Transcript Disclaimer – Please note that the following transcription has been machine generated by an AI software and therefore may include errors and ommissions.

Robin Daly
Hello and welcome to the second series of Cancer Tool, the podcast that explores the benefits of integrative oncology, an approach that brings together standard oncology practice for the raft of lifestyle and complementary approaches in order to provide broader, more holistic care to improve quality of life and outcomes for people with cancer. I’m Robin Daly, founder of Yes to Life, the UK’s integrative cancer care charity, and one of the hosts for the podcast. Series 1 of Cancer Talk was aimed at initiating conversations about integrative oncology and bridging the gap between mainstream and integrative medicine practitioners. And the Series 1 episodes are still available from Yes to Life .org .uk forward slash podcasts and major podcast platforms.

Dr Penny Kechagioglou
Hello, I’m Dr Penny Kechagioglou. I’m an NHS Clinical Oncologist and co -host for the broadcast and in addition to treating patients with all the regular modalities in use within healthcare, I have a passion for integrating evidence- supported lifestyle and complementary medicine into patient protocols. I’ve witnessed first have the enormous benefits this can deliver to patients and their carers. So in Series 2 of the broadcast we are planning focused conversations with healthcare professionals, working directly with people with cancer and applying integrative oncology in contemporary clinical practice with the aim of strengthening the clinical voice and evidence for integration, influencing the wider community including academia and research and beating the case for an integrated UK model of care.

Robin Daly
Good to be back on Cancer Talk.

Dr Penny Kechagioglou
Hi Robin. Good to see you. Hi.

Robin Daly
we’ve got to talk to Sarah Partridge with us today. I bumped into Sarah at the Integrative and Personalized Medicine Show this year. She was passionately extending the virtues of clinical hypnosis and I spotted she was non -collegiate as well and I thought well what an interesting combination and we got chatting and so we’re very pleased to have her on the podcast. Hello Sarah.

Dr Sarah Partridge
Hello, thank you very much for having me.

Robin Daly
So you better weigh in and tell us straight away how you came to be learning clinical hypnosis when you’re an oncologist.

Dr Sarah Partridge
Well, yes, I’ve never quite gone by the book. I grew up in many different countries as a child and was fascinated by different, I suppose, healthcare systems or the absence thereof, because many of those countries were in Africa and Asia. And indeed, through my childhood and my teenage years, my mother tended to have these cyclical depressions, which meant that I was often sitting on her bedside trying to think about the right things to say and usually just talking about the past and trying to think about things in the future that would be nice, seemed to bring her around a little bit more quickly. And that was even before I went to medical school, but I’d always been fascinated by medicine and had resolved from a very young age to become a very much vocational. And indeed, when I went into medical school, it was during my third year of training, when you had a little bit more time to read a little more broadly, that my psychology fascination sort of reignited.

Dr Sarah Partridge
Because indeed, my mother had actually sought out some therapy and she was an incredibly good anecdote relater and would tell us all about her therapy. And it was a soap operatic sort of performance from her part, which is very engaging. And I picked up on that in my third year of medicine, read a lot more about psychology and Carl Jung and was fascinated by the fact that actually how you say things and the power of communication and talking therapy could have such a profound impact. And it really wasn’t until quite a lot later that I came to the hypnosis journey because I ended up fast forwarding to my fellowship once I’d qualified, which I did in Canada. And I had a fellow fellow who had GP friends who’d introduced her to neuro -linguistic programming. And she said, had I ever heard of that? And I said, well, no. And it just so happened that in Vancouver, where we were doing this fellowship, they had an NLP centre and they had open evenings. So she and I decided to go along and see what that was like.

Dr Sarah Partridge
And we were fairly electrified, actually, by the performance that was brought bare on a member of the audience who had a severe phobia of heights. And within 20 minutes, this poor fellow who had, you know, literally been quaking at the very thought of coming up to the first floor where the talks were being held, and had clocked that there was a balcony outside that door that he wasn’t going to go anywhere near because…20 minutes later, he was out on that balcony in the state of Euphoria that actually the years of life that he’d spent, you know, plotting his every move to avoid encountering heights he couldn’t cope with, seemed to be behind him.

