"DRAWINGS FOR PATIENT OUTCOME"
"EMERGENCY ROOM HYPNOSIS"
ALBERT C. BOTTARI, Ph.D.
PART 1: HEALING ATTITUDE:
PART 2: HEALING HUMOR:
PART 3: DRAWINGS FOR PATIENT OUTCOMES:
PART 4: EMERGENCY ROOM HYPNOSIS:
PART 1: HEALING ATTITUDE:
Elaine and Al Bottari
PART 2: HEALING ATTITUDE: [Albert C Bottari, PhD, F.B.H.A. He is a diplomat of IMDHA and serves on it advisory board.] I have been a healthcare provider for more than thirty-five years and found that for the most part it has been very rewarding and stimulating. Starting out in the early 1960s as a Chiropractor and stress management lecturer (yes. in the 60s we knew about stress) I have discovered that with all the "healing modalities... HYPNOSIS is right on top of the healing chain!
All are entitled to their opinion and we have our doubts about certain things, whether it be a food that looks strange, a car that has only three wheels, or a healing modality that allows you to assist yourself in getting well.
Hypnosis is no longer the voodoo of the dark ages and when I discovered IT in the early 1970s. I thought I had found the best tool that could be used to help individuals. Most people discover hypnosis and the benefit of it either by accident, by referral from a frien,. or curiosity.My own discovery was by accident.
My office layouts have always been relaxing, calming, pleasantly aromatic, temperature controlled (68- 70) with real plants and flowers and soothing music. While caring for a certain patient.
I noticed that she would always become very calm as soon as she entered the room and upon lying down on the table, she would inhale and slowly exhale and relax. I asked her what she was doing and I was told, "Coming here is coming to one of the most tranquil places I can be, and then I go to my place and into trance." The time was right for me to learn about this TRACE state and what hypnosis was all about. Thirty years later I’m still learning what IT is all about.
In 1983 I was told that I had cancer of the bladder and needed surgery, chemotherapy and radiation therapy to cure me. The crepe hanger were allover the place. I was told to get my affairs in order and that certain aspects of my life were basically over as I knew them.
Now, who gave these people the authority to dictate my future is unknown; however I decided that I was in control of me and no one else! I had surgery to remove the bladder tumors by a second rate urologist. but one who had the attitude I liked - not the crepe hanger - and I came through great. That night I heard that Dr. Bernie Siegal was giving a lecture at the hospital where I was a guest and decided to listen/hear him. Something about MIND/BODY/SPIRIT and its impact on healing. After the lecture I spoke to Dr, Siegal and that began my commitment to this healing modality HYPNOSIS.
I have NEVER had the chemotherapy or radiation therapy and I REFUSED - to have cancer in my body ever again.
I opened my practice exclusively in hypnosis/hypnotherapy and began my career in this wonderful profession. My education never ceases and boredom never enters my thought process.
In 1991, I founded the New York State Hypnotherapy Association.Inc.. (NYSHA) dedicated to the practice of hypnosis in the State of New York. With three hundred members, we are the only state to have special custom plates within the Department of Motor Vehicles Professional License Plate division identifying our profession. NYSHA is actively involved in the regulation of hypnotists in the state with a pending Registration Act that will mandate the educational hours for registration as well as Continuing Education Units. A great deal of time and effort continues to go into this endeavor.
In 1993 I developed a form of rectal bleeding that was diagnosed by X-Ray as malignant polyps and once again the crepe hangers came out of the woodwork. I informed my surgeon that I have steadfastly refused to have cancer in my body, so these polyps were benign and I refused to sign for a colostomy. In the recovery room my surgeon and pathologist woke me with the news. "You S.O.B., your polyps are benign." They wanted to know how I did it. The issue is that I chose not to have cancer anywhere in my body and have made that a part of my belief system and immune system. I never spell cancer with a capital C. because it is not capital to me. It was discomforting and a dis-ease for a short period of time in my life. No More!
I did ignore other symptoms and as a result I developed a sinus tachycardia. Once again I decided to take control of me. My first cardiologist couldn’t relate to me. My new cardiologist is incredible. He listens!
After three years of medications. I made the decision, with my cardiologist, to have a Pacemaker implant and ablation (radio wave therapy) procedure performed to regulate my heartbeat. Thanks to the prayers of so many people. words of wisdom from Chaplain Durbin, Father Many, Drs. Anne and Jerome Beacham. The Otto's and all the rest of my colleagues, I have recovered 99% and am striving for the other 1%.
