On the Effects of Suggestion in the Treatment of Vasospastic Disorders of the Extremities

Abstract

Nine cases of vasospastic disorders were treated with suggestion, applied in various ways. Six of the nine showed excellent subjective and some objective response. Of the other three, one showed definite marked transient improvement including healing of ulcers, but the symptoms recurred; she was a very unstable, neurotic girl who had much psychologic trauma during the period of treatment and demonstrated vascular spasms on immersing her hands in warm water. A second had rheumatoid arthritis, and a third was irregular with treatment and had complicating scleroderma but her capillary flow and symptoms improved markedly during treatment. One case of long-standing thromboangiitis obliterans showed marked transient improvement but soon relapsed. Several observations on the effects of suggestion, are recorded: (a) Relief of vasospasm over a period of several years. (b) In at least two cases, subjective improvement was present after a year of no treatment. (c) Prolonged vasodilatation with hands becoming pink and dripping with perspiration for hours after treatment was observed. (d) Skin temperature may change rapidly under emotionally charged stimuli. (e) Some patients showed periods of increased symptoms when psychologically traumatized in the home environment. (f) Cold is sometimes less important than psychic trauma in precipitating acute spasm. (g) One patient described improvement in color and configuration of the skin which was not apparent to us. (h) No consistent correlation was observed between actual skin temperature and subjective sense of warmth. (i) Altered capillary flow occurred after suggestion in several instances. (j) Although patients generally respond better when verbal suggestion of improvement accompanies the use of apparatus, one patient did remarkably well on the use of the apparatus alone. These studies emphasize the need for adequate controls in therapeutic studies of vascular disorders in which spasm plays a part.