psychiatric conditions, such as gastroesophageal reflux, chronic sinusitis, and anxiety. When symptoms of asthma are interpreted without regard to such conditions treatment may yield a suboptimal outcome. For example, anxiety-associated dyspnea, tachypnea, and chest tightness can be mistakenly interpreted as resulting from an exacerbation of asthma. Medical treatment directed only for asthma may thus lead to overuse of asthma medications and increased hospitalizations.
The following case study shows how a systemic steroid-dependent patient with asthma benefited from receiving incorporating hypnosis into treatmen routine. By using self-hypnosis, the patient was able to reduce her dependence on bronchodilators. Following modification of her medical therapy under supervision of the pulmonologist, and regular use of hypnosis, the patient ultimately was weaned off her systemic steroid therapy.
The patient accepted the opportunity to be taught self-hypnosis to control her respiratory symptoms. Instruction was provided over two weeks in two 45-minute sessions by her pediatric pulmonologist who had received training in hypnosis through three 20-hour workshops.
In the first session the patient was taught to hypnotize herself by imagining that she was walking from a beach house towards the waterfront. She imagined herself lying down and relaxing. She was instructed that she could allow her body to relax whenever she touched her index finger to her thumb ("finger relaxation technique").
On the physical examination following hypnosis, her expiratory wheezing had diminished greatly. She was congratulated upon her outstanding hypnotic abilities. She was encouraged to practice hypnosis on a nightly basis, and to apply her "finger relaxation technique" several times a day. Within two weeks of daily utilization of self-hypnosis, she reported that she was able to use hypnosis instead of nebulized levalbuterol approximately half the time.
In the second instruction session the patient was shown how to develop imagery within hypnosis of a "tight airway that opens up" in order to help relieve airway obstruction. She was encouraged to utilize hypnosis as much as she thought was helpful to her. Thereafter, during the patient's follow-up visits for asthma management, the pulmonologist inquired whether she was using hypnosis. The patient was encouraged to continue its use, but was not provided with further instruction regarding how to use hypnosis. The follow-up visits occurred on a monthly basis as the patient's asthma therapy was weaned, and every 2–3 months thereafter.
After three months, she was able to wean herself completely off levalbuterol, which she had been using more than four times a day. She explained that she found the use of hypnosis to be as helpful as levalbuterol in treating her shortness of breath. Further, she reported that her bouts of shortness of breath were much less frequent than prior to the use of hypnosis.
Source: www.pubmedcentral.nih.gov