March 11, 2004 -- New research shows self-hypnosis quickly helps kids stop habit coughing.
Habit coughing -- also called cough tic -- is a harsh barking cough that continues long after a child gets over a case of the common cold or flu. It can go on for years. The coughing often happens several times a minute when the child is awake -- but once asleep, the cough almost always stops.
Although the coughing itself may irritate the throat and airway and perpetuate the cough, intensive investigation shows no physical cause for habit cough. Drug treatments -- including cough suppressants -- don't help. But teaching these children self-hypnosis leads to dramatic improvement, report Ran D. Anbar, MD, of SUNY Upstate Medical University in Syracuse, N.Y., and colleagues.
"Hypnosis works by helping the patient ignore the sensation that triggers the cough, thereby allowing the patient not to cough," Anbar says in a news release. "Once the patient stops coughing, there is no longer a trigger for the sensation and the habit stops."
The Anbar team's report appears in the February issue of the Journal of Pediatrics.
Long-Term Habit Coughs Stop Fast
The 51 kids in the study ranged in age from 5 to 17 years, with an average age of about 11. At the time of the study, they'd been coughing for an average of one year, ranging from two weeks to seven years. Most coughed as often as every few seconds, all day long.
The children saw either a pediatric lung specialist or a child psychologist. At the outset, the kids were told that their problem almost certainly wasn't due to a physical problem. They were told that hypnosis could help them, and that they wouldn't be allowed to skip school during their treatment.
Not all the kids got exactly the same instruction, but all were taught the basic techniques of self-hypnosis for up to three 30- to 45-minute sessions. These techniques included:
- Self-Induction. Kids were taught to relax their muscles and to breathe deeply.
- Relaxation imagery. Kids were asked to imagine feeling a favorite place with each of their five senses, or to imagine colored air bringing them comfort with each breath.
- Cough-related imagery. Kids were asked to imagine a switch in their heads that turns the cough on and off, or to imagine engaging in fun activities instead of coughing. Smaller kids might be asked if a cartoon character was causing the cough, what might it do instead?
- Anchoring gesture. Kids were asked to pick a gesture -- such as crossing their fingers -- to cue a relaxation response.
- Validation. Kids were asked to notice how their cough improved during and after practicing self-hypnosis.
- Instructions for home. Kids were asked to practice these techniques every day for at least two weeks.
The results: 40 of the 51 kids stopped coughing after just one hypnosis instruction session. Another four kids stopped coughing in a week, and two others stopped coughing after a month.
Of the 49 kids followed for little more than a year, 22% had their cough return one to three times. All but one was able to control it with self-hypnosis.
Psychological Issues at Heart of Problem
Self-hypnosis was most likely to work quickly in kids who hadn't been able to get out of going to school because of their cough. But this so-called "secondary gain" from coughing wasn't the only psychological factor involved.
One boy, for example, got over his cough when his parent told him frankly about a tumor the parent had but was trying to keep secret from the child.
Five of the children underwent psychotherapy for conversion disorder. Conversion disorder is a psychiatric disorder in which children may use a physical symptom -- such as cough -- to divert attention and feelings away from disruptive family issues.
"Instruction in self-hypnosis is more likely to promote patient autonomy and self-reliance," Anbar and colleagues write. "Strengthening of these attributes might facilitate the work of resolving the psychological issues that may have led to development of the cough."