Pain Management and Enhancing Healing Protocol
Chaplain Paul G. Durbin, Ph.D.
IMDHA Fellows & Diplomats 2000: Standing from left to right - Robert Otto (Fellow), Albert Bottari (Diplomat), Retha Martin (Diplomat), Ann King (Fellow), Paul Durbin (Diplomat), and Jerome Beacham (Fellow); Sitting from left to right - Bishop Martin Patton (Diplomat), and Frank Garfield (Fellow); Not pictured - Irene Hickman (Diplomat) and Sol Lewis (Fellow)
Dr Anne Spencer: "The Founder's Award
is presented to Paul G. Durbin, Ph.D., who has unselfishly given his time and talent in promoting the purpose, objectives and expansion of
the International Medical and Dental Hypnotherapy Association. Chaplain Paul
Durbin is the first to have a door marked HYPNOTHERAPIST in the hospital setting
in the USA. He is making the vision a reality!"
(For pain management and enhancement of healing, a referral from a physician is required. I add to and take from this protocol based upon individual patient's needs.)
When the client arrives, I have him/her fill out the "Client Information" form and the suggestibility questionnaire. After determining the suggestibility of the client and discussing this with client, I continue with the session.
To began, I ask the client/patient to describe their pain. Where is the pain? How long have you had the pain? Is it sharp or dull? It is throbbing or consistent? Is it hot or cold? If there were a scale of pain with the number "1" being just enough discomfort to know that something was wrong and number "10" was the worst pain you could experience without passing out, where would your pain be on that scale between "1" and "10"? Now if your pain is at the number "8" and we can reduce it "3" or less would that be good?
One thing we know about pain is that the more relaxed you are the less you experience pain so I will teach you some relaxation techniques which help reduce the pain and will help you with suggestion and imagery to reduce the pain even further. Have you ever cut your finger and did not know it until later when you saw the blood. That is an illustration of the mind blocking the experience of pain by accident. The use of relaxation and hypnosis help you to block the experience pain intentionally and when needed.
After we have discussed the problem, continue, I would like to go over with you what hypnosis is, what it is not, and how I believe it can be helpful for you.
When we hear the word "hypnosis" we have a mental picture of what hypnosis is. Quite often our understanding of hypnosis is based upon the performance of a stage hypnotist or a movie we have seen or a novel we have read. Clinical hypnosis is quite different from that of the stage hypnotist or the image of hypnosis as presented in movies and novels.
Hypnosis is really a very common experience with each person goes through from one to many times each day. It is like watching television and becoming so interested in the program, that someone can talk to you, but it just does not register. Has that ever happened to you? Hypnosis is similar to traveling to a place you have been to before, but your mind is on something else and without realizing it you find yourself two or three blocks passed where you wanted to go.
If a suggestion were given that was against your personal or moral convictions, you would either not follow the suggestion or you would come out of hypnosis. You are in control and I am only a guide.
Some people believe that when you are hypnotized that you are unconscious, but such is not the case. You will hear everything I say and you will remember much of what I say. Even though I tell you this, when our session is over, you may think to yourself, "I don't know if I was hypnotized for I heard every word you said."
How will hypnosis help in your situation? Though we only have one mind, our mind is made up of two parts. We have a conscious part which consist of about 10% of our thinking power and subconscious part which consist of about 90% of our thinking power. It is kind of like an iceberg: only a small portion of the iceberg is about the water (our conscious mind) while the great majority of the iceberg is below the surface of the water (subconscious mind).
The conscious mind is a logical two plus two is four part of our mind. The subconscious mind is not logical. It has two purposes. It controls over breathing, pulse rate, blood pressure, heat beat, etc. and it seeks to meet our deepest needs, expectations and desires. For instance, if a person wants to reduce the experience of pain, the conscious mind says, "His words or my thoughts can not have an effect on my pain." With hypnosis, you bypass the critical factor of your conscious mind which says it can’t help and goes into the subconscious mind who works to eliminate and/or reduce the pain.
The experience of hypnosis allows you to relax. In the process tensions and pressures of the day will start to disappear. Through hypnosis, your concentration and mental alertness are heightened.
