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                                                     Hypnosis effective in children aged 7-14  

                               Sleep Problems, Enuresis, Nail Biting  by Doug Brunk.


SAN FRANCISCO -- If you're stumped by how to treat children who present with problems that range from thumb sucking and enuresis to nail biting and erratic sleep patterns, consider trying hypnotherapy, Dr. Ellen Hughes advised at a meeting on clinical pediatrics sponsored by the University of California, San Francisco.

In fact, most children are better subjects than adults for hypnotherapy because they're easily absorbed in play, and they have a heightened imagination, said Dr. Hughes, who directs the Osher Center for Integrative Medicine at the university.

"Imagination is really important because it seems to have a much more direct connection with bodily functions than spoken words," she said. Hypnotizability varies with age, but increases markedly among 7- to 14-year-olds.

Guided visual imagery is commonly used to induce hypnosis in children. This involves asking children to imagine their favorite place or choose their favorite animal--"anything that involves creating an image that a child can begin to connect with," she said. This induction phase allows the child to relax. Although relaxation is not absolutely in the definition of hypnosis, there is dearly an element of that. So help the child find a happy place or something that there is a hope or involvement in, where they can become focused and relaxed at the same time.

Other children may respond to auditory imaging like, "think of your favorite song," or "let's imagine playing your piano." Progressive relaxation, eye fixation, and distraction techniques are also commonly used. "You need to adapt treatments to abilities, interests, and preferences of each child," Dr. Hughes said. The goals are enhanced self-regulation, improved locus of control, and confidence."

She listed the following problems as amenable to self-regulation therapy: procedural pain and anxiety, such as kids with cancer who need frequent shots; chronic pain; psychophysiologic problems; nausea and vomiting; enuresis; habit disorders; and sleep problems.

The effects of self-regulation include: improved blood blow in Raynaud's disease; normalization of breathing in panic attacks; reduced muscle tension in headaches; reduction of blood pressure.

Suitable candidates for hypnosis include those who are responsive to hypnotic induction and those who have a problem treatable by hypnosis. Otherwise, "it does not make sense to try to apply this, because the child is going to need to be an active participant and possibly even do a little bit of homework and practice at home," she said.

Children with a definable desired outcome also are good candidates for hypnosis. For example, it's easy to study enuresis, she said, because the child or the parents can keep a record of the number of dry nights.

Hypnosis is contraindicated if the technique has the potential for aggravating emotional problems such as thought disorder, in those severely disturbed by anxiety or pain, and in those with significant cognitive dysfunction. It's also contraindicated if a more effective treatment is available or if the diagnosis is incorrect.

Adequate training also affects outcomes. "Although it's easy to be trained in hypnosis, you probably want to get some professional feedback on how to do this right," Dr. Hughes said. (See box on preceding page.)

The induction process for children is often very quick and organic, she noted. For example, with a young bed-wetting child, first take a history and conduct a physical to rule out urinary tract infection and diabetes. After having the child lie down on the exam table and drawing an outline of his or her body with a marker, ask the child, "Where is the brain?"

After the child points in reply, ask, "Where does the pee come out of?" After the child points in reply, ask, "Do you know that the brain and the bladder talk to each other? When your bladder is full, it tells the brain. The brain then talks to the bladder and says, 'Either hold on until you get to the bathroom and pee, or hold on until you wake up in the morning.' Would you like to work on making the bladder and the brain talk to each other a little better?" Then, use an induction exercise to set the intention that as the child gets used to imagining his favorite place, especially right before bedtime, the brain and the bladder are going to start to talk to each other more effectively. "After this, very frequently there is some improvement in the enuresis," she said. "It does not take a lot of time."

Another popular technique is diaphragmatic breathing, which can help with sleep disturbance, panic, performance anxiety, recurrent abdominal pain, asthma, and anger management. Instruct the child to:

* Put your hand gently on your belly button. Imagine you have a balloon underneath your belly button that you blow up when you breathe.

* Breathe in slowly through your nose and pull the air deep into your lungs. Feel your belly expand like a balloon blowing up. Breathe in slowly to a count of three or four.

* Keep your shoulders loose and relaxed while breathing in.

* Breathe out slowly through your open mouth and feel your belly go back in, like a balloon deflating.


Pediatric News, Dec 2001 v35 i12 p26(2)

Full Text: COPYRIGHT 2001 International Medical News Group

Disclaimer: The services we render are held out to the public as non-therapeutic hypnotism, defined as the use of hypnosis to inculcate positive thinking and the capacity for self-hypnosis. Results may vary from person to person.  We do not represent our services as any form of medical, behavioral, or mental health care, and despite research to the contrary, by law we make no health claim to our services.