Dr Sarah Partridge
And we had just seen this rapid phobia cure inactive. And so I started reading all about NLP at that point. And when I came back from my fellowship, did an NLP course, which was… And like no other, in so much it was a huge affair orchestrated by Richard Bandler who is one of the founders, but also Paul McKenna, a well -known hypnotist, and another chap who was called Michael Brown who was in marketing, I believe. But they orchestrated a very good course, although it included about 700 people, and would never have signed up to a course with 700 people in it, probably, had I known. But I went home very elated every evening because the structure showed you that, really, we all work through information in very different ways. And actually, the more I thought about it, the more I read about it later, it did actually come down to the hypnotic side of things, which really played into where I could perhaps use it within the medical framework.

Dr Sarah Partridge
And so I then went on a deep dive into training and did a diploma in hypnotherapy, and have integrated it in my career for patients who’ve needed it, and many, many have done. And it has always blown me away with its powerful impact for people who are willing to open up to using it. And that, in its own right, has taken me on a very fascinating journey throughout the next 20 years. All right. And here I am.

Robin Daly
See, what did you get?

Dr Penny Kechagioglou
Fascinating. I hear that from a colleague. It actually sounds, and you mentioned the keyword of communication, how communication is very important, especially in the field that we are working in. Is that where the hypnosis is based on? Is it something that we can basically all somehow utilise in our clinical practice?

Dr Sarah Partridge
I think it very much is, and in fact, I would argue that you probably don’t need to have a formal, full -on training in hypnosis. You need to have an understanding of it to be able to utilize what it can do best, which is actually inspiring hope and empowering patients to use their own thought processes much more positively. I mean, all hypnosis, they say, is self -hypnosis, and actually we often do it but call it different things. So sometimes people will say, well, I gave myself a good talking to, and then I managed it. Or I just went off and I just imagined I was somewhere else. And those are hypnotic techniques in one sense. But I think as clinician, we all in oncology and many other specialties have a difficult time aid with the restricted time we have to see patients in, but also to discuss really distressing issues for patients, not least their cancer diagnoses, but also the treatments and investigations which are not altogether pleasant,

Dr Sarah Partridge
particularly if they have anxiety as a background alongside. And the structure of hypnosis is that if you interspersed lots of phrases like, I think you might be surprised at how easy you might find this. And a lot of people imagine it might be worse than it really is, but actually try and knock those negative thoughts into the stratosphere and really focus on the fact that you can do this and bring yourself back into your breathing and really give them a little coaching session, which is actually a lot to do with hypnosis. A patient in most consulting rooms when they’re fearful, they’re already in the trance state of sorts because they’re focused on what you’re saying. But actually what is often happening, particularly in that initial diagnostic consultation where you’re telling them the worst news that they ever feared, is that their mind has stopped listening to you and they’re off on a journey towards the grave,

Dr Sarah Partridge
and all that they can see is a cascade of awfulness coming. And that is a trance, but a very negative trance. And what you have to try and do is to break into that with lots of hope and effectively care with a capital C that they can actually relax because you’re going to be there for them and all the people on your team are there for them and we know what we’re doing and hopefully give them that sense that through the process their anxieties can be calmed and it’s a natural reaction that they’re having. So I think the communication skills training often is linked up to trying to get that compassion and empathy across. Empathy is one of those trigger words however that some people don’t like because you can draw attention to the wrong things and some people feel that empathy can be a negative if you’re always focusing on the negative.

Dr Sarah Partridge
Like how is your pain? We often ask that so often. So it’s really difficult sometimes to know where the pitfalls are and the hypnosis training I suppose gives you a slightly more formal path to being able to negotiate that in the ring -fenced setting for a strategic input with a patient who’s willing to go along this journey with you because you’d never do hypnosis on somebody who doesn’t want to have hypnosis but you can often have hypnotic conversations that help people get out of their anxiety stage. It is for most clinical hypnotherapists something that becomes a conversational habit rather than a formality a lot of the time. So a lot of people who train in hypnosis actually are usually directing the patient’s attention to something different whilst they’re setting to maybe cannulating them and doing something that actually is a very positive distraction and in that way you get the best of all worlds.