Some people get up in the morning and say TGIF or TGIM (Monday - for workaholics) "I say TGIT or Thank God it’s today."
I make a choice every day to get up happy and smile and say Thank You Lord for another day. regardless of the temperature or weather inside or out. We are have the same choice. I choose to be happy, loving, caring, helpful and good. You have the same choice.
Surround yourself with people who believe as you do. These are the ones with a POSITIVE ATTITUDES. who will lift you up when you stumble. You can rely on them completely.
PRAY, any way you wish to and to whomever you wish to. The MIND/BODY SPIRIT is not a ghost who vanishes or who is to be called upon only when needed: but the MIND/BODY/SPIRIT is the SOUL of everything. It makes you Who you are.
PEACE, HAPPINESS, LOVE, CHARITY, HOPE and FORGIVENESS = YOU.
PART 2: HEALING HUMOR:
[Albert C Bottari, PhD, F.B.H.A. He is a diplomat of IMDHA and serves on it advisory board.]
PART 2: HEALING HUMOR: Humor is defined as, "something that is or has the ability to be comical or amusing and in the physiological definition it is fluid contained in the body such as blood or lymph." What better way to help heal anyone then by getting their own body to react to the healing process by engaging the blood and lymphatic systems.
In California there is the American Association for Therapeutic Humor or AATH. Its President Steve Sultanoff, is a psychologist and feels that Humor changes our emotional state, our perspective on life and, through laughter, our physiological state. This is NOT a new idea because in the Bible it states "A merry heart doeth good like a medicine".
A recent movie starring Robin Williams called "PATCH ADAMS" is a true story on the life of a physician who defied medical gravitas for three decades to make patients laugh. Within the confines of healing there are NO confines. We make our walls, close our own doors, shut our own windows and laughter is usually the farthest idea in our mind, especially when we don't feel well. The severity of the illness, whether it be heart disease, cancer, diabetes, hypertension or terminal athletes foot is NOT relevant. The mind, body, spirit reaction and yourself are the only things that can make YOU happy. Listening or seeing something really humorous can do many things for you. The image you portray with your patients can be the difference between healing or hindering their recovery.
How many of you can recall the episodes of Candid Camera and the talking mailbox or the plant that would not stop watering the person watering it or the new job applicant interview when the applicant was told to hold a ridiculous pose or Lucille Ball in her famous wine making scene crushing grapes with her feet? It has now been proven what many of us have known for years that humor really heals in the following ways:
Provides exercise by increasing heart rate, stimulating blood circulation and breathing and improving muscle tone. You can double your heart rate by watching a Laurel and Hardy movie. It has been calculated that 100 laughs equal 10 minutes on a rowing machine. It's called "inner jogging";
Reduces pain, by firing the release of endorphins, the body's natural painkillers. Laughing reduces the amount of medication and shortens recuperation time. Reduces stress by lowering levels of cortisol, a stress hormone tha weakens the immune system. Stimulates the immune systems by increasing the interferongamma hormone that fights viruses and regulates cell growth. Stimulate mental functions such as alertness and memory by raising levels of adrenalin and other chemicals that prepare the body for action.
CANCER CARE AND OTHER DIS-EASES: In dealing with cancer patients or others who may have a catastrophic disease or dis-ease and their respective families therapists must be sure that their own mental attitude towards the diseases wholesome. Therapists MUST learn to listen to the patient and then the family and must NOT put into the session any of their own negative thoughts.
In PAIN MANAGEMENT COURSES one of the first principles taught is to allow the patient talk out their feelings and for the therapist to listen. Have the patient draw on white paper with different color crayons or markers and indicate on a scale where their pain is, was or had been. Drawings give great insight into the patients feelings, pain or direction for their future management.
NEVER say, "I know what you mean and what you are going through", UNLESS you have been there. "Been There and Done That", ONLY works if it is true ! If a patient no longer feels comfortable with you or feels that you can't be "trusted" because you told an untruth, assist them in getting them another therapist.
Dr. Judy Goldblum wrote a book called "101 Fun Things To Do When You Lose Your Hair". Once children and adults can make fun of what they're most afraid of, they're more in control. Laughing about your illness is a stimulus that is much better than crying. Actually crying is really laughter but laugher uses less muscles.
