Evolution of the brain
The triune brain theory…. The brain is not user friendly (it isn’t planet-friendly either!) …. We share the inside of our skull with a hissing snake and a howling wolf:
Reptilian Brain: Thalamus, Putamen, Globus Pallidus, Claustrum etc To do with movement. Genetically Determined of Imprinted Behaviour which is therefore ritualised, compulsive, obsessive, rigid, stereotyped, non-negotiable,ubflexible.
Palaeo-Mammalian Brain: Cingulate Gyrus, Hyppocampus and Hypocampal Gyrus, amygdala. Adds Emotion – therefore more flexible
Neo-Cortex. 30 Bn neurones, with 1 million billions synapses. Mega-Ram! (Est 1000 terrabites) Communication with other brains gives unlimited problem-solving ability.
Left Brain: verbal, logical, linear, rational, mathematics, abstract thought.
Right Brain: intuitive, emotional, visuo-spatial skills. Wholistic. Pessimistic… Patients are in right brain when we see them… sharpen up your skills in recognising and communicating with the patient in right Brain.
Graph of Suggestion and Biological Arousal: patients in states of fear, pain or ignorance are highly suggestible and in Right Brain functioning. They are in a hypnosis-equivalent state – you just need to know how to use it!
“Hypnosis” in the Emergency Situation
Ref: "Patient Communication" Jacobs. Published by Brady
C = Confidence. The frightened patient "needs" someone
to take charge of the situation, but that someone must be totally
confident and certain of what needs to be done!
R = Rapport. The patient must be willing to put all
his trust in you. Imagine how the patient must be feeling and let your
language and behaviour convey that you understand. Breathing at the same rate
and using the same language maybe helpful in building this trust.
E = Expectation. What the patient 'expects' to happen generally will
happen. Let your words cultivate a positive mind-set.
D = Directives. Use the progressive present tense
wherever possible e.g. "...your eyes are becoming more relaxed.." etc.
Also when giving directives remember:
I = Images. Positive pictures expressed in the language of a smart 10-year-old. Simplicity and Clarity are the watchwords.
B = Believable. Stay within the patients' credibility
L = Literalness. The patient is likely to take your
suggestions absolutely literally, and where two possible interpretations exist, they will opt for the more pessimistic one. e.g. "It's all over!"
E = Enthusiasm. Remember that the emergency patient is very perceptive of and responsive to the emotional tone in your voice. Therefore be positive and optimistic
Communicate with scared patients in Right Brain Language – by analagy, pictures with emotion.
The placebo effect, the laws of suggestion … maximising your placebo effect…. Suggestion produces physical changes.
We are inundated by suggestions constantly (1700 hits per day – est). Try to ensure you are surrounded by a good environment of positive and helpful suggestions.
Happiness (and depression) are both infectious
Clinical Hypnotherapy: Cheek and LeCron (pub Grune and Stratton)
Left Brain Right Brain Springer and Deutsch (pub Freeman)
The Ghost in the Machine: Arthur Koestler
Hypnotherapy: Dave Elman (pub Westwood)
Patient Communication for First Responders: Donald Trent Jacobs (pub: Brady)
Shared Care for Neurology: Shevlin, Misulis and Samuels pub Martin Dunitz
The Amazing Adventures of Henry and Ho-Ho(pub Word4word)
BMJ Eds (Depression) of 5.2.05 and 3.1.04
Hypnosis in the Casualty Department: Goldie BMJ 8.12.56
Angina Pectoris and the Placebo Effect: Benson and McCallie (NEJM: 21.6.79)
Post-Operative Analgaesia.Requirements...McLintock et al (BMJ:6.10.90)
BMJ: 7.12.02 pg 1319
BMJ: 14.9.02. pg 561
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