The New Language of Medicine – The Magic of Verbal First Aid
You’re walking down the road. A man is hit by a car in front of you. Once you collect yourself, you naturally and correctly think of what you can DO, meaning calling 911, applying compresses, covering a person with a blanket, etc. So, you call 911. And let’s assume you have some first aid training and you use it all appropriately. The ambulance is on the way. When you’re done DOING, what do you SAY? N.A., a skilled and well-respected paramedic in one of my workshops in Albuquerque, told the group how one day he was standing with a woman hit by a car. She had broken bones, multiple lacerations, profuse bleeding. She was in pain. He knew what to do, but not what to say. Intuitively and wisely, he knew she needed to hear something, but he didn’t know what it was or what would help her.
Words As Healing Tools.
Knowing the right words at the right time can make a critical difference-sometimes the difference between life and death. Words, well-chosen, well-said, can facilitate rapid healing of burns, lower an elevated blood pressure, reduce pain and increase compliance. Conversely, words ill-chosen, thoughtlessly used, can cause great damage by encouraging hyperventilation, increasing anxiety and thereby pain response and bleeding, destabilizing heart rate and pulse, and over-stimulating the immune system.
Dr. Dabney Ewin, MD, Clinical Professor of Psychiatry & Surgery, who teaches medical hypnosis to the students at Tulane University Medical Center in New Orleans, has said that words are influence our physiology. “Our pharmacopoeia in hypnosis is the dictionary. Just as you pick the right drug in practicing medicine, you pick the right words in practicing hypnosis.”
He has also warned other physicians, “Our patients are frequently frightened and we need to be careful what we say.” How do words have such a profound impact on our physiological processes? Let’s take a look at an example in an ordinary life: If you are embarrassed, point out and laughed at, blood would flood the capillaries in your cheeks, your heart rate would probably increase, gastric juices would rise, adrenaline would probably be released. That’s quite a marshalling of physical responses to a couple of words.
Consider another example everyone has at one time or another experienced: If you have a frightening dream, which consists of little more than images in your mind, you might wake up sweaty, your heart palpitating, your muscles tired and twitchy. Indeed, a special chemical is required during sleep to paralyze us so we don’t physically respond to our dreams as if they were actually occurring.
The point: What we think, see in our mind’s eye, the images we form in response to the words we hear have very distinct physical consequences. Where there is danger, the likelihood of an image or thought eliciting a strong physiological reaction is even higher.
People who are frightened are highly suggestible and are looking for guidance from a trusted authority figure. And if you’re the one helping, you’re the authority figure for the moment. What you say will most definitely have an impact on that person in ways you might not have ever imagined.
Some people have likened this response to herd instinct. A herd leader (either lioness, gazelle, or horse) that senses danger will run in a particular direction or take a specific action that the rest of the herd will follow by scent trail. For humans, words take the place of scent. While an antelope may emit certain pheromones that scream, “Hey, this way,” a human will express himself verbally.
A person in pain, fear, and trauma most often wants and needs the same thing. Biological processes can be marshaled towards a person’s survival and healing when we know what to say and how to lead them.
In 1919, in The American Review of Tuberculosis, Dr. Tohru Ishigami found that the prognosis for a TB patient depended more on what the “patient has in his head than what he has in his chest.” He was watching certain patients follow rather predictable paths to recovery when some suddenly became severely ill. What he discovered upon examining their histories was that those who died had almost all experienced some kind of trauma-a loss, a crisis-gone into despair and given up.
In 1971, a striking example of the power of mental images was documented by Dr. Carl Simonton, a radiologist at the University of Texas. He was treating a patient with advanced, terminal throat cancer. He weighed 98 lbs. and his odds for survival were only 50%. Weak and severely ill, he still needed radiation. But Simonton knew that it was very unlikely that he would survive it. Desperate, he turned to visualization, asking the patient to “see” or form a mental image of his immune system as white blood cells successfully attacked the cancer as he received the radiation. The patient saw it as snow covering a black rock. The result was a complete remission. To think, to feel, to be conscious, it seems is to practice brain chemistry. And the truth is, no one really understands fully how it works, although we know that it does.
What to Say and How to Say It.
Whether you are the helper, the loved one, the friend, the doctor or the helpful stranger, for the time that you are with the victim, you are the authority and your emotional state is contagious. Always take a moment to center yourself whether through a deep breath, a brief moment of prayer, or by collecting your thoughts. Your calm confidence may be just the medicine that’s needed. You’re there because you want to help. Remember that frightened people tend to focus their attention on the person who seems most sincere. Speak in a calm, clear, kind voice.
Praise any positive responses the victim or patient gives you and stay realistic. There is no better way to present insincerely than by diminishing, invalidating, or dismissing a person’s genuine discomfort or fear. Stay away from comments such as “Everything’s fine” (unless you are absolutely certain!) or “Oh, that’s nothing!” If you can think of nothing to say, hold the person’s hand (if you can safely do so) and tell them, “The worst is over. Help is on the way. I’m staying with you.” We want to be respectful, realistic, and confident. We want to project some authority (without being demanding) and keep our comments uncomplicated. A few examples are:
“I’m Jackie. I’m going to help you. Will you do as I say?” “You’re really scared, I can see that. I’m going to help you now.” Keep in mind that when in doubt, leave it out. If you’re not sure whether what you’re about to say is a good idea, forget it. You can listen, hold a hand, lend your support in many other ways. You don’t need to use words to be a compassionate and helpful presence. Although if you’re going to use them, it helps to know how. Unless you’re very sure of your medical knowledge, make no specific references to physiological processes. Keep your comments general and positive.
Once you have established a solid rapport with the person you’re helping, you’re ready to deliver a therapeutic suggestion. The first rule is to keep it simple. If you don’t know what to suggest, you can rely on a rather general healing statement, such as: “You can relax knowing the healing has already begun.” Know that imagination is more powerful than knowledge, particularly in a stressful time. The person’s responses will be coming from imagined possibilities, not from the facts. In The Worst Is Overwe describe Verbal First Aid in more detail and explain how a person can imagine a burn injury being “cool and comfortable” and reduce scarring, inflammation and pain.
Every thought or image can cause a physical reaction. So, it’s up to us to make that reaction a healing one.
c. Judith Acosta, 2008. All rights reserved.