There are several groups throughout the United States that utilize humor in one form or another. In Florida, Leslie Gibson, a nurse directs the Comedy Connection and says that more than 60% of her patients report decreased pain and actually enjoyed their hospital stay. In general however, doctors are less inclined to use humor, because most of them have "white coat syndrome" and stiff shirts with ties. Nurse and other professionals use all their talents. In physician medical circles the concept of therapeutic humor is progressing very slowly, because HUMOR does NOT have NAME! Something that helps heal people MUST HAVE A NAME that is difficult to pronounce or it AIN’T gonna work! The concept of being silly is counter to everything they have "LEARNED" in medical school. Patients must take their disease or dis-ease seriously. If physicians aren't serious they may risk being called incompetent, unless your like Clifford Kuhn, M.D. who joined with Jerry Lewis and started teaching humor in 30 medical schools. Dr. Kuhn says "you don't even have to tell jokes, just concentrate on having FUN.
My whole pitch in dealing with patients who are ill, is to get them back in touch with their sense of humor. It is one of the most powerful healing resources. It doesn't cure anything that I know of, but it does GREAT things for the immune system and stress levels in the body. We are Sitting on a gold mine, H U M O R, let's NOT suppress it. It is the responsibility of the Healthcare Practitioners, the nurses, the doctors and all allied healthcare givers to entertain and amuse the patient while God does the healing.
PART 3: DRAWINGS FOR PATIENT OUTCOMES: THE USE OF DRAWINGS TO IDENTIFY MIND, BODY AND INTERACTIONS:
Albert C. Bottari, Ph.D., F.B.H.A.
85 - 34 104th Street #C
Richmond Hill, New York, 11418
Since time began drawings have been used to explain, to record and to tell others events, feelings, prayers and thoughts that the drawer is communicating. Understanding ourselves is very much like an iceberg where only one third of is can be seen because the rest is submerged below the water. Like an iceberg, there is a great deal of information about ourselves that is submerged in our subconscious mind.
Dr. Susan R. Back, a London analyst who studied with Dr. Carl G. Jung, initiated an approach using drawings and colors to help patients get in touch with their subconscious or inner voice. She experienced that spontaneous drawings created by an individual could help them identify that total of mind-body interaction, especially at critical moments in their life.
Dr/ Bernie Seigel, an internationally known surgeon and ECaP (Exceptional Cancer Patients) founder and Carl Simonton are using this approach with their terminally patients. They find that these drawings can build a bridge between the doctor and the patients, the family and the surrounding world. The meaning of spontaneous drawings can guide health care professionals to assist critically ill patients to live as near their essential being as possible, whether in recovery, remission or before the patient's life transfer to the light.
The help the patient create a meaningful drawing, the following instructions are given: On a piece of paper positioned vertically draw a picture of yourself and draw a picture of your illness and your treatment. On a piece of paper positioned horizontally, draw a picture of any scene that comes to mind. Provide the patient with a box of crayons that include colors, including white and encourage them to take as much time as necessary to complete the drawings. The drawings are then analyzed in terms of spatial representation and colors used.
A PICTURE OF YOURSELF:
SPACE: How much of the page one uses for the figure of self can indicate how they feel about themselves. The larger the size of the picture represents a higher sense of self image and self esteem. Generally the larger the picture, the better they feel about themselves. A tiny picture may indicate that the person is feeling small, shy or insignificant.
DIRECTION: Thing that point or are moving toward the LEFT or WEST could be considered to indicate a negative or backward direction. The word left comes from the Latin word "sinister" or "sinestra". If something is on the left or held in the left hand the message may be that the person does not like what is going on. Left may also be represented as the West because the sun sets in the West and darkness comes soon. Things that point to or are moving to the right or East can indicate a positive message, as the sun rises in the East and light will come soon.
BODY PARTS: The more body parts drawn the better. This may show that the person has more of a complete image of him or herself and will share that with the world. Individual body parts each convey their own message.
HEAD: The size of the head in relation to the rest of the body can show the degree that one is intellectualizing or thinking about things. A large head may indicate that one is dealing with life through intellectual methods. The head facing right can indicate that one likes what is going on. The head facing left may indicate negative feelings or dislike for what is going on. A head with no body probably indicates that a fully intellectual approach is being used and that one may be denying feelings or the body, or that they do not wish to think about their body right now.