Dr Sarah Partridge
You’ve got a patient who Well, it didn’t even feel the needle going, you know, oh, I thought that was going to be far worse. And then you’ve already started that process of dismantling the start of a potential phobia, really.

Robin Daly
I can see what you’re talking about, how it strays into the world of coaching which of course Penny knows all about and which again puts a lot of focus on language and the way you use it. So really interesting. You identified there this moment of passing under bad news to somebody of course that is such a major trauma for people. It’s not really, it’s just dealt with and it’s done and they’re just left to deal with it afterwards usually but you know many many people will tell you exact date when they were told even the time of day it was just like before I knew I had cancer and afterwards it’s like life’s never the same again and there are not many things in life you can say that about that you’ll actually remember in that kind of detail but it’s just etched in them very often and so the kind of thing you’ve been talking about as ways of helping them through that I mean anything that helps has to be good at that point.

Dr Sarah Partridge
Absolutely. I mean, as Penny and I have spoken about, the whole world of integrative health care is very much trying to match the patient with what will work for them. And, you know, I think sometimes the word hypnosis is a trigger for something negative in a lot of people. Ironically, you know, sometimes the stage in the media portrayal of hypnosis being something that means that you’re under the control of somebody else without any of your own willpower being possible to utilize is very damaging. And clinical hypnosis in a setting within health care is so totally different to that. And indeed, even on the stage, to be honest, the underlying mechanism for it is one of agreement because people who get invited up onto the stage have been often pre -selected to be highly hypnosis adjustable who want to be on the stage because they’re maybe naturally a little bit more exhibitionistic or extrovert.

Dr Sarah Partridge
So I think it unfortunately has left a wake of sort of misconceptions that one has to actively undermine and correct, I think, before you can really go forward with everybody. You know, you can’t get stuck in trance. People fear being stuck in a state that they can’t help themselves out.

Robin Daly
when it’s rebranding ready and another name for what you do would be helpful.

Dr Penny Kechagioglou
I would be very interested in hearing from you, Sarah, how you integrated clinical hypnosis into your practice.

Dr Sarah Partridge
Well I treat head and neck cancer which is somewhat tricky because for radiotherapy you have to get the patient in a position that is absolutely reproducible over up to 30 treatments and in order to do that you have to make a rather snug mask or shell out of a thermoplastic which is initially warm but then is folded round their face and neck once it’s been in a hot water bath and as it cools down over about 10 minutes it takes the patient’s shape and then has little clips that go on to the treatment couch and the first you know problem you get with patients and a mask or in a mobilization device of any sort is people with claustrophobia have real terrors and so in the head and neck setting probably the most frequent time I use it is in claustrophobic patients and I know that you know many patients with claustrophobia or phobias have such a terror which they cannot control that it’s almost life -threatening as in they will walk away from treatment rather than have that you know particular procedure so I’ve had you know numbers of patients who’ve really had really terrible times where not even sedation is working and I’ve been called in as a sort of last resort and sometimes I’ve often questioned whether it was going to work I mean one chap had been I think locked in a trunk for four hours aged five when he was playing hide -and -seek with his brother and his brother was found early but nobody found him for another four hours and poor little lad he he had a terrible fear of dark places and he he had tried four attempts at this mask being made with ever increasing sedation which was now getting to near dangerous levels and and I established what had been his trigger most people with claustrophobia can tell you that very very quickly and we had a half an hour where I basically took him into a trance state I invited him to close his eyes but interestingly he did not want to close his eyes and I I had a man lying at Richard as a board as unrelaxes you could possibly imagine staring at the ceiling which you could understand having been stuck in a trunk for four hours it’s very dark you probably don’t want to invite darkness into your your life you can help it and I didn’t think it was going to work but half an hour later he had his mask made he still looked quite rigid and he was quite tense but he managed to have that mask made and for every treatment he had because we embedded this in the the hypnosis that I gave him that phobia that that memory just went further and further away and what I do is I unlatch all of the emotion that comes with that memory within that trance state and you floated away and often then I remind people who’ve been claustrophobic that they started life in a very snug dark warm place which was their mother’s womb and that that comfort and you know love and protection is is what they can take forward and the mask we reframe in terms of its defensiveness it’s a shield it’s a means to support them while they relax within it while they have the radiotherapy very accurately given to target their tumor but spare all their normal tissues and if you can tell people this sort of deep emotional messaging whilst they’re in trance a little magic happens that’s different to if you just tell them when they’re sitting there without the preamble if you like and so this this trance state is is a means where we can communicate with the deepest unconscious parts of ourselves and that can often reset and and turn back the clock on these terrifying events that set up phobias.

