Chinese psychophysiology:
Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; maintains smooth flow of Qi and Xue (Blood); and reflects emotional harmony and movement.
» Healthy expressions are kindness, spontaneity, and ease of movement.
» Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry eyes, skin, and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. Liver Xue Xu (Blood Deficiency) predisposes to Xue Yu (Blood Stasis).
» Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216) Xue Yu (Blood Stasis) often begins with Qi Stagnation.
therapies
imagery:
Some studies have shown that guided imagery can decrease anxiety, analgesic requirements, and length of stay for surgical patients. In one study involving colorectal surgery patients several significant changes were observed in the group using guided imagery in comparison to controls. Before surgery, anxiety increased in the control group; it decreased in the guided imagery group. Postoperatively, worst pain score was significantly higher for the control group and least pain was also significantly different. Total analgesic requirements and time to first bowel movement were significantly less in the imagery group. (Tusek DL, et al. Dis Colon Rectum 1997 Feb;40(2):172-178. )
affirmation:
I lovingly forgive and release all of the past. I choose to fill my world with joy. I love and approve of myself. (Hay, 1984, p. 159)
I am willing to change and to grow. I now created a safe new future. (Hay, 1984, p. 160)
hypnotherapy:
Discuss recovery from anesthesia within patient hearing range; review the range of possibilities from gradual recovery to sudden awakening after a long sleep (implying that it's not "if" the patient will recover but "when"). (Zahourek, p. 96)
process paradigm: (experientially oriented)
What is the symptom preventing me from doing? What is the symptom making me do? (see process interview: psycho/neurological system, process interview: immune system)
related materia medica listings:
the shadow and physical symptoms
converting a signal to a symptom
affirmations: guidelines and precautions
hypnotherapy
process paradigm
footnotes
Tusek D, Church JM, Fazio VW. Guided imagery as a coping strategy for perioperative patients. AORN J 1997 Oct;66(4):644-649.
Abstract: Patients who undergo surgery usually experience fear and apprehension about their surgical procedures. Guided imagery is
a simple, low-cost therapeutic tool that can help counteract surgical patients' fear and anxiety. The authors randomly assigned 130 patients undergoing elective colorectal surgical procedures into two groups. Members of one group received routine perioperative care. Members of the other group listened to guided imagery tapes for three days before their surgical procedures, during anesthesia induction, intraoperatively, in the postanesthesia care unit, and for six days after surgery. The authors measured patients' anxiety levels, pain perceptions, and narcotic medication requirements. The patients in the guided imagery group experienced considerably less preoperative and postoperative anxiety and pain, and they required almost 50% less narcotic medications after their surgical procedures than patients in the control group.
Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum 1997 Feb;40(2):172-178.
Abstract: PURPOSE: Guided imagery uses the power of thought to influence psychologic and physiologic states. Some studies have shown that guided imagery can decrease anxiety, analgesic requirements, and length of stay for surgical patients. This study was designed to determine whether guided imagery in the perioperative period could improve the outcome of colorectal surgery patients. METHODS: We conducted a prospective, randomized trial of patients undergoing their first elective colorectal surgery at a tertiary care center. Patients were randomly assigned into one of two groups. Group 1 received standard perioperative care, and Group 2 listened to a guided imagery tape three days preoperatively; a music-only tape during induction, during surgery, and postoperatively in the recovery room; a guided imagery tape during each of the first six postoperative days. Both groups had postoperative patient-controlled analgesia. All patients rated their
levels of pain and anxiety daily, on a linear analog scale of 0 to 100. Total narcotic consumption, time to first bowel movement, length of stay, and number of patients with complications were also recorded. RESULTS: Groups were similar in age and gender distribution, diagnoses, and surgery performed. Median baseline anxiety score was 75 in both groups. Before surgery, anxiety increased in the control group but decreased in the guided imagery group (median change, 30; P < 0.001). Postoperatively, median increase in the worst pain score was 72.5 for the control group and 42.5 for the imagery group (P < 0.001). Least pain was also significantly different (P < 0.001), with a median increase of 30 for controls and 12.5 for the imagery group. Total opioid requirements were significantly lower in the imagery group, with a median of 185 mg vs. 326 mg in the control group (P < 0.001). Time to first bowel movement was significantly less in the imagery group (median, 58 hours) than in the control group (median, 92 hours; P < 0.001). The number of patients experiencing postoperative complications (nausea, vomiting, pruritus, or ileus) did not differ in the two groups. CONCLUSION: Guided imagery significantly reduces postoperative anxiety, pain, and narcotic requirements of colorectal surgery and increases patient satisfaction. Guided imagery is a simple and low-cost adjunct in the care of patients undergoing elective colorectal surgery.