Coughs can be caused by a variety of factors, including GERD, asthma, upper respiratory infections, and allergies. Some patients also have habitual coughs known as cough tics, which can last for years without being triggered. Coughing may occur several times per day, but once asleep, the cough almost always ceases.
Medications do not help with a habitual cough because there is no physical cause for it. However, because many doctors are slow to recognize habit cough, children are frequently treated with asthma, allergy, acid reflux, and/or tic disorders with no improvement before a diagnosis is made.
Here’s a story of an FD patient who used self-hypnosis to block out the sensation that causes coughing. In her own words, Alyson Brenner, Michael Brenner’s mother, discusses her family’s experience with self-hypnosis.
Hypnosis can be very effective in the treatment of habitual cough. It should be considered early in the treatment plan for any child who has a chronic cough that does not improve with medical therapy.
In April, my son Michael, now 34 years old with a diagnosis of Familial Dysautonomia, was seen by his pulmonologist, Dr. Mikhail Kazachkov, for a telemedicine consultation for evaluation of respiratory problems. Michael is followed by Dr. Kazachkov for management of his asthma and mild restrictive lung disease. Chronic cough was the main reason for the visit and had been bothering Michael for some time. Previous treatment with antibiotics did not remedy the issue, and it seemed that the cough was strongly related to certain routines, such as administration of inhaler medications, getting ready to eat meals, and G-tube feeds. He had no cough during sleep. The doctor was able to witness a coughing episode during the video call which was accompanied by dramatic body language after only a suggestion that he administer a dose of his inhaler.
The doctor determined that Michael’s cough was psychogenic, precipitated by certain routines which were causing him anxiety and he referred Michael to the Breathing Clinic run by Jessica Erkman, CPNP who had vast expertise and experience in the management of psychogenic breathing disorders. A video session was arranged.
Michael met with Jessica Erkman through a video conference and she talked with him about how his brain learns, anticipates things, and learns when he does certain things. She talked about his cough and how previous experiences he had contributed to how the body automatically reacts. She described how he needs to retrain the brain to “not cough” and how he can feel comfortable.
Michael learned to use his mind and imagination before it was time to do a task, such as a tube feed, by going to a happy place or experience in his mind. He learned to breathe while bringing his body to the happy place and become relaxed. Jessica stressed that “You are in charge of your brain!” She instructed Michael to think about being the “boss of his body” while thinking of the happy place/activity. She also explained that powerfully using the mind takes practice and that the more he does this, the more control he will gain at being the boss of his body.
We immediately saw a reduction in the duration and severity of the cough when Michael began this practice. At this time, the cough does persist, but Michael understands that he needs to “put in the work” to get the desired results. He is happy with knowing the root cause of the issue and is committed to continuing the practice of being in total control.
As a parent, it is important to keep looking for answers when your child has an issue. We started by addressing the cough with his pulmonologist who was thorough in exploring all of the medical possibilities and was able to determine, by observation, the true issue at hand. He was most instrumental in referring Michael to someone who could help him, and for that, we are so grateful!
Hypnosis can be very effective in the treatment of habitual cough. It should be considered early in the treatment plan for any patient who has a chronic cough that does not improve with medical therapy.