As you relax, many thoughts may pass through your mind, but that is ok. You may feel comfortably light or pleasantly heavy and there may be some tingling in various areas of your body. You are aware of being very relaxed and comfortable so that you are more likely to follow suggestion than at other time. The mind has what is called a "critical faculty." When under hypnosis, the "critical faculty" is bypassed and instead of evaluating the suggestion, the mind lets it go directly into the subconscious. When the subconscious accepts the suggestion, it begins to work to make it a reality.
In order to reinforce suggestion, I will teach you self hypnosis. When practicing self hypnosis, suggestions should be stated in positive statements instead of negative because the subconscious mind understands positive statements better than negative ones. Repeat the suggestion, repeat the suggestion in so doing, you increase the effectiveness of the suggestion. Visualization and imagery will add to the success of the suggestion and in so doing, you increase the effectiveness of the suggestion. Visualization and imagery provides the subconscious mind a model to attain. To come out of hypnosis you say to yourself that you come out of hypnosis at the count of three and count yourself out.
Do you have any questions? (If so I will discuss them with the client)
When we have completed the discussion period, I go through some suggestibility exercise to determine the clients response to suggestion and to determine the types of suggestion which will be most effective with the client. After a few suggestibility exercises, I convert one of the exercises to hypnosis. When the induction is completed, I ask the client to open her eyes and move to the recliner. I suggest that when she closes her eyes in the recliner, she will go twice as deep into this peaceful state of hypnosis. When the client is settled in the chair, I lead her through a progressive relaxation procedure and deepened the hypnotic state. Following the deepening procedures, I proceed with hypnotherapy.
It has been my policy to teach relaxation, imagery, and self-hypnosis to people with whom I use hypnosis. I believe that this helps the patient to be more independent and gives them the message that they have a influence over their life and health.
SCRIPTS USED DURING FIRST SESSION:
CALM AND RELAXED: As you lie there deeply relaxed, you can let the words "calm and relaxed" repeat themselves in your mind, slowly, softly, soothingly, over and over...calm and relaxed...each repetition of those words help you to feel more...calm and relaxed...Now let the words "calm and relaxed" flow down, out of your mind and throughout your entire body, "calm and relaxed" as if they are flowing in your bloodstream, to all parts of your body...strengthening, healing, nourishing, calming, relaxing, soothing...feeling stronger and more confident with every passing moment, with every breath that you take, as the words "calm and relaxed" flow throughout your body, feeding, strengthening, and calming your body and your mind...and realizing within yourself that you are now using your own resources to strengthen and calm yourself, enabling you to remain strong and calm even when under stress. All that I'm doing is helping you learn how to focus your concentration for your own benefit...and now that you are aware of your ability to strengthen and nourish yourself, this process can continue even when you are not aware of it,...just as an underground river continues to flow, strong and sure, even when you are standing on the ground and are unaware of it;...just as a flower continues to grow even though you can't see the growth from moment to moment...And the growth and strengthening within you continues to develop...increasing your self-confidence, self-appreciation and self-acceptance, experiencing the freedom to make health changes in your life style and the opportunity for the future to be different from the past or present as you progressively improve in all areas of your life.
DEVELOPING ANESTHESIA AS FORGETTING SHOES ON FEET, ETC.: There is a tremendous amount of learning you have acquired during your lifetime of experience in developing anesthesia throughout your entire body. For example, as you sit and listen to me now, you've forgotten the shoes on your feel...and now you can feel them; you've forgotten the glasses on your nose...and now you can feel them; you've forgotten the collar around you neck...and now you can feel it. You listen to an entertaining lecture and you forget about the hardness of the chair. But if it happens to be a very boring lecture, your chair feels so utterly uncomfortable. You sense those things. We've all had tremendous experience in developing anesthesia in all parts of our bodies. So how did you get that anesthesia for the shoes on your feet? Not because there is a drug put into the nerve; not because you were told to have the anesthesia, but because in your life long learning you have acquired the automatic ability to turn off sensations and to turn them again. Now as you begin to think about others things, your subconscious mind can block other unpleasant sensations in your body, so that you progressively feel better and better.
