Journal of the Psychophysical therapists Guild of Australia
Volume25, March 1999
HYPNOTIC INTERVENTION IN THE TREATMENT OF
_____________________________ Sivan McGarry
Endometriosis is a condition where endometrium (the lining of the uterus) is found in abnormal locations outside the uterus. These patches of endometrium respond in the same way as the normal lining of the uterus to the hormonal changes of each menstrual cycle. The internal bleeding that occurs with each cycle then leads to the formation of blood-filled cysts on the affected organs which continue to grow with each menstruation.
The most common places for these cysts to occur are on the ovaries, the uterosacral organs (thickened portions of the sheet of connective tissue covering the pelvic organs), the rectovaginal septum (the membrane dividing the rectum from the vagina), the sigmoid colon (that portion of the lower intestine that leads into the rectum), the lower genital tract, the round ligaments of the uterus, and the peritoneum (membrane) lining of the pelvis.
In rare cases endometrial cysts have been found as high up as the small intestine and liver and even on the lungs. Because the cysts are producing blood with each menstrual cycle and the blood is sticky, it is common for some of these organs to adhere to each other. For example, the vagina can be ‘stuck’ to the colon, an ovary can be twisted over and ‘stuck’ to the side of the uterus or the peritoneal wall, or parts of the intestines can be ‘stuck’ together.
Based on medical diagnosis it is estimated 15% of women will develop this disease during their menstruating years and it is usually diagnosed between the ages of 30 and 40. What causes the endometrial cells to migrate outside the uterus is not known but new theories are espoused every few years, the latest being a genetic link.
According to the Endometriosis Association of NSW, the symptoms are as follows:
Pain may be felt:
- With periods
- During ovulation
- In the bowel during menstruation
- When passing urine
- During or after intercourse
- In the lower back region
Other symptoms may include:
- Alternating diarrhoea and constipation
- Abdominal bloating
- Heavy or irregular menstrual bleeding
- Constant tiredness
- Increasing PMT
Some women may look at the above lists and think that at least half of these symptoms are normal side effects of menstruating and that they experience them every month. Let me assure you that when endometriosis patients talk about pain they are talking about intense pain. Women who have had children and endometriosis say the pain of childbirth is mild compared with the pain of endometriosis. And when organs are ‘stuck’ together the pain is not limited just to the time of menstruating although it is more intense during that period.
Prophylaxis and Treatment
Medical treatment is varied depending on the severity of the symptoms and hasn’t changed in the past 20 years except for the names of some of the drugs. In mild cases the contraceptive pill is prescribed or laproscopic surgery may be performed with removal of the cysts by laser.
Doctors often tell patients to get pregnant as this leads to a cessation of the disease. This is a ridiculous ‘stop-gap’ measure as it only lasts for the time of the pregnancy and as soon as menstruation recommences so does the endometriosis. Besides after 6 or 8 children the novelty would probably wear off. Never-the-less endometriosis has sometimes been referred to as “career woman’s disease” simply because such women aren’t usually having children.
In more serious cases drug therapy is used. Gonadal Hormones are the most commonly prescribed drugs for endometriosis. Drugs such as Depo-Provera, Duphaston and Primulot-N are progestogens (a derivative of progesterone) and are designed to inhibit ovulation and suppress oestrus cycles. Drugs such as Zoladex which cause premature menopause may also be used. In severe cases radical hysterectomy to remove the uterus, tubes and ovaries is performed followed by hormone replacement therapy.
Our strategy in using Hypnotherapy to control endometriosis if it’s to be effective has to be two fold.
Firstly we have to remove endometrial cysts that are already outside the uterus and secondly we have to prevent any more migrations from the uterus. Some of you may be thinking, “But what about pain control? Shouldn’t that be taught first?” The answer is quite simply no. When somebody is in such severe acute pain they are incapable of putting themselves into the self hypnotic state necessary to practise pain control and, by removing the endometrial cysts at a time when they are reasonably pain-free, they should not have any pain to control.
In other words taking away the pain is not going to fix the problem and such an approach may in fact mask the progress that is being made. So the priority should be an all-out attack on the source of the problem. If progress is difficult, pain control intervention may be necessary so that the patient is able to concentrate sufficiently well, but it is never the treatment of choice – because it isn’t really treatment for the problem.
For the first part of this technique we’re going to concentrate on removing the cysts that are already there. Explain to your patient that first she will need to find out where the endometrial cysts are and then she is going to use a mental laser to remove them. After putting the patient in a medium to deep state of hypnosis, suggest that she start drifting down inside her body that she’s drifting down to the peritoneal cavity, the cavity that holds and protects the organs of her body.
Make sure that she’s not inside any of her organs but just drifting in the space around her organs. Have her locate her ovaries and tubes and the outside of her uterus and then have her start looking for any endometrial cysts. You might suggest that they’ll show up as bright fluorescent dots to make them easier to locate. Give her plenty of time to locate them in her own way using a finger flick as confirmation.
When she has indicated that she has located a cyst have her use her laser to burn it off. Explain that this will not be painful. When it is removed have her watch as the skin heals and becomes fresh new healthy tissue. And then move on to the next cyst.
If she finds any tissue or organs ‘stuck’ together have her adjust the laser to a very thin beam and gently laser the tissue or organs apart so that they slowly drift back to their normal positions. Once again have her watch as the tissue heals. You can suggest that she has a small healing machine to apply after the laser if you feel this would help facilitate the return to healthy tissue.
Once all the existing cysts are removed it’s time to move on to the second part of this technique which is preventing any more endometrial cells from migrating from the uterus. To accomplish this, the patient will have to be familiar with the mind mirror. Have her visualise her body in the mind mirror with the uterus, tubes and ovaries showing in their correct positions. Now have her visualise either a green or violet light (whichever is easiest for her) around these reproductive organs.
Tell her this light will act as a barrier to prevent any endometrial cells from ‘escaping’ from the uterus. Have her rotate her body to show the sides and back and to make sure the light totally surrounds the whole area, totally encasing it in light. She needs to strengthen or charge up this light every day for the first week and then twice a week for a month and from then on she can probably do it once a week for maintenance.
This technique as presented does depend on the patient being visual or capable of visualisation. It is also necessary that she knows where in the body her reproductive organs are so it may be useful to have a diagram or anatomy book handy for these cases. In the auditory patient the approach is modified so that the patient will talk to, and have conversations with, the various organs and areas involved and the kinaesthetic patient will work with the various textures and sensations that are unique to each organ and of course to the endometrial cells.
Endometriosis can be, and often is, a recalcitrant disease and many patients who will make good progress with the suggested treatment will back-slide after a time because once they’ve got it on the run they will often ‘forget’ to practice their maintenance program. Follow up sessions should therefore be allowed for and the patient should have been assured that you are their safety net and that they can come back if necessary for a ‘booster’ if it should be required.
© Copyright Sivan McGarry, 1999. All Rights Reserved.
Encyclopaedia Britannica © 1999
Endometriosis Publications in the form of specific pamphlets e.g.:
“Diagram showing a side view of the female reproductive system with particular reference to those areas commonly affected by endometriosis”, “Laser surgery for the treatment of endometriosis”, etc. are available from the Endometriosis Association NSW, 40 Bigge Street, Liverpool, NSW 2170