The Power Of Suggestion

One almost universal condition found in illness is

hypersuggestability. Here is the nurse's despair and her hope.

Suggestion may come from without or from within. When from within, we

call it autosuggestion.



Many of the sick are temporarily resting their reasoning faculties and

their judgment. The sick body is causing a feeling of "jangling nerves,"

and the mind, too, is strongly tempted to be sick. So ev ry harsh sound,

every jolt, almost every sentence spoken in their hearing suggests

immediate nervous reactions. The mind does not wait to weigh them. The

nervous system reacts to them the second the impression is registered.

The whole self is oversensitive, and the very inflection of a voice has

enormous significance. Let the nurse remember that her way of giving a

treatment, her expression, or her very presence becomes a potent

stimulus on the second, one to which the patient's mind responds like a

flash-light when the button is pressed.



The nurse must comprehend the principle of the nervous effect on the

patient of all that is done and said, and realize her tremendous

privilege in making those stimuli wholesome. The nurse who has a

sympathetic insight, with unswerving loyalty to orders, can carry them

out with the average patient, unpleasant though they may be to him, in

such a way that his wholesome emotional response will be called forth, a

response of co-operation, or of faith or of good breeding, or of

"downing" the impulse to indulgence; or a response directed toward

holding the nurse's interest and attention, and so keeping her in the

room; such a response as will gain some privilege, etc.



But there are some patients in whose cases ordinary persuasion,

suggestion or requests fail. They are too nervously or mentally sick to

be moved by logic, or to respond with customary grace to a request which

their reason is not awake to answer. All usual suggestions may fail of

effect. And for these few, in order that health may be at all assured,

even the discipline of force may be necessary. But the nurse must use

this only as a last resort, of course, and in accordance with the

doctor's orders, and then solely as treatment leading toward the ways of

health. Before turning to this final method she should clearly, firmly,

and kindly explain the principle of the discipline if the patient's mind

is at all capable of grasping it. In any case, force should be used only

as the surgeon uses his knife. It hurts, but only to help and to save;

and it is not called upon when other methods can secure the needed

results. But force, thus limited in its application, may prove the only

suggestion which will bring about the action necessary to health on the

part of the patient. Force unwisely and unkindly used proves a damaging

suggestion, causing reactions of fear or anger; or it may lead to

delusions of persecution and to strengthened resistance.



Many suggestions come to the patient from within. Discomfort in the

right side may suggest appendicitis. A slight indigestion, often purely

nervous, may be interpreted as inability to care for certain diet, etc.

The wise nurse will displace as many of these as she can by casual

suggestions on her own part. She will demand of herself that her very

presence be quieting, calming, happy; that her conversation with her

patient shall vibrate with a certain something that gives him courage

and strengthens the desire and the will to health; that her care of him

shall prove confidence-breeding. The patient's attitude, when he is at

all suggestible, is largely in the nurse's hands, and she can make his

illness a calamity by dishonest, fear-breeding, or suspicion-forming

suggestion. After all, the whole question here is one of the normality

of the nurse's own outlook on life and people. The happier, truer, and

more wholesome it is, the more really can she help her patient to both

bodily and mental health. Of one thing let the overzealous nurse beware.

Do not irritate your patient by a patent, blatant, hollow cheerfulness

that any one of any sense knows is assumed for his benefit. Personally I

know of no more aggravating stimulus.



What We Attend To Determines What We Are.--This is one of the first

laws of education. If the child's attention from birth could be

controlled, his future would be absolutely assured. But attention is a

thing of free will and cannot be forced by others. It can be won through

interest or self-directed by will. The child's attention is entirely

determined by interest, interest in the morbid and painful as truly as

in the bright and happy. Punishment interests him tremendously because

it affects him, it interferes with his plan of life, it holds his entire

immediate attention to his injured self. But something more impelling

quickly makes him forget his hurt feelings and he is happy again. The

average sick person is emotionally very much like the child. His will at

the time, as we noted before, is tempted to take a rest, and his

interest is ready to follow bodily feeling unless something more

impelling is offered. The nurse who can direct attention to other

people, to analyzing the sounds of the street, to understanding

something of the new life of a hospital or sick room, to planning a

house, or choosing its furniture or equipping a library, or supplying a

store; to intelligent references to books or current events; or to

redecorating the room--all in his mind; to an appetizing tray, a dainty

flower, a bit of sunshine, a picture, etc., is fixing the patient's

attention on something constructive, helping him to get well by

forgetting to think of himself.



Thus the nurse, knowing the laws of attention, can keep herself alert to

divert and direct her patient's thought to wholesome interests. Knowing

the possibility of thought substitution, she can open up new channels

of thinking. Knowing the power of the will to assist in health bringing

and health keeping, she can sometimes stimulate long-dormant

determination. Let her beware, however, of making the convalescent too

dependent upon help from without, but prick his pride to gradually

increasing doing for himself. Arouse his reasonable ambition, but let

him realize that life must be taken up again a step at a time; and that

he can do it. If limitations must be accepted, try to inspire the

feeling of pride in accomplishing the utmost possible within a

limitation, and an acceptance of the inevitable without bitterness.



Attending to the unhappy, the painful, the boring without looking beyond

makes life unhappy, painful, and a bore. Not that the nurse should

ignore these realities, but she can accept them whole-souledly herself

as not the final things, as merely the rocks that can be used to stand

upon and get a view of the something better for everybody. When they are

thus used by the wholesome mind, facts, the very barest and meanest of

them, can be made useful as stepping-stones to the happier facts beyond

them.



If the nurse can direct or tactfully lead the patient's attention away

from himself and his illness, she has found a big reinforcement to his

treatment. This question is so vital in the care of patients that it

will be discussed at greater length later on.