THE SETTING SUN PAIN METAPHOR: See yourself sitting on a tropical beach at sunset. Notice the bright red sun as it descends on the far horizon. See the colors begin to change from orange to crimson, and then a deep, dark red-orange. Notice that as the sun approaches the water, there actually seems to be two suns, one in the sky and one in the water. See the sun gradually sink into the ocean. See the colors change from red to purple and then to blue. Notice the magical stillness that pervades everything just at sunset when the ocean is as smooth as glass and sounds seem to travel forever. Enjoy the delicious feeling of tranquility. Realize that tranquility is available to you whenever you need it, on a moment's notice, merely by giving yourself your own personal signal to relax! Perhaps you might enjoy letting your finger and thumb come together to be your sign and that can be your signal to experience immediate relaxation whenever you choose to employ it.
(If client is a Christian and religious use): THE HEALING TOUCH OF JESUS: I suggest that the patient visualize Jesus standing beside the bed. Jesus places His hand on the painful area. If the painful area is a place where touch by another would be inappropriate, I have the client visualize Jesus’s hand on his/her head. I begin, "You feel the hand of Jesus on the area of discomfort. You feel that His touch is very warm and the warmth is drawing out the discomfort. Slowly but surely, the discomfort is being reduced, slowly the discomfort is being pulled from your body by the healing warmth of Jesus' hand. His touch is reducing the discomfort and bringing healing to the area."
I repeat this thought in various ways and then suggest that the physical presence of Jesus is becoming a spirit and is slowly fading from view, but they will continue to feel Jesus, His presence with them. I conclude with the therapy.
Count out of hypnosis and conclude session. Give client "Pain Management and Enhancing Healing" tape.
Update from client and continue counseling as needed.
SCRIPTS USED DURING SECOND SESSION: (Changes in scripts depending on the counseling situation with client.)
20 DOWN TO 1 -- INDIRECT INDUCTION:
THE YARDSTICK FOR DEEPENING:
PAIN OR ANXIETY AS THE OBJECT IMAGERY:
SUGGESTIONS FOR SELF-HEALING And perhaps beginning to remember that God created within you an inner, central core of existence, that place deep within the central part of mind and a place of inner healing power and life force. And remembering that from the very beginnings of existence, the mind and body have known how to heal themselves. The body knows how to heal our scrapes and wounds and injuries, how to generate new cells and new tissue whenever needed. And the body knows equally well how to regulate its own healthy functioning; regulating heart rate and breathing, and body temperature and blood pressure, all effortlessly, subconsciously, automatically maintained at moderate healthy levels. And the body knowing how to maintain its own healthy blood chemistry, maintaining the necessary hormonal and chemical components for a healthy functioning mind and body: maintaining and regulating the proper level of potassium, of endorphins, all the necessary hormonal and chemical components that allow for an active, alert mind and body, but without overstimulation.
And in similar fashion, the body maintaining an immune system effortlessly, automatically, warding off invading organisms before they have a chance to gain a foothold. Building resistance, maintaining resistance, building antibodies, the white blood cells surrounding the invading viruses or bacteria, like fearless knights on beautiful horses. And the body knows how to regulate its metabolic system; the metabolism being designed to help us stabilize our bodies at a normal, moderate, healthy level. And in every way, mind and body working for health, healing maintenance of healthy functioning. And somehow knowing of these inner resources, the strength, the growth, the healing, the life force, making everything easier. Day by day in exercising, you are getting better and better, healthier and healthier.
1 UP TO 20 -- COMING OUT OF HYPNOSIS:
Client update on progress and counseling:
SCRIPTS FOR THIRD SESSION:
DAVE ELMAN INDUCTION:
BREATHING FOR PAIN REDUCTION SCRIPT: If you like, you may close your eyes now for most people find it easier to do this exercise with their eyes closed. So just let you eyes close. It is very important that you pay as much attention as you possible call to the experience of your breathing. I know you can attend to whatever you want, and I want you to pay attention right now to your breathing. Really notice what it feels like, each time you breathe in, each your breathe out. Notice the rising and falling of your chest, notice the change in tensions of the material of your shirt as your chest fills with air each inhalation, notice that the air is cool as it enters your nose, and warm as it leaves. It has been warmed by the very process of your life.
