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Etude en anglais sur l'éfficacité et l'utilité de l'hypnose thérapeutique
Alcohol and Drugs - Breast Augmentation - Childbirth - Dental Hypnosis - Depression - Dermatology - Dyspepsia - Habits - Impotence - Pain Management - Phobias - Pre and Postoperative - Sports Improvment - Stress Management - Study Skills - Addiction - Weight Management
Alcohol and Drugs
Am J Clin Hypn. 2004 Apr;46(4):281-97
Self-hypnosis relapse prevention training with chronic drug/alcohol users: effects on self-esteem, affect, and relapse.
Pekala RJ, Maurer R, Kumar VK, Elliott NC, Masten E, Moon E, Salinger M.
Biofeedback Clinic (116B), Coatesville VA Medical Center, Coatesville, PA 19320-2096, USA. Ronald.Pekala@med.va.gov
This study evaluated the effectiveness of a self-hypnosis protocol with chronic drug and alcohol patients in increasing self-esteem, improving affect, and preventing relapse against a control, a transtheoretical cognitive-behavioral (TCB), and a stress management (attention-placebo) group. Participants were 261 veterans admitted to Substance Abuse Residential Rehabilitation Treatment Programs (SARRTPs). Participants were assessed pre- and post intervention, and at 7-week follow-up. Relapse rates did not significantly differ across the 4 groups at follow-up; 87% of those contacted reported abstinence. At follow-up, the participants in the 3 treatment conditions were asked how often they practiced the intervention materials provided them. Practicing and minimal-practicing participants were compared against the control group for each of the 3 interventions via MANOVAs/ANOVAs. Results revealed a significant Time by Groups interaction for the hypnosis intervention, with individuals who played the self-hypnosis audiotapes "at least 3 to 5 times a week" at 7-week follow-up reporting the highest levels of self-esteem and serenity, and the least anger/impulsivity, in comparison to the minimal-practice and control groups. No significant effects were found for the transtheoretical or stress management interventions. Regression analyses predicted almost two-thirds of the variance of who relapsed and who did not in the hypnosis intervention group. Hypnotic susceptibility predicted who practiced the self-hypnosis audiotapes. The results suggest that hypnosis can be a useful adjunct in helping chronic substance abuse individuals with their reported self-esteem, serenity, and anger/impulsivity.
Breast Augmentation
Peter H.C. Mutke, M.D. (UCLA) performed the first study. He presented his results as a research paper to the Department of Neuropsychiatry, University of California, Los Angeles, February 28, 1971. As of 1994, Dr Mutke was still with UCLA and has been active in the American Council of Hypnotist Examiners.
2. Williams, J.E., Stimulation of breast growth by hypnosis. "Journal of Sex Research," 1974, 10:316-326. His thirteen volunteers averaged 2.11 inch increase in the circumference of their breasts (2 cup sizes).
3. Staib, A.R., and Logan, D.R., Hypnotic Stimulation of Breast Growth. "The American Journal of Clinical Hypnosis," 1977, 4:201-208. They repeated Dr. Williams' results with similar results. They also found women's waist size decreased by 1.4 inches. Their follow up study showed that 81 % of the breast enlargement was retained several months after the women stopped their visual imagery.
4. Willard, R. D., Breast enlargement through visual imagery and hypnosis. "The American Journal of Clinical Hypnosis," 1977, 4:195-200. Dr Willard used a different technique than Dr. Williams (who used age regression and age progression) and achieved an average 1.44 inch increase in breast size for his 22 volunteers. Every woman had an increase in their breast circumference.
Beran, Roy (a neurologist at Adelaide Children's Hospital, England) presented the results of his study to the February 1979 National Convention of Hypnotherapists in Adelaide. Dr. Beran showed that the breast volume (he measured the breast's cubic displacement of water) more than doubled during the three month hypnosis program.