Dr Sarah Partridge
And absolutely, you embed what we call ego strengthening in the trade, but you empower people. You say, you can do this. You’re going to get better and better. You’ll be surprised at how little you have to experience the discomfort because you will be ever more able to ignore the side effects of the treatment. In fact, you’ll be surprisingly quick at healing and you can, you can, you can, not ever, you can’t. It’s all very, very positive. And so I think I’ve had very few patients for whom it hasn’t worked. The only downside is that sometimes people don’t really feel that it’s made a big difference, but the majority of people have found that it’s been relaxing and helpful in some way, but the vast majority have found it’s really been helpful when they’ve taken it on themselves and continued listening to audio files.

Dr Sarah Partridge
And so I think I wouldn’t be without it. And that’s why I’m so keen to talk about it really, because I think you, you can sign post patients to be able to do this for themselves. And indeed, I set up the website that we aspirationally called transform medical, because we wanted to try and have some means where patients could access these sorts of audio files within the medical settings that they’re going to encounter through a cancer pathway. And hopefully, even if their clinician isn’t familiar with hypnosis, still be able to access this for themselves. Because I think it, you know, there’s definitely where there’s a will, there’s a way, you know. And I think that is a very central, pivotal message that I think all our patients need to hear, because I think often, well too often, sadly, we’re in the medical profession, too good at giving people prognoses that are finite, or quoting statistics at them.

Dr Sarah Partridge
And I really, really don’t endorse that. I don’t feel that we do know when people’s numbers are going to be up. And I think there are so many different ways that people can defy the odds, as the integration health care pathway often shows. You know, there are patients out there that really do unexpectedly well, as their doctors say.

Robin Daly
Just tell me, when you do something like that, you achieve something that no amount of sedatives was able to achieve, does this have a bit of a ripple effect with your colleagues? They sort of take interest?

Dr Sarah Partridge
It’s interesting, I mean, I think I’m known, you know, within my department for having a passion about hypnosis and I do get referred patients with that in mind. I think it still seems to many of them somewhat, perhaps, off the standard path. I mean, to be honest, I’m just always happy to help anybody who’s having difficulty and I think that, you know, from the point of view of different strategies, you know, work for different patients and a lot of people do resort to, you know, diazepam or sedation. But I think, you know, the more we can empower patients not to be dependent on a polypharmacy to get through their treatment, the better. And the amazing thing about hypnosis is that, you know, we see patients going through treatment on simple analgesia whereas the majority of patients without hypnosis are on heavy -duty opiates and, you know, that take some time to get off.

Dr Sarah Partridge
So it’s very true that when you’re in a trance, and this was one of the initial phenomenon noted about hypnosis, was that in trance, patients don’t feel pain in the same way. So it’s a very, very versatile tool.

Robin Daly
Well, we’ve just been talking to a pain specialist last time about the nature of pain and learning quite a bit, I was, anyway, about what pain is and actually how much control we do have over what happens.

Dr Penny Kechagioglou
I’m wondering, Sarah, whether any of your colleagues, our colleagues, have actually tried it, because, you know, obviously it’s a tool, isn’t it, to reduce anxiety, reduce stress. From what you were saying, it can be used for, you know, various conditions, I guess.

