Over the years, we came to learn that it “takes a village” to
have a smooth transition in how communication is used
throughout the department.
relaxation techniques, visualising pleasant scenes, and performing mental exercises. 20 This type of focused attention on
a more pleasant outlook than the immediate surrounding reality is the essence
of self-hypnosis. We evolved the concept
of guidance in self-hypnotic relaxation in
radiology and showed efficacy in three
large prospective randomized clinical
trials: in the “Lancet Study” testing applicability with concurrent access to IV
conscious sedation during vascular and
renal procedures; in the “Breast Trial”
during large core breast biopsy in a pure
outpatient model, and the “Tumour
Embolisation Trial” as a model for more
invasive therapy with high complication
potential. 16, 21, 22
Patients had less pain, less anxiety, fewer medications, and fewer complications.
Being able to increase hemodynamic stability and outcomes came as particularly
valuable side effects—not negligible in
a climate of mandated safety initiatives,
pay-for-performance, and trends towards
open “report cards.” Use of these methods resulted in the considerable savings
of $338 per case in the catheterization
Over the years, we came to learn that
it “takes a village” to have a smooth tran-
sition in how communication is used
throughout the department. We have de-
veloped a method of patient interaction
called Comfort Talk TM in which schedul-
ers, receptionists, nurses, technologists,
and physicians are extensively trained in
advanced rapport skills and setting ex-
pectations. A core group of healthcare
professionals then provides additional
guidance in self-hypnotic relaxation. We
used this model when we were asked
to help a large private MRI practice. Af-
ter team training, the non-completion
rate of MRIs was reduced by 40% and
resulted in annual savings of $140,000,
with maintained success at the time of a
one year follow up. 24
Hypnotic Language in the Modern
Although successful use of relaxation
and hypnotic techniques in radiology,
mainly MRI, dates back to the 1980s,
these methods received surprisingly little
attention. 20, 25, 26 Main impediments were
early beliefs that such techniques are best
provided by mental health professionals,
and that traditional hypnotic techniques
and desensitization approaches just took
too long for a busy practice. The beliefs
are changing. It has become apparent
that guidance in self-hypnotic relaxation
on the examination table can be applied
without interruption of workflow and
that personnel already involved can perform it expertly. 27
Openness towards and usage of alternative approaches has made great
strides with the public. 28 More and
more traditional medical institutions
are opening alternative centers to respond to the need. The balance has
swung far towards Comfort Talk TM type
interventions, in which smooth communication can help patients through a
stressful time, improve outcomes, and
give patients the assurance of caring
and the respect they seek. In our experience, patients appreciate the effort
made to help them through their examinations. Informed patients will
choose their healthcare facilities based
on whether they can receive this kind of
assistance and will shun places that are
hostile to the concept. With patient expectations rising, it makes sense to train
one’s radiology team in advanced communication.
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diagnosis. Radiology. 2009;250:631–637.
11Gustafsson O, Theorell T, Norming U, Perski
A, Ohstrom M, Nyman CR. Psychological
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12Ewin DM, Eimer BN. Ideomotor signals for
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Charles C. Thomas Publishers; 2006.
13Bayer TL, Coverdale JH, Chiang E, Bangs
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14Silvestri A, Galetta P, Cerquetani EC, et al.
Report of erectile dysfunction after therapy with beta-blockers is related to patient
knowledge of side effects and is reversed