And in a moment, I want you to begin counting your breaths... each one... either as you inhale or exhale.., it doesn't matter. I'm going to keep talking to you for a while, but I want you to pay direct and complete attention to counting your breaths.
Begin now. Count each breath. If you become distracted and forget, that's all right...just bring your attention back, and resume counting. If you don't remember at which number you forgot... that's ok... just start over against the beginning. Just keep counting... don't pay attention to me, I'm not saying anything important at the moment anyway, and it will be difficult to determine when I do, so just keep counting.
And while you're counting, I'm going to talk to you about some experiences you might have, if you knew how, and you do; and I'm going to suggest various experiences to you... and you can respond fully or partially. You might respond quickly, or with some delay. You might respond predictably, or you might surprise yourself. I don't know how you'll respond, and I hope you'll allow yourself tile opportunity of responding in more than one way. And keep counting.
You know how to explain a lot things. And some things you don't know how to explain, but you can enjoy them just the same. For instance, you don't need to understand how a television work in order to enjoy it And you certainly don't have to be able to explain why it happened in order to enjoy the comfort you can feel later today. Because later today, and I don't know precisely what time it will be - how can I know precisely what time it will be? - later today, you will have the opportunity to suddenly discover how really well you are feeling - without any need to explain how it happened. It be 2 o'clock this afternoon, or five minutes after 3 or fifteen minutes after 4 or perhaps exactly at 5 o'clock. I don't know what time it will be - in fact it may not have to do with actual time on the clock, it may seem more related to what you are doing at the time. You might be taking off' a shoe, or lifting a glass to your lips, or turning the page of a magazine of book - I don't know what you will be doing - when you'll have tile sudden awareness that you are feeling better than you expected. And you will not have ally way to explain it, nor will you need to. For some reason, you'll just realize you'll just feeling better, with nothing to brother you, and nothing to disturb you. And you won't even have to memorize the fact that I've told you this. And you wont have to believe that you've been hypnotized. After all, who's to say that you were? In fact, if you are asked later today, if you were hypnotized, you can take comfort in the fact that you can say really don't think so. You really don't think you were hypnotized. And who is to say that you were? The fact that you are feeling better might be accounted for in a number of other ways. And you don't even have to think about it. But when I see you next time, I'11 be really interested in any surprises you might have had... particularly pleasant surprises. (Count out of hypnosis)
IF NEEDED THE FOLLOWING SUBCONSCIOUS QUESTIONS FOR PAIN MANAGEMENT AND ENHANCING HEALING CAN BE USED AS NEEDED:
SUBCONSCIOUS QUESTIONS FOR PAIN MANAGEMENT: (Using ideomotor response finger response or pendulum)
1. IS THERE SOME EMOTIONAL REASON WHY YOU ARE EXPERIENCING THIS PAIN?
2. HAVE YOU GONE THROUGH SOME EXPERIENCE IN THE PAST THAT IS CAUSING YOU TO EXPERIENCE THIS PAIN? _______________________________________________
3. ARE YOU IDENTIFYING WITH SOMEONE ELSE, PERHAPS A PARENT OR SIGNIFICANT OTHER WHO HAD PAIN? __________________________________________
4. ARE YOU USING THIS PAIN AS A MEANS TO PUNISH YOURSELF? ________________
5. ARE YOU USING THIS PAIN AS A MEANS TO PUNISH SOMEONE ELSE? __________
6. ARE YOU TRYING TO HARM YOURSELF BY THIS PAIN? ________________________
7. IS THERE SOME CONFLICT CONCERNING SEX THAT CONTRIBUTES TO YOUR PAIN? ________________________________________________________________________
8. DO YOU EXPERIENCE PAIN BECAUSE YOU FELL GUILTY ABOUT SOMETHING?____
9. DO YOU EXPERIENCE PAIN MORE WHEN YOU ARE LONELY? __________________
10. DO YOU EXPERIENCE PAIN MORE WHEN YOU FEEL STRESS OR TENSION?_______
11. DO YOU EXPERIENCE PAIN MORE WHEN YOU ARE ANGRY? ___________________
12. DO YOU EXPERIENCE PAIN AS A MEANS OF DRAWING ATTENTION DRAWING ATTENTION TO YOURSELF? ____________________________________________________
13. IS THERE ANY SUBCONSCIOUS REASON YOU NEED TO CONTINUE WITH THIS PAIN? (IF ANSWER IS "YES" ASK, "CAN YOU, OR DO YOU WANT TO DISCUSS WHY YOU NEED TO CONTINUE?)
