- Hypnosis for Burns
A relatively new area for special attention by Psychologists concerns burn injuries. Dr. Dabney Ewin, who was once Clinical Professor of Surgery and Psychiatry at Tulane Medical School in New Orleans, trained the first psychologists for work in the burns unit teams of some major hospitals in the US. He believed the use of hypnosis could be very important in the treatment of burn patients.
Dr. Ewin first saw how helpful hypnosis could be for minor burns years ago when his daughter had a bad case of sunburn. He tried out hypnosis and it seemed to greatly reduce the pain and reduce the normal skin damage. After this he began to use hypnosis with burn patients, coming to the view that hypnosis is so important in the early treatment of burns that it would be unethical not to use it. He gave evidence in various scientific meetings – photographs and so on - that early use of hypnosis in burns treatment reduces the damage from the burn, leads to rapid healing, great reduction of scar tissue, and much less pain and discomfort.
Dr. Ewin points out that the depth and severity of burns usually depends partly on the heat applied and partly on the body's inflammatory reaction to this event. The inflammatory reaction involves a great increase in the amount of fluid in the burn area. Sometimes this fluid leads to such great swelling that skin and muscle are split apart and this development is one of the really destructive aspects of the burn experience.
One of the important factors that affects the body's reaction to a burn, Dr Ewin says, is the negative emotional state of the victim. Both the burn and treatment of the burn can be excruciatingly painful and fear of treatment sets in early. As well there is often anger or guilt and a sense of helplessness and hopelessness resulting in depression. These emotional changes, and the behaviour that goes with them, may make the physical response very much more severe, enhancing and maintaining inflammation and interfering with healing.
Although dealing with emotional distress is one of the reasons for promoting the use of hypnosis for burn treatment, Dr. Ewin argues that it can also directly help to prevent the body's inflammatory reaction and thus limit the depth and severity of the burn. For quite some time there have been published studies showing that the degree of inflammatory response to a standard burn can be reduced by hypnotic suggestion as well as by simple reflexes induced by putting the feet in cold water. But Dr Ewin points out that even with third degree burns the damage, and risk of infection, can be greatly reduced by the early use of hypnosis.
One of Dr Ewin's most impressive cases concerned a young man who worked in an aluminium factory who slipped and stepped into molten aluminium up as far as the knee. The temperature of the molten metal was 950 degrees Centigrade. The protective boots and sturdy work trousers burned off almost instantly. Although he got himself out of the aluminium quickly, and ice-packs were applied immediately, the burns were very deep, and typically would have required skin grafts and weeks in hospital and day after day of misery. The outer layers of skin were cooked brown and peeling, while the inner layers were blanched white with no apparent blood supply. In normal circumstances the tissues would have begun to swell with fluid over the next few days leading to the typical tissue damage described earlier.
In this case the injured worker was in luck. The factory managers knew of Dr. Ewin’s work and they contacted him to let him know the man was on his way to hospital. Hypnosis was carried out within thirty minutes of the initial burn, along with standard medical procedures. The worker was quite responsive to hypnosis so Dr. Ewin was confident that he would progress well. He attributed his rapid recovery to this unique aspect of the treatment. No antibiotics were used, though often these are provided in burn cases as a preventive measure, and the man required only three aspirins a day to relieve discomfort, even though he would have been given narcotics on request. Dr. Ewin kept a photographic record of the case. There was no swelling of the leg, no infection and rapid healing. The man left hospital on the 19th day after the burn, and his injury healed without scar tissue and with re-growth of hair. His psychological recovery was indicated by the fact that he quickly returned to work and was soon promoted to foreman.
This case is only one of hundreds of serious burn cases that Dr Ewin dealt with. Not surprisingly he became a strong advocate for changing the way that burn injuries are treated. In particular, since he believed that injury continues for some time after the initial exposure, he favored the use of hypnosis within the first two hours of a burn as a basic part of treatment. Since this would usually require someone with hypnosis skills and familiarity with burn treatments, Dr Ewin considered that burn centres without someone competent in the use of hypnosis were poorly staffed.
More readings will be added to my blog from time to time. Have a quick look now to see the first posting on my blog PSYC1PLUS