MOUTH: Many depressed people draw smiles on their face. This may mean that they are only smiling for the public or are hiding their true feelings. Note whether the mouth is smiling or frowning.
EYES: What direction are the eyes looking towards? Forward looking eyes may mean that the patient is facing up to things. Eyes looking left may indicate that they do not like what they are seeing. Eyes looking right may show that they are expecting a brighter future. Eyes that are drawn bigger/larger than one would expect may indicate that the individual is "seeing" much more or is visually oriented.
NOSE: The nose can be a sign of breathing in life giving energy and getting sustenance and care. No nose may mean that a person is feeling stifled or unsupported.
NECK: A narrow neck can mean feelings of fragility and vulnerability. A thick neck may show that one feels they can handle the situation or problem.
SHOULDERS: Broad shoulders may mean carrying a heavy burden or able to handle a heavy load. Narrow or rounded shoulders may indicate that the burden is heavy or is just rolling off the shoulders. Rounded shoulders may also indicate that the person has learned to "shed" some to burdens of every day life.
ARMS: Arms in an open, outstretched position may indicate emotional vulnerability. If the arms are in different positions, it may indicate ambivalent, mixed or undecided feelings. No arms can indicates a feeling of helplessness. Arms drawn parallel with the sides of the body may be considered to be in a neutral position.
HANDS: Hands indicate action and independence. No hands may indicate a feeling of helplessness or not being able to take any action. A hand or arm going off the page can indicate that the person is reaching for something and can't seem to "grab it" at this time.
LEGS: Legs often indicate movement or independence. No legs may mean a helpless feeling or feelings. Legs going off the page and not continued on the other side can indicate feelings of being "stuck" in a situation or stuck with a "problem".
FEET: Feet represent movement, mobility or travel. No feet can mean no movement, no ability to move out of a situation. Feet pointing in the same direction may mean that one knows where they are going, (left negative, right positive). Feet going in two different directions may mean indecision and uncertainty. Feet on the ground can mean a feeling of being secured and grounded. Feet not on the ground may indicate a sense of not being grounded or "floating around". The larger the size of the feet, the more the patient may be thinking about movement, mobility or travel.
BODY PROPORTION IN RELATIONSHIPS TO OTHER PEOPLE AND THINGS ON THE PAGE: Size indicates how important something is. The bigger the size of any given object on The page the more important is it. THE BODY MAY BE LARGER THAN OTHER OBJECTS IF IT IS THE MOST IMPORTANT ASPECT OF ONES SELF. Other objects may be bigger if the body is NOT important. Proportional closeness of objects indicates support or other ties. Things that are drawn touching are strongly linked.
COLORS: Colors can indicate many different messages and feelings as they are used in a picture of one's self or in a scene.
RED: Unless something is normally colored red such as apples, a valentine heart, blood, etc., it usually indicates strong feelings, danger, hurt or pain. Diseases are often drawn in red.
BLACK: Black can indicate grief, sadness, or depression. A body drawn in black can mean extreme depression. Black shoes may mean sadness, depression or that one dislikes what is going on at the moment.
ORANGE: Orange generally indicates change but may sometimes mean an accident or "dream-like" behavior of something about to happen.
WHITE: Drawing with a with a white crayon or paint like material on a white piece of paper may mean that the person is hiding something that needs to be uncovered.
PURPLE: Purple may reveal possessiveness, something of a spiritual nature or communication with ones Devine belief system or religious experience.
YELLOW: Yellow is considered energy, supporting or life giving.
BROWN, GREEN AND BLUE: These are "healthy" colors that seem to say "all is well here".
WHAT YOU CAN LEARN FROM THE DRAWING OF A SCENE: A scene can be analyzed using all of the above indicators as to size, spatial relationship and colors. In addition, the scene can also indicate a time component and evaluate the person drawing the scene in terms of the individual characters/pictures included in the scene. (animals, trees, water etc.).
TOP LEFT INDICATES: FUTURE
TOP RIGHT INDICATES: PRESENT
BOTTOM LEFT INDICATES: INDICATES VERY NEAR FUTURE
BOTTOM RIGHT: PAST
The time component to a representative felling can be identified by observing here a major or significant figure is drawn as outlined in the above diagram. Individual elements of the scene can provide further messages from the subconscious mind.
OBJECTS: What is in the scene? A prominent or larger object such as a mountain, tree, plant or animal may represent the person drawing the scene. Look for what the object is doing or saying to other objects on the paper.