15. IS IT OK WITH YOUR SUBCONSCIOUS MIND FOR YOU TO GET RID OF THE SOME OR ALL OF THE PAIN? _________________________________________________________
(IF ANSWER IS "NO" ASK, "CAN YOU, OR DO YOU WANT TO DISCUSS WHY YOU DO NOT WANT TO GET RID OF SOME OR ALL OF THE PAIN?"
IF NO RESOLUTION GOT TO "THERAPY BETWEEN SESSIONS?"
SUBCONSCIOUS QUESTIONS FOR ENHANCING HEALING:
1. ARE THERE ANY EMOTIONAL PROBLEMS CONTRIBUTING TO THIS DISEASE?_____
2. HAVE YOU GONE THROUGH SOME EXPERIENCE IN THE PAST THAT CONTRIBUTES TO THIS DISEASE? _____________________________________________________________
3. ARE YOU IDENTIFYING WITH SOMEONE ELSE, PERHAPS A PARENT OR SIGNIFICANT OTHER WHO HAD THIS DISEASE? _________________________________
4. DO YOU USE THIS DISEASE AS A MEANS TO PUNISH YOURSELF? ________________
5. ARE YOU USING THIS DISEASE AS A MEANS TO PUNISH SOMEONE ELSE? _______
6. ARE YOU TRYING TO HARM YOURSELF BY THIS DISEASE? ____________________
7. IS THERE SOME CONFLICT CONCERNING SEX THAT CONTRIBUTES THIS DISEASE? ______________________________________________________________________________
8. DO YOU HAVE THIS DISEASE BECAUSE YOU FELL GUILTY ABOUT SOMETHING?
9. DO YOU EXPERIENCE THE SYMPTOMS OF THIS DISEASE MORE WHEN YOU ARE LONELY? _____________________________________________________________________
10. DO YOU EXPERIENCE THE SYMPTOMS OF THIS DISEASE MORE WHEN YOU FEEL STRESS OR TENSION?
11. DO YOU EXPERIENCE THE SYMPTOMS OF THIS DISEASE MORE WHEN YOU ARE ANGRY? ______________________________________________________________________
12. DO YOU EXPERIENCE USE THIS DISEASE AS A MEANS OF DRAWING ATTENTION DRAWING ATTENTION TO YOURSELF? _________________________________________
13. IS THERE ANY SUBCONSCIOUS REASON YOU NEED TO CONTINUE WITH THIS DISEASE? (IF ANSWER IS "YES" ASK, "CAN YOU, OR DO YOU WANT TO DISCUSS WHY YOU NEED TO CONTINUE?)
15. IS IT OK WITH YOUR SUBCONSCIOUS MIND FOR YOU TO BE HEALED OR TO REDUCE THE SYMPTOMS OR TO ELIMINATE THE SYMPTOMS OF THIS DISEASE? ______________________________________________________________________________
(IF ANSWER IS "NO" ASK, "CAN YOU, OR DO YOU WANT TO DISCUSS WHY YOU DO NOT WANT TO GET RID OF SOME OR ALL OF THE PAIN?"
IF NO RESOLUTION GOT TO "THERAPY BETWEEN SESSIONS?"
IF NEEDED FOR POWERFUL RELEASING CONSCIOUS AND SUBCONSCIOUS NEED FOR PAIN "HAND TO FACE FOR THERAPY" AND IF HAND DOES NOT TOUCH FACE GO TO "THERAPY BETWEEN SESSIONS"
ADDITIONAL SCRIPTS FOR PAIN MANAGEMENT FOR CHRISTIANS
SELF-INDUCED (HYPNOTIC) DEEP MUSCLE RELAXATION SCRIPT FOR CHRISTIANS: