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Published online by Cambridge University Press: 14 June 2004
This is report of the successful use of behavioral treatment in a medical crisis. The intubation process inadvertently punctured a patient's throat during the application of general anesthesia while having a routine arthroscopy. This resulted in a rapidly spreading infection, spiking temperature and dehydration. To locate the puncture, a barium swallow x-ray was necessary, but the patient's weakened condition made standing impossible. A friend and experienced therapist accompanying the patient helped him stand for the several minutes necessary to complete the barium swallow by countering the hypotensive state with angry imagery to stimulate an adrenalin surge. Several principles of effective therapeutic practice were demonstrated by this case, including the importance of the alliance, of technical eclecticism, of engaging the patient in the treatment process, and therapist experience.
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