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Nearly a hundred doctors are trained in the technique of hypnosis to put children to sleep before surgery. It is a question of soliciting the active imagination of the little ones by entering their universe and by resorting to a rich visual imagery. The choice of words used matters. The medical team also uses the photos to allow the little patient’s mind to wander away from the operating room, and away from the pain.
Hypnosis, stronger than fear
“Lila, it’s your turn!” »Dr Charlotte Hautefort, young head of the ENT department, brings the 4-year-old blonde into his office. His mother accompanies him with a backpack, clothes and toys. The reason for this consultation? Not very bad, since it is only a question of removing a plug of earwax from him. But its extraction and the examination of the eardrum require that the girl is calm and does not move. A nurse approaches the small patient who is sitting on the examination table. Dominique Lauga-Boutonnet was trained in specific hypno-analgesia techniques like nearly a hundred caregivers at the Robert Debré hospital. She immediately spotted the Dora the Explorer backpack. After some discussions with the mother to find out about what Lila likes to do (coloring, a lot), she explains: “I’m going to put on a magic mask for you to go with Dora … Choose the felt with the scent you prefer to travel with her : strawberry, pineapple, blueberry, orange? »Lila grabs the strawberry one and begins to color a picture… This is the scent that Lila has chosen for MEOPA, the mixture of gases used to reduce the pain and anxiety associated with caring procedures.
Sedation is all the more desirable when the child suffers from a chronic disease which requires him to undergo repeated examinations which are not very pleasant (myelograms, lumbar punctures, etc.). “He knows, he apprehends and he tenses up. All the more reason to put all his conviction and his heart to help him endure them, ”explains Isabelle Ignace, psychologist, specialist in hypnosis at the hospital’s pain assessment and treatment unit. Thanks to the suggestions and metaphors used by the specially trained caregiver, the method allows the child to no longer focus on painful care. And to travel in his bubble while he is given an infusion, draws blood or removes a plug of earwax … No question, of course, of saving a general or local anesthesia like Emla, to erase pain if necessary. But, unfortunately, it cannot bypass the fear of gesture, which is often more powerful than the evil itself. Especially in a toddler who does not feel safe in this situation that he does not understand, paralyzed by worry, even anguish, that he feels in the eyes of his mom or dad and who potentiates his pain.
A relentless story to distract the child
Martin, 5 months old, waits, half asleep in his stroller. Josée, her mother, is visibly consumed with worry. We take him to the casts and samples box. Thierry Moreaux, nurse anesthetist and childcare worker, Isabelle Ignace’s accomplice in hypno-analgesia, takes a whistle bubbler from his pocket! ” In pediatrics, we should all have one He comments, with a mischievous smile. Another adult who does not deny his child’s soul and does not shy away from the pleasure of communicating it! He approaches the baby, speaking in a soft, monotonous voice, humming a rhyme, not leaving him with a word. He questions the blanket, returns to his little master, to his mother, then, still without pause, begins to blow pretty iridescent bubbles above him. Martin lifts his small arms to catch one that brushes his lips. He is in his bubble. There is a bubble which flies towards the ceiling of the box, carrying with it the concern that he no longer feels touching his arm: the syringe! “In a child under 3, hypnotic techniques are more like distraction,” he comments. To achieve this, it takes a lot of involvement and conviction on the part of the caregiver. Energy and creativity too, so that the child feels the particular bubble of communication caused by the hypnotic state. ” You have to dare to create, above all to believe in what you are saying, to establish a relationship of trust and to keep the link without stopping with the child. He said again. It is therefore necessary beforehand, and sometimes in a very short time, to collect clues from the family on what makes their child “vibrate”: Dora the Explorer, Babar, Barbapapa, football, the plane …
Make him travel in his favorite universe
Karamoko, a shy little African of 4, came with his daddy for stitches, is dressed like a real footballer. Fastoche! Isabelle Ignace makes him try on the mask and adapts a small red and yellow plane to its mouthpiece: “ The harder you blow, the higher the plane will go … Vroum, vroum, what a trip! She told him. In the middle of a continuous train of words, she pushes the metaphor: “From the top of the plane, you see the stadium, you are going to referee … It’s the penalty, Karamoko! In fact, this is the time when the doctor has just done his points. Incredible: the little boy, yet so fearful, hardly realized it! “Our hypnosis techniques are adapted to the age as well as to the tastes and preferences of the child, they use his active imagination, the goal being to put him in a state of deep reverie. We use distraction techniques that allow us to use rich visual imagery, ”she explains.
The usual supports in pediatrics, bubblers, puppets, dolls, various stories or balloons of different colors in which the child is made to blow, mobilize his breathing and have an analgesic effect that mothers know well when they give birth to their child. baby. “An Indian study shows that a child who blows in a balloon can significantly reduce his pain during a venipuncture”, explains Thierry in turn. ” Making him blow in a balloon is a way of making him reconnect his breathing while, spontaneously, he blocks it as soon as he is afraid. And we also tell him that he will send to the ceiling, in the ball, anything that does not please him, ”adds Isabelle.
The right words and the right images for successful hypnosis
The hypnotic state itself is achieved by alchemy of the heart more than by pure technique, although it requires proper training to achieve it. A wise choice of words, and wise of photos. First, the choice of words. You have to tell him “Don’t worry” and “It’s not obvious what you’re going through”. And instead of giving into the game-truth, and warning him: “I sting you and I warn you”, it is better to do what we have to do, the injection. Or just say: “Here we go, here we do what we have to do, and you, you can continue in your imagination”, while we focus all our attention on the chosen photo, that is to say the image and its support, by pushing the metaphor (the penalty for Karamoko, for example). But without lying! Declare: “It’s over! », While we are still in the process of puncturing, it is to deceive the child’s confidence.