Excerpt of the RESULTS section of the Willard study:
At the end of 12 weeks, 28% had reached the goal they had set at the beginning of the program and desired no further enlargement. There were 85% who could tell a significant enlargement in their breasts had been accomplished, and 46% found it necessary to buy a larger brassiere. Forty-two percent had a loss in weight of greater than 4 pounds and still had enlargement of their breasts. The average increase in circumference was 1.37 inches; the average increase in the vertical measurement was 0.67 inches and the average increase in horizontal measurement was 1.01 inches.... [note: the study was continued past 12 weeks to let those who hadn't reach their goals to do so.]
In this study, 63% of the subjects had had children and complained of pendulous breasts. These subjects expressed a desire to reclaim the fullness and contour of the breasts which they had before the pregnancies. All of these subjects reported they were very pleased with the increase in fullness and firmness of their breasts at the end of the study....
The only two subjects who subjectively felt there had been no significant increase, did have a measurable increase in size. Both subjects had difficulty obtaining the visualizations. All of the subjects reported an increase in firmness of their breasts. All of the subjects who began the study with one breast smaller than the other found them to be equal in size at the end of the twelve weeks.
Childbirth
Contraception 2007 Jan;75(1):52-8.
The use of hypnosis to improve pain management during voluntary interruption of pregnancy: an open randomized preliminary study.
Marc I, Rainville P, Verreault R, Vaillancourt L, Masse B, Dodin S.
Chaire Lucie et André Chagnon pour l'Avancement d'Une approche intégrée en santé, Hôpital St-François d'Assise, CHUQ, Université Laval, Quebec City, PQ, Canada.
OBJECTIVE: This report describes an open randomized study that aims to determine whether a brief hypnotic intervention during first-trimester surgical abortion reduces requests for pain medication. METHODS: Thirty women undergoing first-trimester surgical abortion at the family planning clinics of a large hospital in Quebec City were randomized into a control group that received standard care and a hypnosis group that received, in addition to standard care, an intervention of hypnosis, including analgesia suggestions 20 min before and throughout the surgical procedure. Patients in both groups were given the option to control their pain with nitrous oxide (N(2)O) sedation administered through a nose mask as often and for as long as they wanted during the procedure. N(2)O sedation as the primary outcome was assessed at each step of the procedure. The patient's self-reported anxiety and pain were also assessed during the procedure as secondary outcomes. RESULTS: Thirty-six percent of patients in the hypnosis group requested N(2)O sedation during the procedure versus 87% in the control group (p<.01). No differences between the groups were found in reports of pain and anxiety during the procedure. CONCLUSION: These results suggest that hypnosis can be integrated into standard care and reduces the need for N(2)O in patients undergoing first-trimester surgical abortion. This reduction in N(2)O consumption did not lead to significant changes in pain or anxiety, and a larger sample size is required to assess the possible effects of hypnosis on those variables.
PMID: 17161125 [PubMed - indexed for MEDLINE]
MCN Am J Matern Child Nurs. 2002 Nov-Dec;27(6):335-40; quiz 341.
Self-hypnosis: alternative anesthesia for childbirth.
Ketterhagen D, VandeVusse L, Berner MA.
Women's Health Center, Waukesha Memorial Hospital, Waukesha, WI 53188, USA. debra.ketterhagen@phci.org
The purpose of this article is to inform nurses about the use of self-hypnosis in childbirth. Hypnosis is a focused form of concentration. Self-hypnosis is one form of hypnosis in which a certified practitioner or therapist teaches an individual to induce his or her own state of altered consciousness. When used for childbirth pain, the primary aim of self-hypnosis is to help the woman maintain control by managing anxiety and discomfort though inducing a focused state of relaxation. Before the widespread use of pharmaceuticals for pain, hypnosis was one of the few pain relief methods available for labor. However, as new technologies for pain relief emerged, hypnosis received less attention. Most nurses have little experience with hypnosis, and there is limited information available in the literature. However, because nurses are at laboring women's bedsides, it is important that nurses learn about self-hypnosis to be able to inform pregnant women fully about all pain control options and to maximize the benefits for the woman choosing hypnosis.
