[Use of positive suggestions in medical practice: experiences in the intensive care unit]

The stressful states (e.g. the state of illness, sickness, acute or chronic pain, comatose and perioperative states) can be considered as psychological states in which we are more susceptible to all suggestions, including the deliberate or involuntary, direct or implicit ones. Under these conditions whether conscious of unconscious, peoples' thinking processes change, become literal, direct and somewhat paranoid, overly sensitive for not only to the direct, but to the implicit, inner meanings of communicative messages, as well. Research evidence shows that even the comatose people may maintain contact with the environment, therefore the conversation around and other communicative effects may serve as a special suggestion. These messages can be (unconsciously) interpreted by the patients following different logic than it would have been processed in the waking state. Treating people who are in these special stressful states one should carefully analyze all of the meaning layers of his/her communication, to make the helpful, positive suggestions more effective, and avoid the negative, destructive ones. The possible negative suggestions are those words, labels, and actions, that may be proper from practical, economical or organisational point of view, but we do not take their implicit suggestive meanings into considerations. The paper gives a detailed overview about the role of suggestions used during the management of a patient in intensive care situations, and some guidelines are outlined to make our (possible) negative suggestions to be helpful and positive.