Dr Sarah Partridge
and that we have, as part of our webinars and our attempts to sort of teach about hypnosis, included our health care professionals. I think the sad thing is that there is an interest out there, but often people don’t make the time to come to these events and it’s one of the mixed blessings of the remote access type of interaction, is that a lot of people will sign up and you get a good turnout, but very few actually turn up because, you know, when you got to the end of the day, you’re exhausted. Actually, if you’d only have come, you’d have felt much less exhausted by the end of the session, in a place you don’t know that. And I really love hypnosis for my own mental wellbeing, because actually, I mean, the same as all of us, we have exhausting days and sometimes very, very frustrating days, and you have a lot of emotional churning about sometimes the people you’re dealing with and,

Dr Sarah Partridge
you know, the politics of medicine sometimes, and having a technique that is actually incredibly quick, that revolves around having a little strategy of batting, you know, those emotions into space, or just taking some breathing time and just going into your own favourite place, is an incredibly effective tool. And you do sort of come out of the other side of that, refreshed and invigorated, and it’s very strangely effective on how it can switch off a lot of negative emotions, or certainly allow you to sort of pick up when you are starting to ruminate, because I have been through very frustrating times in my career where rumination was a real problem, or if only I’d said this and, you know, I shouldn’t have done that.

Dr Sarah Partridge
And actually, the first part of recognising what needs to change is recognising what’s going on in your own head. And so part of the strategy of learning hypnosis and self -hypnosis is being able to recognise there is negative thought patterns, which are telling you something about your whole state of wellbeing, and then being able to control that very easily and relaxing as well, which is often, you know, not going along with any of your rumination, quite the opposite. So I think, absolutely, you’re spot on. We need to find a way of trying to promote this for a self -care tool, and in fact, because I have my President’s hat of the Royal College of Medicine for the section of hypnosis and psychosomatic medicine, we’re trying to formulate ways of integrating with a lot of other different sections,

Dr Sarah Partridge
telling them about hypnosis, and, you know, designing events that allow us to get the message across, because it’s a total travesty, it’s not taught in medical schools, really. It should have been, there was a directive that it should have been, but it sort of fell out of the list of things to teach. As with many.

Dr Penny Kechagioglou
other things that fell out of that case. Yes, yes.

Robin Daly
Well in a sensible situation it would be the first thing you tried and it would be the hypnosis and if that didn’t work okay out with the heavy drugs that would be the right way around you rather than you being the last resort let’s get Sarah in

Dr Sarah Partridge
Well, indeed. I mean, I think empowering patients though and allowing patients to be, you know, to have access to the tools is something I’m hoping to change within my trust. And I think we are getting sort of more integration that the anesthetists are certainly learning how to use hypnosis far more regularly now, because of needle phobias and, you know, that sort of thing and pain management. So I think it is getting there, but I very much endorse that, you know, by empowering our patients to try and explore these different avenues, you know, what we need to try and do is to build in these sort of options where you can remind people gently and maybe open up a fora within the cancer charity setting in a fairly spaced setting where maybe some of the recordings can be used in a nice quiet space.

Dr Sarah Partridge
We’re trying to do some radiology work actually at the moment because using the claustrophobia audiophile, which a lot of patients have problems with with MRIs, of course, using a claustrophobia audiophile half an hour before and during patients going through an MRI scanner may be a game changer. In fact, one trust up north, I think has saved £250 ,000 in six months from just giving patients some hypnosis to address that and avoiding sending them down to London to an upright scanner. So I think it is a cost efficient intervention. And if you think about the number of patients who wouldn’t need to take as many drugs, who would bounce back more quickly, patients on ITU have been shown in a series of randomized controlled studies to get off ventilators on average two days earlier, get off ITU tuna, they engage better with their rehab, they have less PTSD and post ITU psychosis is a very real problem.

Dr Sarah Partridge
And so it is really something that I think as a profession, we really need to take some notice of it because it could bring so much and save us as clinicians, a lot of stress by using it ourselves, but also for dealing with patients who were by using it less stress themselves, because I think we all catch stress in highly contagious conditions. Indeed.

Robin Daly
You know, it’s way, and furthermore, of course, you’re, you’re opening up the possibility of a tool for the patient as well to take away with them.

Dr Sarah Partridge
and a life tool. Absolutely, yeah.

Dr Penny Kechagioglou
and an inexpensive way to actually deal with symptoms but also clearly improve outcomes.