SUN: The sun usually indicates support and life giving energy. It may also represent the person's family or friends or may symbolize a death or represent changes. Sunrise may also mean a new life.
WATER: Water can indicate the persons life situation. What is the water doing? Is it moving or standing still? How important is it in the drawing? Is it small or a large body of water and what is in it?
VEHICLES: Cars, roller skates, trains, ships, bikes, airplanes, bikes or other things with wheels indicate travel, mobility, independence or movement in life. Which direction are the vehicles heading? What color are the vehicles and who is "driving" the transportation source?
THE NUMBER OF OBJECTS IN THE DRAWING ARE VERY SIGNIFICANT. Count the number of objects and the individual objects that are part of a nomogeneous larger picture. For example, cont every ray of the sun, every apple on the tree or peaks on a mountain. The individual parts of a larger object often represent people in a family or group.
PEOPLE AND ANIMALS: Who are the people and animals in the picture? What are they doing? What colors are they wearing or what colors are they? Are they touching? Look to see how big they are, which way they are going or how far away they are in the drawing.
HOUSES: When a person draws a house, it can be symbolic of their life or home. The larger the house the more positive the symbol. Doors and windows show a healthy feeling and the lack of windows or doors may mean that the person is feeling left out, locked in or trapped in some way. A chimney means sustenance, life giving energy, breathing and warmth. See if there is smoke coming out of the chimney. No smoke may mean that the Person has been feeling a lack of warmth or support.
DETERMINE IF YOUR ANALYSIS OF THE DRAWINGS ARE CORRECT: After you have examined the drawings and noted your own thoughts, put your observations aside and ask the patient to explain what their drawings means to them. How do the various parts of the drawing relate to their own private life? What meaning can they give you about the drawing?
Discuss your observation and gently explore if your observations are relevant to what the patient is seeing in the drawing or themselves or a scene. Mutual sharing, respect and understanding allow the drawings to have meaningful significance and paint new pictures of health, worth more that a thousand words, because they were messages from the patients subconscious mind.
PART 4: EMERGENCY ROOM HYPNOSIS:
Albert Bottari teaches a class.
We hypnotherapists have one of the greatest "tools" to help mankind in so many ways. The tool is hypnosis. However in order to understand our profession and invoke the trust of others into our fold we must teach, be taught, learn to listen and continue in our pursuits of education.
Emergency Room hypnosis is not for everyone and definitely not for the "squeamish" or weak of heart individual. In the ER you will encounter patients and their loved ones, that are hurt, in pain, bleeding, fractures, lacerations and associated injuries. You must be able to control yourself, emotionally and physically to care for your "charge". Taking care of your charge may include giving support to the family of an expired patient so you must be trained in giving such counseling. You will be called to do your best in assisting with the care of the patient, once you have established yourself.
In order to obtain the referral patterns we all need for our client/patient base, we must establish a rapport with the facility its doctors, nurses, social workers and other care givers. You will not get this rapport if you don't know what you are doing and be assured you will be "tested" along the way by various individuals. That is why education and belonging to professional organizations like the IMDHA is very important to you, your client/patient and your referral source.
Although we are becoming a recognized modality in the healing professions we are still living in the shadow of the "Manchurian Candidate" and of the stage hypnotist.
In the ED you will NOT have the time for a "progressive relaxation" induction, you will have seconds or at best minutes to induce a client/patient into a comfortable trance-like state so treatment may begin. Once again, education and training will enable you to sharpen your skills at rapid induction.
Emergency Room staff have NOT been trained to deal with professionals who are not physicians, nurses etc., and are therefore skeptical to call a hypnotherapists to assist in caring for an individual who would benefit from their intervention. You must earn their trust and "talk-the-talk". You must know medical terminology and anatomy. Buy a book, go on the internet, better still take a course on the subjects. If you do not know what "they" are talking about , "they" won't refer to you, trust you or involve you in the course of treatment.
You will be called upon to exercise your competence in pain management, blood flow reduction, bereavement counseling, cardiac flutter management, reducing blood pressure, child birthing, crisis management and intervention, forensic hypnosis with crime victims and follow up criteria.
In order to establish yourself within the referring medical community, you must be competent and professional. Your education and the continuing of your education is the key to gaining "acceptance" as the HYPNOTHERAPIST in your facility, hospital, ambulatory surgery center and community.