Dr. Nicoline Kooger Infante is a physician specializing in anesthesia, a member of the WFH and holder of an AFC (certificate of complementary training) in medical hypnosis.
Doctor at the Anesthesia Center of Clinique La Colline since 2008, Dr. Kooger Infante offers the practice of medical hypnosis to patients who wish to use this technique.
She answers our questions on this subject.
What is medical hypnosis?
Medical hypnosis is a technique that aims to induce a modified state of consciousness – the hypnotic state – and use it for therapeutic purposes. It manifests a natural disposition of the brain, which we have all already experienced. Whenever we are very focused on an ongoing activity, such as reading an exciting book or driving our vehicle on the highway during long journeys, we are in a hypnotic state, to the point where we no longer feel what is happening around us. During the hypnotic state, the patient is more receptive to suggestions offered by the hypnotherapist. This can change the patient's perceptions. It complements anesthesia and improves the patient's well-being and comfort before, during and after the operation.
Is it FMH training?
I followed a theoretical and practical training of 2 years at the cantonal university hospital of Geneva. It allows you to obtain a Certificate of Additional Training (AFC) in medical hypnosis, recognized by the Federation of Swiss Physicians (FMH). Like any training obtained at the WFH, continuing education is required by regularly following the scientific literature, practical courses and workshops.
In which cases can medical hypnosis be used?
Patients who are interested and motivated by the technique to improve their comfort before (state of significant stress, fear of the hospital environment, phobias of needles), during and after anesthesia at the Clinic.
We do not do surgical interventions under hypnosis alone, but it can be a complement to interventions in local anesthesia, endoscopies to reduce the doses of sedatives and analgesics. The surgeon must be supportive of this approach.
It is often practiced for chronic pain. Hypnosis makes it possible to modify the perception of the painful state, to better manage it and to reduce the taking of medication. This requires several hypnosis sessions and learning self-hypnosis. It is used for painful dressing changes (for example in burn victims) thus avoiding repeated complete anesthesia. Some dentists use hypnosis to decrease the feeling of discomfort. Hypnosis can also help modify behaviors such as smoking, bruxism (involuntary teeth grinding), eating disorders and is used as a therapeutic means by psychiatrists and psychologists trained in the technique.
(Note: hypnosis for chronic pain or behaviour change is not practiced on the Hill)
What is the course of a medical hypnosis and what does it feel?
At Clinique la Colline, I use it daily during anesthesia, without really calling it "hypnosis" and with the patient's agreement. Before anesthesia, I suggest that patients focus on their breathing and project themselves into a landscape, a place evoking a pleasant experience. Focusing on details of the landscape (color, sensation, smell) makes it possible to induce a hypnotic state without the patient being really aware of it. I then suggest a state of well-being during and especially after anesthesia reinforcing the effect of pain medications. The suggestion of a feeling of thirst and hunger upon waking helps to alleviate the postoperative nausea state. It is essential to use chosen words and avoid negations (such as "you will not be in pain, you will not be nauseous) that would activate a negative semantic network and cause an opposite effect.
For needle phobias, I induce the patient by a classic technique, such as fixing a point on the wall and deepening the hypnotic state by placing the patient in a comfortable and safe place. Then I suggest that the hand where I have to put the drip becomes insensitive for example by imagining to plunge it into a bucket of ice.
Can I wake up during a state of hypnosis?
Contrary to what the etymology of the word hypnosis (Hypnos = god of sleep) suggests), the hypnotic state is a state of awakening with a modified consciousness, requiring the collaboration and acceptance of the patient. You cannot hypnotize a patient or make him accept suggestions against his will.
Also, if the hypnotic state is insufficient to ensure the comfort of the patient, either we take a break to deepen the trance state, or we use the combination of analgesics and sedatives.
