THE MEDICAL METAPHOR FOR NUCLEAR WARFARE: A CRITIQUE fANE M. ORIENT* I. The Process "physician-patient" interaction Reflections of an observer.—The clatter of coffee cups has ceased. The background buzz of private conversations has subsided. No impatient fidgeting betrays lapses of attention. All eyes are fixed, almost unblinkingly , on the slides. The group appears to breathe slowly and almost in unison. The Pima County Medical Society, usually an animated group, is transfixed as the representative of Physicians for Social Responsibility (PSR) illustrates the devastation of Hiroshima and Nagasaki. Next he shows a map ofTucson, with red concentric circles marking the range of various effects of a hydrogen bomb dropped on our city. Members ofthe audience try to imagine their skin charring and their eyeballs melting in the instant that the city is vaporized. Everything worth fighting for is being incinerated. Civilization is being annihilated, the human race extinguished. The cockroaches will inherit the earth. Silence prevails for many minutes after the speaker concludes. The scene is reminiscent of many others, such as a special mission at church, in which the preacher told of hell fire and damnation, ready to seize one out of a parked car in lover's lane. Effective salesmen, orators, musicians, and actors all elicit similar responses, whether or not they are conscious of the technique they use. The group induction demonstrated at workshops of the American Society for Clinical Hypnosis differs only in that it is deliberate. The physiologic evidence ofthe trance state is the same: the steady gaze, the paucity of body movement, the slowed respiration [I]. Hypnotic induction technique.—The principles of hypnosis have been * Adjunct assistant professor, Department of Internal Medicine, University of Arizona College of Medicine, Tucson, Arizona. Address: Medical Square Suite 9, 1601 North Tucson Boulevard, Tucson, Arizona 85716.© 1984 by The University of Chicago. All rights reserved. 0031-5982/84/2702-0387$01.00 Perspectives in Biology andMedicine, 27, 2 · Winter 1984 | 289 known for many years. One simple induction mediod, gaze fixation, is accomplished automatically by showing slides. Having individuals visualize scenes, especially familiar ones, is effective for either induction or deepening. Presenting statements which are obviously true prepares the subjects to acceptjuxtaposed ideas and suggestions. In the terminology of neuro-linguistic programming, an implied causal linkage is established [2]. One of the hypnotist's most powerful tools is metaphor [S]; storytelling was a mainstay of Milton Erickson's legendary psychotherapeutic repertoire. For overcoming resistance, negative suggestions may be employed. For example, "This is not an American guilt trip" or "Don't believe me, read." Confusion techniques may also succeed widi difficult subjects, perhaps by overloading or distracting the dominant hemisphere, permitting access to the unconscious mind [2]. Contradictory ideas and overwhelming amounts of numerical data may accomplish this result, even unintentionally. Responsive members of the audience facilitate die induction ofothers [4]. The hypnotist's reputation contributes to his success. Physicians for Social Responsibility deliberately takes a professional approach [5, p. 237], taking advantage of the public credibility of physicians in matters of health. diagnostic suggestions The ideas presented in lectures and seminars for continuing medical education credit by PSR have been collected in book form [5] and are widely disseminated in the lay and the medical literatures. The frequently cited premise is that the discovery of nuclear energy marked a turning point in history, changing everything except human nature. A nuclear holocaust would mean die destruction ofcivilization (art, education , literature, capitalism, communism) and probably the extinction of the human species. This last epidemic is "unthinkable," though we must overcome our "psychic numbing" and think about it to realize that it must be prevented at all costs [5, p. 31]. The etiology of the disease is a "renaissance of militarism in the American population" [5, p. viii]. The symptoms are poverty and disease due to the diversion of resources into the arms race, and psychological illness from living in die shadow ofthe Bomb. There is no treatment, not even palliation, for nuclear war. posthypnotic suggestions for preventive therapy Given the alleged uselessness of treatment, specific actions directed toward prevention are demanded. First, we must carry the message of the horrors of war to the people and their leaders...