Br J Anaesth. 2004 Oct;93(4):505-11. Epub 2004 Jul 26.
Hypnosis for pain relief in labour and childbirth: a systematic review.
Cyna AM, McAuliffe GL, Andrew MI.
Department of Women's Anaesthesia, Women's and Children's Hospital, Adelaide, South Australia 5006, Australia. cynaa@wch.sa.gov.au
BACKGROUND: In view of widespread claims of efficacy, we examined the evidence regarding the effects of hypnosis for pain relief during childbirth. METHODS: Medline, Embase, Pubmed, and the Cochrane library 2004.1 were searched for clinical trials where hypnosis during pregnancy and childbirth was compared with a non-hypnosis intervention, no treatment or placebo. Reference lists from retrieved papers and hypnotherapy texts were also examined. There were no language restrictions. Our primary outcome measures were labour analgesia requirements (no analgesia, opiate, or epidural use), and pain scores in labour. Suitable comparative studies were included for further assessment according to predefined criteria. Meta-analyses were performed of the included randomized controlled trials (RCTs), assessed as being of "good" or "adequate" quality by a predefined score. RESULTS: Five RCTs and 14 non-randomized comparisons (NRCs) studying 8395 women were identified where hypnosis was used for labour analgesia. Four RCTs including 224 patients examined the primary outcomes of interest. One RCT rated poor on quality assessment. Meta-analyses of the three remaining RCTs showed that, compared with controls, fewer parturients having hypnosis required analgesia, relative risk=0.51 (95% confidence interval 0.28, 0.95). Of the two included NRCs, one showed that women using hypnosis rated their labour pain less severe than controls (P<0.01). The other showed that hypnosis reduced opioid (meperidine) requirements (P<0.001), and increased the incidence of not requiring pharmacological analgesia in labour (P<0.001). CONCLUSION: The risk/benefit profile of hypnosis demonstrates a need for well-designed trials to confirm the effects of hypnosis in childbirth.
Fertil Steril. 2006 Mar 25;
Impact of hypnosis during embryo transfer on the outcome of in vitro fertilization-embryo transfer: a case-control study.
Levitas E, Parmet A, Lunenfeld E, Bentov Y, Burstein E, Friger M, Potashnik G.
Fertility and IVF Unit; Department of Obstetrics and Gynecology, Soroka University Medical Center.
OBJECTIVE: To investigate whether hypnosis during ET contributes to successful IVF/ET outcome. DESIGN: Case-control clinical study. SETTING: Academic Fertility and IVF Unit, Soroka Medical Center, Beer-Sheva, Israel. PATIENT(S): Infertile couples undergoing IVF. INTERVENTION(S): Ninety-eight IVF/ET cycles with hypnosis during the ET procedure were matched with 96 regular IVF/ET cycles. MAIN OUTCOME MEASURES: Comparison of clinical pregnancy and implantation rates between the two groups. RESULT(S): We obtained 52 clinical pregnancies out of 98 cycles (53.1%) with an implantation rate of 28% among hypnosis IVF/ET cycles, and 29 out of 96 (30.2%) clinical pregnancies and an implantation rate of 14.4% in the control cycles. Our overall IVF program pregnancy rate for the same period was 32.1%. Logistic regression analysis was performed emphasizing the positive contribution of hypnosis to the IVF/ET conception rates. CONCLUSION(S): This study suggests that the use of hypnosis during ET may significantly improve the IVF/ET cycle outcome in terms of increased implantation and clinical pregnancy rates. Furthermore, it seems that the patients' attitude to the treatment was more favorable.
Dental Hypnosis
Fogorv Sz. 2002 Oct;95(5):199-203
[Psychic aspects of the overactive gag reflex (gagging) in connection with a clinical case]
Gaspar J, Fejerdy L, Fabian TK.
Semmelweis Egyetem, Fogorvostudomanyi Kar, Fogpotlastani Klinika, Budapest.
