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Spoken Medicine

Therapeutic Suggestions and Imagery in Pain Management

Jackie Levin RN, MS, AHN-C, CHTPConsultant, Coach and Clinical EducatorIntegrative Approaches to Health-Wellness and

Pain, Palliative and Hospice Care

Objectives

• Describe Spoken Medicine, Therapeutic Suggestions and Imagery

• Experience the mind-body-spirit connection using Therapeutic Suggestion and Imagery strategies

• Recognize the impact you can make with simple tools

• Strategies for integrating Spoken Medicine

into your nursing practice.

Spoken Medicine

Precepts• Language is multi-dimensional

– Verbal (mind), non-verbal (body), and meta-verbal (spirit)

• Language has the power to heal and destroy• We can develop our ability to “listen” and

“speak” therapeutically

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Spoken Medicine

A way of communicating that therapeutically enhances the current strategies employed in managing pain and changes, in some way, the patient’s experience and perception of pain.

…As long as you believe something, your brain operates on automatic pilot, filtering out input from the environment and searching for references to validate the belief, regardless of what it is. People with such strong levels of certainty are often closed off to new input.

Tony Robbins

We all can be explorers

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Holistic Paradigm

Mind

BodySpirit

Thoughts

SensationsHeart/Soul

Mind-Body-Spirit Connection

• What the mind thinks and heart feels, the body experiences

• The greater the coherence among the 3 realms, the greater sense of well-being

• The more vivid and true the image/TS is the more authentic the experience

• Fight/Flight mechanism

Potentially shift fear, anxiety and a limited view of possibilities into greater potential for healing, reduced pain and improved sense of wellbeing

Shift the Angle of Perception for a Wider View

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Holistic Nurse Theory

Health as Expanding Consciousness

– Underlying pattern that cannot be fully understood by examining the parts

– Heath is more than disease, its information in the field Margaret Newman(2008)

Power as Knowing Participation in Change– Awareness, choices, freedom to act intentionally, and

involvement in creating change Elizabeth Barrett (2010)

When we come into contact with the other person, our thoughts and actions should express our mind of compassion, even if that person says and does things that are not easy to accept. We practice in this way until we see clearly that our love is not contingent upon the other person being lovable.

Thich Nhat Hahn

Therapeutic Suggestions

• Specific communication style – More about listening than speaking– Intentionality and specificity of language

• Increases receptivity to therapeutic ideas

• Enhance motivation and exploration for own body-mind-spirit potentials

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Therapeutic Suggestions

• Development of Rapport– Basic

• Every day communication

– Advanced• Pacing and Leading Presencing

• Aware of your own projections in the interaction

• Listening for underlying patterns, images, metaphors

Pacing and Leading

It’s a dance!

You follow

Then you lead

The patient then leads

And you follow

Projections

How to stay behind the camera and not on the screen

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Projections

• What are your preconceptions and beliefs about the situation?

• What fears, anxieties and stressors are present for you?

• How can you monitor these and not project them onto situation?

Underlying Patterns

What’s below the IcebergMetaphors

Symbols

Stories we tell ourselves

Imagery

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Where would you rather be than here right now?

My Background

Your Background

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Imagery

Imagery is a dynamic inter-dimensionalcommunication system linking the Body-Mind-Spirit

Imagery is received and expressed through the senses – Visually, sounds, smells, tastes, touch, thoughts– Understood directly or indirectly through symbols

and metaphors

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Pain Descriptors

• Beating

• Burning

• Cold

• Constant

• Cutting

• Drilling

• Heavy

• Hot

• Nagging

• Pounding

• Pulsing

• Scalding

• Stinging

• Taught

• Throbbing

Where to Begin

• Start where the person is– Cognitive, Physical, Emotional states

• Listen for clues on how to offer a new way of – Being– Thinking– Feeling

• What window in would be best?– Body, Mind or Spirit?

Images of Pain

– It feels as if someone has my head locked into a vice.”

– “It feels like sulfuric acid is being poured into my bladder”

– “It feels like a tight knot.”

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Your mind begins to wonder…

• Visual: Tight knots---untie the knots?

• Auditory: Drums pounding--change rhythm?

• Kinesthetic: Hot iron--decrease the dial, change the fabric e.g. silk to cotton?

But you don’t know what the person’s body-mind-spirit wisdom knows, so you ask….

Facilitate Patient’s Description

• If it had a size-bigger or smaller than fist

• If it had a weight—heavy or light

• If it had a color—black or white or color

• If it had a sound—what would it be

• If it had texture—rough or smooth

• Can anything change here?

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Integrative Pain Management

Integrating Spoken Medicine

• Prepare for procedures --Acute Pain– Imagine process– Imagine successful outcome of procedure

• Listen to pts description of pain --Chronic Pain– Facilitate change in perception

• Distressing situations-take hold of the reigns until they can--– LeadPaceLead vs.– PaceLeadPace

When we come into contact with the other person, our thoughts and actions should express our mind of compassion, even if that person says and does things that are not easy to accept. We practice in this way until we see clearly that our love is not contingent upon the other person being lovable.

Thich Nhat Hahn

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Sometimes your joy is the source of your smile, but sometimes your smile can be the source of your joy.

Nhat Hanh

Loaves and Fishes

This is not the age of information

This is notThe age of information

Forget the news,And the radio,And the blurred screen.

This is the timeOf loaves and fishes.

People are hungry,And one good word is breadFor a thousand.

David Whyte

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Jackieluna22@gmail.com

www.leadingedgenursing.com

Port Townsend, WA

C: 206-304-7703

Contact Info:Jackie Levin RN, MS