I learned a lot about the power of words after I specialized in pediatric hypnosis and counseling. For instance, I found out that much of that power relates to the imagery that can be evoked by descriptive words. Further, words can be used to provide a memorable explanation, encouragement, or even for treatment.
Earlier in my career, I worked in the field of pediatric pulmonology, which involves taking caring of patients with many different lung problems. Many of my patients at that time had asthma. Caring for these patients was very rewarding, because usually such patients responded readily to their therapy.
The secret to helping them to do well was to convince them to take their medications as prescribed.
Through trial and error, I learned how to cajole my patients into inhaling a foul-smelling asthma medication. In the following example, I introduced 12-year-old Naomi to such therapy.
“This medication comes in two flavors,” I explained. “Yucky and mint yucky.”
Naomi made a face.
“What flavor would you like?” I asked.
“Mint, I think.”
“Good! Do you know why the yucky flavor is there?” I asked.
She shook her head.
“It’s there to remind you to rinse your mouth out after you inhale this medication,” I explained. “Do you know why you would want to rinse your mouth out?”
“No.”
“So you won’t get athlete’s foot of the mouth,” I concluded with triumph. I explained to Naomi’s mother that patients who use this medication can develop a fungus infection in the mouth, and that athlete’s foot is a kind of fungus infection.
“Yuck!”
It took me several years to figure out why my “patter” was effective in helping children take this medication.
First, I gave them a choice. By choosing one form of the “yucky” medication the children were cooperating with its prescription.
Next, I gave them an important reason for the poor taste of the medicine. The taste was there to help prevent something bad from happening. (This can be termed “reframing.”)
Finally, the image of “athlete’s foot of the mouth” is a memorable one. Few children who remembered this image forgot to rinse their mouth out.
I knew that my message was getting through when I wanted to change the “yucky” medication to a different one.
“I have good news for you,” I told Naomi. “The new medication hardly has any flavor at all.”
“But how will I remember to rinse my mouth out afterwards?” asked Naomi.
Bingo! My message must have been heard loud and clear, I thought.
Thus, I learned that the words I use to accompany the prescription of a medication to explain its use have an important impact on how well the medication might work for a patient, especially as these could affect their cooperation with taking it.
I also found out that sometimes words might have an unintended harmful effect. To evaluate the health of my patients’ lungs, I often asked them to undertake lung function testing. As part of this procedure patients were instructed to blow out as hard and as fast as they could into a mouthpiece which is connected to a large machine.
The respiratory therapist who usually conducted this testing was supposed to enthusiastically encourage patients to perform this test. It was not uncommon for me to walk by the pulmonary function laboratory and hear the respiratory therapist yell, “Blow! Blow! Blow!” as the patient was exhaling into the machine.
On one occasion, I was coaching 12-year-old Dan about the importance of blowing with as much effort as possible into the pulmonary function machine. “I want you to blow really hard,” I said. “Let’s see you blow so hard that you blow your guts out.” I smiled.
Dan smiled.
“Let’s get started,” said the respiratory therapist.
Dan inhaled deeply and started blowing very hard into the machine. “Blow! Blow! Blow!” yelled the respiratory therapist.
Dan blew very hard into the machine.
I smiled.
Dan blew even harder into the machine.
“Keep going! Keep going! Keep going!” yelled the respiratory therapist.
Dan kept going. Then he blew out his guts as he threw up all over the floor.
The respiratory therapist handed me a towel. As I was cleaning up, I reminded myself that a physician should be very careful about what he says to his patients.
Hence, I learned again that words can have an impressive effect on patients. In retrospect, I might have better encouraged Dan by telling him he could exhale fully, just like when a balloon quickly lets out its air.
Once I learned to employ hypnosis, I used words to help some of my patients overcome their asthma.
Rich was a 16-year-old who had dealt with asthma for most of his life. The asthma was first diagnosed when he was a toddler who developed wheezing during an infection with respiratory syncytial virus (RSV. As an aside, this is the same RSV for which we now have an effective vaccine available!)
After this illness, whenever Rich developed a respiratory infection, his asthma would be triggered.
After I taught Rich how to use hypnosis to calm himself, as well as how to interact with his subconscious, I asked, “Would it be okay if we spoke with your subconscious to help you overcome your asthma?”
“Sure.”
I asked his subconscious whether it was willing to be given instructions regarding how to help with Rich’s asthma. It gave its assent by raising Rich's index finger, which we had established previously meant Yes.
“Great,” I said. “Many times, asthma symptoms start because a patient worries that he is about to experience an asthma attack. This fear often starts the very first time a patient experiences a flare-up of his asthma. Often, when the fear is resolved then asthma symptoms become much less intense, or even stop. Does that make sense?”
Yes.
“Your job, then, is to go back into Rich’s memory to the very first time he thought he could not breathe. Let me know when you have found that memory by raising the ‘Yes’ finger. It does not matter whether Rich is able to recall this memory.”
Yes.
“Good job. Now, teach young Rich how to use hypnosis to calm himself. Let me know when you have finished doing that by raising the ‘Yes’ finger.”
After 15 seconds, Yes.
“Great. Now, replay the memory in Rich’s mind. Only this time, have young Rich use hypnosis to remain calm while he is experiencing his asthma. In this way he will not develop a fear of asthma. Let me know when you’ve accomplished that.”
After 5 seconds, Yes.
“Great work. Is Rich still fearful about his asthma?”
No.
Over the 2 years following this session, Rich reported no further asthma symptoms, despite contracting a few upper respiratory infections that would have triggered his asthma in the past.
While only some of my patients were able to overcome asthma, as did Rich, the vast majority learned how to use hypnosis to calm themselves in dealing with their breathing issues, and this helped greatly reduce their asthma symptoms (Anbar, 2016, Anbar, 2021).
Words can have a powerful impact. Health care providers need to use words wisely to best help their patients.
For instance, stating that a blood test will “hurt a little bit” while intending to be helpful, can actually add to discomfort by introducing an idea of “hurt.” Contrast this with the statement, “We will make you as comfortable as possible,” which often helps by introducing the idea that a medical procedure can be carried out with “comfort.”
Words can also carry a lot of impact in any other area of human interactions including between family members, in schools, at work, and during team activities. For this reason, it is important to be careful with the words you choose to use for instruction, encouragement, and to effect change.
References
Anbar, Ran D. 2016. Asthma. In: Gary R. Elkins (ed), Handbook of Medical and Psychological Hypnosis: Foundations, Applications, and Professional Issues. New York, NY: Springer Publishing Company, pp. 161-167.
Anbar, Ran D. 2021. “Changing Children’s Lives with Hypnosis: A Journey to the Center.” Lanham, MD: Rowman & Littlefield.
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