The overactive gag reflex is one of the etiologic categories of psychosomatic symptoms, which most often arise from environmental stressors. If organic disturbances, anatomic anomalies, or biomechanical inadequacies of existing prostheses are not key causes, the services of trained specialists are needed to help with behavioural management of the problem. Hypnosis can provide the clinician with a set of techniques, which may be used to augment or facilitate a particular course of treatment. In the case report, the patient's history and her overactive gag reflex suggested to use hypnosis therapy. The responsibility of a dentist can be found in his possible recognition of eventually necessary psychotherapy when consulting a patient.
Rev Belge Med Dent. 2003;58(2):99-104
[Hypnosis techniques used to diminish anxiety and fear: review of the literature]
Willemsen R.
Service de dermatologie, AZ Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Jette. riawil@pi.be
Hypnosis can be a valuable technique in the management of patients who fear medical treatment. Hypnosis leads to a stronger concentration and a more focussed attention, and thus to a better acceptance and greater effectiveness of suggestions. Literature indicates that hypnotherapy can reduce pain and fear in case of dental or medical phobia. After a short review of the existing literature on the topic, the practical aspects of the hypnotic approach are explained.
ASDC J Dent Child. 2000 Jul-Aug;67(4):263-7, 231
The use of imagery suggestions during administration of local anesthetic in pediatric dental patients.
Peretz B, Bimstein E.
Department of Pediatric Dentistry, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.
The aim of this study was to evaluate the effects of suggestion before and during the administration of local anesthesia to children. These effects were then observed and correlated with social, behavioral and dentally related variables. Eighty children between the ages of three and sixteen years and who required at least one injection of local anesthesia were monitored. Retrospective examinations of their dental records provided the information regarding the behavior and dental treatment histories of the patients. All other data were provided through observation during the dental treatment phase. During the first treatment session, before the injection, each child was asked to select a favorite, pleasant memory or image. Where children had difficulty in identifying an image, one was proposed by the dentist. After an image had been chosen, the patients were asked to concentrate on the image and to visualize it during the procedure. The majority of children had chosen their own images, and significantly visualized the same images throughout the injection procedures. Image selection and visualization had no association with gender, age, the parent's assessment of the child's behavior, previous dental experience, behavior (both past and present) or, management techniques (both past and present). We conclude that imaging techniques may be successfully utilized in the administration of local anesthesia to young children (from three years of age) in an effort to mitigate untoward, pain-related stress.
Eur J Oral Sci. 2002 Aug;110(4):287-95.
A 3-year comparison of dental anxiety treatment outcomes: hypnosis, group therapy and individual desensitization vs. no specialist treatment.
Moore R, Brodsgaard I, Abrahamsen R.
Department of Oral Epidemiology and Pediatric Dentistry, Dental Phobia Research and Treatment Center, Royal Dental College, Aarhus University, Denmark. roding@post8.tele.dk
Outcomes of hypnotherapy (HT), group therapy (GT) and individual systematic desensitization (SD) on extreme dental anxiety in adults aged 19-65 yr were compared by regular attendance behaviors, changes in dental anxiety and changes in beliefs about dentists and treatment after 3 yr. Treatment groups were comparable with a static reference control group of 65 anxious patients (Dental Anxiety Scale > or = 15) who were followed for a mean of nearly 6 yr. After 3 yr, 54.5% of HT patients, 69.6% of GT patients and 65.5% of SD patients were maintaining regular dental care habits. This was better than the 46.1% of the reference group, who reported going regularly to the dentist again within the cohort follow-up period, and 38.9% of a control subgroup with observation for 3 yr. Women were better regular attenders than men at 3 yr. Specialist-treated regular attenders were significantly less anxious and had more positive beliefs than regular attenders from reference groups. There were few differences between HT, GT and SD after 3 yr. It was concluded that many patients can, on their own, successfully start and maintain regular dental treatment habits with dentists despite years of avoidance associated with phobic or extreme anxiety. However, it also appears that these patients had less success in reducing dental anxiety and improving beliefs about dentists long-term than did patients who were treated at the specialist clinic with psychological strategies.
