The week before an operation is often harder than the operation itself. You lie awake running through what might go wrong. That worry is not only unpleasant. People who are very anxious before surgery tend to report more pain afterwards.
Hypnosis before and around surgery is one of the better-researched uses. Pooled analyses of trials have found that patients given hypnosis have, on average, less anxiety and less pain, and trials in breast surgery found that a fifteen-minute session beforehand reduced pain, nausea and fatigue afterwards.
Here is a script to use in the days leading up to an operation or procedure.
Before you start
- This is an addition to medical care, not part of it and not a substitute for anaesthetic or pain relief.
- Follow every instruction you have been given about fasting, medicines and what to bring. Nothing in the script changes them.
- Tell your team if you are very anxious. They can help, and anaesthetists are used to it.
- Read the script first, fully awake, and change anything that does not fit your operation.
- Record it in a slow, calm voice, pausing at the dots.
- Listen once a day for a week beforehand if you can, and on the morning itself.
- Never listen while driving.
It takes about twelve minutes.
The script
Settling
Make yourself comfortable… and let your eyes close.
Take a slow breath in… and a long, easy breath out. Again… in… and slowly out.
With each breath out, let your body settle and soften.
Your forehead smooths… your jaw loosens… your shoulders drop…
Your arms grow heavy… your hands rest…
Your chest and stomach soften… your legs grow heavy… down to your feet.
Sounds can come and go, and each one lets you relax further.
Deepening
I will count from ten down to one. With each number, let yourself become more comfortable and more at ease.
Ten… nine… settling… eight… seven… calmer… six… five… four… deeply comfortable… three… two… and one.
Your calm place
Now go to a place where you feel calm and at ease. Somewhere real, or somewhere you imagine.
Look around… notice the colours and the light…
Hear the sounds of this place…
Feel the air on your skin… and what is beneath you…
Let the calm of this place soak into you. This place is always here, and you can come back whenever you wish.
The day itself
From this calm place, look ahead to the day of your operation, as if watching a film.
See yourself waking that morning, calm and ready. You have done what you were asked to do.
See yourself arriving. The people around you do this every day. They are skilled, and they are there to look after you.
Each person you meet, each question you answer, each check they make, is a sign of how carefully you are being cared for.
Sounds and activity around you are simply the sounds of people doing their work well. They let you feel safer.
When the time comes, you breathe out slowly, and go to your calm place. You can leave everything to the people looking after you.
Afterwards
Now see yourself afterwards, waking gently, knowing that it is done.
You are comfortable. You breathe easily and deeply.
Your body knows how to heal. It has done so all your life, and it begins at once.
Any sensations you notice are signs of healing. You ask for pain relief whenever you need it, and it works well.
Your stomach is settled and calm. In good time, you feel thirsty… and then hungry… and you enjoy your first drink.
You find it easy to rest… and easy to move when you are asked to. Each time you move, each deep breath, helps your recovery.
Each day you are a little stronger and more comfortable.
See yourself at home, some weeks from now, well, doing something you enjoy… and glad it is behind you.
Suggestions
In the days before your operation you feel calmer and more confident.
You sleep well.
Whenever a worry comes, you breathe out slowly, and it loosens its hold.
You trust the people looking after you, and you trust your body to heal.
A cue
Whenever you want this calm, breathe out slowly, press your thumb and finger together, and think of your place. In the waiting room… in the anaesthetic room… on the ward… it is there for you.
Returning
I will count from one to five, and you will come back feeling calm and refreshed.
One… beginning to return.
Two… feeling coming back into your arms and legs.
Three… aware of the room.
Four… a deeper breath.
Five… eyes open, awake and alert.
(At bedtime, leave out the counting up and end with: “And you can drift into a deep, restful sleep.”)
Adapting it
- Awake procedures (endoscopy, biopsy, dental work, scans): replace “waking gently” with “you stay in your calm place throughout, and time passes quickly.”
- Local or spinal anaesthetic: add “you may feel touch or pressure, and you remain comfortable.”
- Day surgery: add going home the same day.
- If nausea is a worry: dwell on the settled stomach.
- If you fear the anaesthetic itself: add “you drift off easily, and wake easily when it is time.” And do raise it with the anaesthetist.
- If you do not want detail, leave out the film of the day and keep only the calm place and the recovery.
Safety points
- Do not suggest that you will feel nothing or will not need pain relief. Pain after surgery should be reported and treated. Good pain control helps you move, breathe deeply and recover.
- Do not suggest reduced bleeding or rapid healing as a promise. The evidence for effects on healing is thin.
- Do not ignore symptoms afterwards. Follow your discharge advice about when to call.
- Self-hypnosis is not hypnosis in place of anaesthetic. That is a specialist technique used in a few centres with an anaesthetist present.
On the day
- Listen in the morning, or use your cue.
- Tell the nurse and anaesthetist you are nervous, and that you have a relaxation routine you would like to use.
- Ask whether you can use headphones while you wait.
- In the anaesthetic room: slow breath out, thumb and finger, your place.
Other things that help
- Ask questions beforehand, and write them down so you do not forget.
- Know the plan: what happens when, who will be with you, how you get home.
- Prepare your home for coming back.
- Limit late-night searching online.
- Keep to normal routines in the days before, as far as you can.
The bottom line
A week of daily practice before an operation costs nothing and is supported by a good body of research. Build your calm place, rehearse the day and a smooth recovery, and take the cue in with you. Leave the medicine to the people whose job it is.
That’s the end of the series. Start again from the beginning: What Is Hypnosis, Really? A Plain-English Guide
This article is for general information and is not medical advice.