Dr Sarah Partridge
Exactly. And I think once they can get into the habit of doing it for themselves, they can make it whatever they need it to be. And, you know, I think for medical students, it’s to help as well. They’ve done studies in medical students showing that they have less viral infections, they cope with exam stress better, they perform better, assist learning. They’ve even done studies in HIV patients in the pre -current era with all the marvelous drugs we have for that. But they actually managed to show that patients taught self -hypnosis with HIV in the 80s had less age -defining illnesses. So actually, that’s quite remarkable when you think that they have a defective immune system anyway, you know. So there’s something very deep going on with hypnosis.

Robin Daly
of the mind. Yeah, very interesting. I was just thinking of you in your position. I mean, something that I’m often thinking about is that an oncologist, you know, set aside the hypnosis, an oncologist is in a very powerful position to give quite a negative message or a very positive and empowering message anyway. And you obviously, you’ve got a special weapon as well, a very special tool you add to it. And you’re giving your patients this incredibly empowering message, which I mean, I’d like to hear all oncologists talking to their patients in the way that you do, which is not closing things off and having certain things about things they don’t know really, and saying, well, you know, we don’t know what’s possible,

Robin Daly
let’s do our best here, and giving them an open way forward where they might do a lot better than anybody expects. And I think that’s so important. And the interesting thing about the hypnosis is, it’s like a technique, if you like, for doing that, for giving people a decent supportive message, you know, a positive one, to help them the most. So, you know, if that could be rolled out as something for people to learn, it would be marvelous.

Dr Sarah Partridge
Well, I mean, our main push is to try and actually educate the health care professionals because they are the signed posters and I think clinical nurse specialists and, you know, allied health professionals of every level can also, you know, assist in that. And so the hope is that with more digital tools like the audio files, you know, it’s not going to be a manpower deficit or an expensive intervention to put into place. Organizationally, but there are a few more people to persuade before we can actually get that seen as a normal featured most trust.

Dr Penny Kechagioglou
It could incorporate it within almost like your treatment protocol, right? I mean, if you know you’re going to treat your head and neck patient with so many.

Dr Sarah Partridge
treatments. I very much flag that for my patients that we can play the audio files while they’re having the radiotherapy through the Linux audio system. I think it’s all about normalisation and having it as part of the normal spectrum of things that you can do to help yourself. And a lot of patients do need a little bit of hand -holding to help themselves initially. Once they’ve got the hang of it, you know, they run with the bathroom. Amazing.

Robin Daly
I think there is more room in general public awareness for some other kinds of approaches these days. There’s quite an appetite for things which are like non -drug, for example, if possible. And so it’s a great time to be pushing your message, I think.

Dr Sarah Partridge
I hope the NHS’s current predicament might allow us to rationalise doing things a little bit differently going forward, because we all need sometimes to think outside the box and do things not only that people have always done them. And I think that in the whole integrated health and oncology world, you know, it is part of that as well. So I think hypnosis is but one of the large armamentarium that we can talk to patients about. And yes, I think time is the most challenging thing. And so I think we have to really make more connections between people who can, so that the patient has a much more sort of punctuated journey with different specialists. And then they can hopefully find the thing that works for them.

Robin Daly
Yeah. Yeah. All right. Well, fascinating. Thank you very much indeed, Sarah. It’s absolutely passionate about your topic, as usual. First, I’ve come to expect and very persuasive. So I hope that some of our listeners will be persuaded by your message to want to take a look, to introduce it into their practice. I can just see that, you know, such an enormous range of possible applications for a technique like that in medicine.

Dr Sarah Partridge
Well, thank you for allowing me to run away like a train again. I thought of my favourite topic.

Dr Penny Kechagioglou
but

Dr Sarah Partridge
Thank you. All the best. It’s been a real pleasure.

Dr Penny Kechagioglou
Thank you so much, Sarah. Thank you very much.

Robin Daly
Thank you for listening to Cancer Talk. Do subscribe and look out for the next edition of our podcast. And if you have friends and colleagues interested in the development of UK Cancer Care, do pass on the details of Cancer Talk. Goodbye.