tl;dr According to Professor Dr. Faymonville it is impossible to use hypnosedation during a sternotomy because it precludes spontaneous breathing.
The question of whether hypnosis is so strong that you could even use it to perform open-heart surgery without further anesthesia continues to bother Mattias Desmet. In a previous post, I explained why I think this is such an important issue for him: “‘Mass formation is exactly the same as hypnosis’ he repeatedly states, and therefore, if hypnosis, in reality, is not as powerful as he presents it, then logically mass formation is also not as powerful.”
Peter Zegers, with whom I wrote an extensive fact-check of Desmet’s bestseller, discovered that Desmet already mentioned this idea of open-heart surgery under hypnotic sedation in an earlier book and has probably been telling students this in his classes for many years. You can find a video registration of such a class (2019-2020), in which he tells it exactly as he wrote it down in his book:
Faymonville […] uses hypnotic sedation in operations on a daily basis. And its use is certainly not limited to minor operations. Sometimes it concerns open-heart surgeries in which the surgeon has to cut right through the sternum. Perhaps more remarkable still is that, through hypnosis, Faymonville can not only provide general anesthesia, but she can also achieve precise manipulations of the body, such as stopping the bleeding of a vein. On her suggestion ‘You will stop bleeding now’, one can see how the blood vessel contracts. As an aside: Note that the contracting of a vein completely escapes any conscious control or intention of the subject itself, but that the intention of another person (i.e., the doctor that performs the hypnosis) seems to have a grip on this.Lacan’s logic of subjectivity (2019), p.46
Two remarkable claims in this fragment. The first is that Faymonville herself would have been involved in open-heart surgery under hypnosis. Desmet has made it known in statements since then, though, that this was a mistake on his part. The second claim about the manipulation of a specific blood vessel is actually at least as remarkable.
On his Substack Desmet published in collaboration with Tineke De Cock a long article on the use of hypnosedation in history in which they also try to tackle the criticism that it can’t be used for open-heart surgery.
Professor Dr. Marie-Elisabeth Faymonville – the Belgian anesthetist who relaunched hypnosis in the operating theater after decades of distrust in 1991 – said a few years ago in an interview with the Belgian newspaper De Morgen (read here for non-subscribers), however, that hypnosis cannot be used in open-heart surgery. Her arguments are not entirely clear, but she cites as a reason that the heart must be stopped during such procedures. She suggests that this technical limitation precludes the use of hypnosis as a substitute for general anesthesia. This argument is somewhat questionable for a couple of reasons.Hypnosedation – Mind over matter in the operating room (Substack, 2023)
I quoted from the same newspaper article in my first post on this matter to show that the person Desmet brings up as THE authority has herself stated that open-heart surgery under hypnosis is not possible at all. The reason she gave for this in this quote did not seem like the whole story at the time, as I was also familiar with (rare) surgeries performed on a beating heart. And that is exactly what Desmet and De Cock bring up. They argue, somewhat correctly, that this argument from Faymonville is not the final blow, but, on the other hand, hold very easily to Dave Elman’s completely unverifiable story that such an operation would once have been performed under hypnosis.
And to take things one step further: if sawing through a leg is possible under hypnosis, without any form of anesthesia (as described f.e. in The Lancet article mentioned above), do we then have many reasons to doubt that sawing through the breastbone under hypnosis, without any form of anesthesia, is possible as well? All the evidence suggests that Dave Elman’s achievement – open-heart surgery under hypnosis – is indeed possible.Hypnosedation – Mind over matter in the operating room (Substack, 2023)
But they neglect to think further about other reasons that would rule out open-heart surgery under hypnosis or to ask this expert herself for a more detailed explanation.
An enlightening phone conversation with Professor Faymonville
Zegers and I first contacted Professor Dr. Marie-Elisabeth Faymonville via mail, and on 11 April I had a brief, but enlightening conversation with her on the phone. Right away, she explained that the reason open-heart surgery is not possible under hypnotic sedation is not that the heart should be stopped, but that the problem lies with the ventilation. A sternotomy (“cutting straight through the breast bone” as Desmet has repeated over and over again) changes the ventilatory mechanism of breathing, it makes spontaneous breathing impossible! If the thorax is opened you can no longer create the negative pressure which is necessary to inhale and therefore you need mechanical ventilation during such operations. During hypnosedation the patient is conscious and breaths spontaneously, so this cannot be combined with a sternotomy. It’s simple as that.
This also makes clear that the story of Elman simply can’t be true, at least it must be a distortion of what happened. Although Faymonville told me she knows his name, she dismissed this story as an impossibility.
Desmet is also completely wrong about stopping the bleeding of a specific blood vessel. What Faymonville found in her research is that, in nasal surgery, they had less bleeding in a general sense when they performed it under hypnosedation versus general anesthesia. The difference is that under hypnosedation the patient breathes spontaneously and does not create overpressure as occurs with mechanical ventilation. When Desmet is quoting Faymonville suggesting ‘You will stop bleeding now’ his fantasy must have run wild.
I also asked Faymonville what she thought of Desmet’s description of hypnosedation used with surgery as “focussing the attention on one small aspect of reality and causing people to lose awareness of the rest of reality.” She explained to me that she sees it more as enabling the patient to dissociate from the surgery; physically he is in the operating room, but mentally he is completely absent. It’s more like a different conscious state than a focus on one aspect of reality.
Of course, Desmet could have learned this years ago and avoided spreading his misconceptions on this subject, if he had just contacted Faymonville himself, which he never did.
I think we can now conclude with sufficient certainty that open-heart surgery under hypnosis is not possible. The problem is mainly in breathing, as soon as you open the chest, the patient will need mechanical ventilation, which precludes the use of hypnosedation.