Major elements of a 15-minute suggestion therapy session for habit cough/somatic cough disorder*

Open the session by expressing confidence that the coughing will stop.

Explain the cough as a vicious cycle that started with an initial irritant that is now gone and that the cough itself is causing more irritation and more coughing.

Instruct the patient to concentrate solely on resisting the urge to cough for an initially brief time period (eg, 1 minute). Progressively increase this time period and initiate an alternative behavior, such as sipping lukewarm water or inhaling a soothing cool mist from a vaporizer, to "ease the irritation."

Tell the patient that each second the cough is delayed makes it easier to suppress further coughing.

Repeat expressions of confidence that the patient is developing the ability to resist the urge to cough: "It's becoming easier to hold back the cough, isn't it?" (Nodding affirmatively generally results in a similar affirmation movement by the patient.)

When the patient shows that he or she is able to suppress the cough (usually for approximately 10 minutes), ask in a rhetorical manner, "You're beginning to feel that you can resist the urge to cough, aren't you?" (Say with an affirmative head nod.)

Close the session when the patient can repeatedly respond positively to the question "Do you feel that you can now resist the urge to cough on your own?" Only ask this question after the patient has gone 5 minutes without coughing.

Express confidence that if the urge to cough recurs, the patient can do the same thing at home (autosuggestion)^¶.

* Tic cough is also known as habit cough. Somatic cough disorder was previously known as psychogenic cough. Although these types of cough have distinct definitions, they may not always be distinguishable clinically,and the initial approach to management is similar, unless clear markers of somatic cough disorder are present.
¶ The autosuggestion is for 15-minute sessions at home, in which the patient concentrates on holding back the cough using sips of lukewarm water to "ease the irritation causing cough."

Graphic 58800 Version 7.0

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Major elements of a 15-minute suggestion therapy session for habit cough/somatic cough disorder*