Mind-Body Techniques in Wound Healing
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I n the realm of wound care, healing may stagnate despite the healthcare provider's best efforts. The behavioral tendencies or attitudes of the patient may contribute to the chronic nature of wound healing. Perhaps the patient has disassociated from the wound - showing up for the appointment is enough, and the healing part is up to the healthcare provider. In another scenario, the patient may feel powerless to make the recommended changes: The sheer pain and stress of having a wound does not allow the patient to make a behavioral change such as smoking cessation. Another subset of patients seems to have lost all goals and hopes to ever heal. Depression is evident in their speech and body language. Finally, some patients simply have more invested in staying wounded. For this type of patient, the wound may provide an excuse not to return to work. The patient also may fear the loss of attention if he or she actually were to heal.
In contrast, a common group of behavioral attitudes exist in the patient who does heal. Attainable goals expressed include returning to work, attending a daughter's wedding, or taking a planned vacation. The healed patient may have been more receptive to learning and compliant with treatment. Often, this type of patient does not express fear of the physical wound. Instead, the patient is curious, willing to look at the wound, and above all, eager to participate in the healing process.
When considering those who heal and those who do not, no disparity in the treatment options offered to both groups is readily evident. However, a common thought pattern emerges in those whose healing has stagnated. The mind and spirit, and overall willingness to heal, play a significant role in the body's ability to heal physically. The challenge for the healthcare provider is to understand the deeper wounds that are intimately related to the physical wound. The purpose of this article is to review the literature regarding wound healing and mind-body health, as well as to provide the clinician with a model of mind-body techniques that can facilitate healing in the chronic wound patient.
Curing versus Healing
Clinical goals often are structured toward curing through the removal of symptoms.1 Evidence-based research strives for positive and measurable outcomes. However, when providers shift the emphasis from treating the wound to treating the human being in which the wound exists, a deeper opportunity for healing may be achieved.2 Only then can healthcare providers truly serve as co-facilitators of healing, rather than merely attempting to cure the superficial symptoms. This stated, healing is accomplished by the individual who is sick.1 Healthcare providers bring the gifts of love and kindness to their patients through their skills and compassion. Mother Theresa of Calcutta once said, "It is not how much we do, but how much love we put in the doing." A healthy caregiver-patient relationship will enable the innate doctor within to go to work.2 However, a critical role in the healing process is the patient's participation and desire to heal. Herein lies the challenge for even the most resourceful clinician.
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