J Orofac Pain. 1994 Fall;8(4):397-401.
A cognitive-behavioral approach to temporomandibular dysfunction treatment failures: a controlled comparison.
Oakley ME, McCreary CP, Clark GT, Holston S, Glover D, Kashima K.
Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California, Los Angeles 90024-1762, USA.
The effects of cognitive-behavioral treatment for patients with temporomandibular disorders were studied by comparing active treatment to a wait-list control condition. Patients were predominantly women and had been referred to the study after having poor response to dental/physical medicine care. Patients' conditions were evaluated pretreatment and posttreatment based on self-report measures of pain, distress, and jaw function problems. They were examined by a dentist who assessed pain-free opening, muscle palpation pain, and tenderness of the temporomandibular joints. The 5-week cognitive-behavioral treatment included relaxation training, self-monitoring of stressors, and cognitive coping strategies. Treatment had its greatest impact on improving mood, especially anxiety; however, there were some effects on the patients' experiences of pain.
Dent Clin North Am. 1986 Oct;30(4 Suppl):S93-105.
Relaxation skills for the patient, dentist, and auxiliaries.
Schutt NL, Bernstein DA.
The aforementioned stress reduction techniques can be useful for some people, but not all individuals will benefit to the same degree with a similar technique. Those who manifest severe stress symptoms, such as ulcers, hypertension, and migraine headaches, are advised to seek a medical evaluation before attempting relaxation or any other type of stress reduction method. The relaxation skill most beneficial for an individual's own needs might be best sought through a qualified therapist. Those who desire reduction in general tension, or who wish a rejuvenation during the workday, may well benefit from less controlled stress reduction techniques, such as taped instructions, breathing, and imagery methods. A trained therapist can provide the most appropriate relaxation method for an individual's needs. We, as health care providers, can enlighten our patients about methods which can aid them in dealing with anxiety and stress and thus gain better control over the pace of their lives and ours.
Dent Clin North Am. 1988 Oct;32(4):745-61.
Hypnosis in the treatment of dental fear and phobia.
Forgione AG.
Gelb Craniomandibular Pain Center, Tufts University School of Dental Medicine, Boston, Massachusetts.
The term hypnosis is currently used to define an area of research and treatment that employs suggestion. Within this area, suggestion refers to the induction of expectancies by implicit or explicit means, usually involving concentration and the expectancy that the suggested results are possible. This use of suggestion differs from the common use of the term suggestion, which is a logical offering for a change in behavior or thought. The long history of hypnosis is testimony to its effectiveness, although there has been controversy as to why it works. Patient selection is important. Further, fear must be distinguished from phobia. Combined with other treatment techniques, such as systematic desensitization, it is a powerful behavior modification method. To prevent accidental delivery of suggestions that may be counterproductive to treatment, the study of hypnosis is important even to those health care professionals who have no intention of employing it in their practice.
Am J Clin Hypn. 1991 Apr;33(4):235-40.
Treatment of tongue thrust with hypnosis: two case histories.
Golan HP.
Boston City Hospital, MA.
Tongue thrust is a relatively infrequent habit which can result in disruptive, permanent oral malocclusion, bone changes, and facial disharmony. The use of hypnotic phenomena can augment myofunctional therapy. Temperature control, glove anesthesia, relaxation, and imagery enhance demonstration of the proper way to swallow. The cornerstone of having the patient actually feel the contraction at the insertion of the masseter muscles provides an inner biofeedback which provides a very positive signal that the improper habit is being corrected. Hypnosis can then be used in the manner described to achieve a good clinical result.
Depression
Int J Clin Exp Hypn. 2007 Apr;55(2):147-66
Cognitive hypnotherapy for depression: an empirical investigation. [Article in English, French, German]
Alladin A,
Alibhai A.
University of Calgary. Calgary, Alberta. Canada.
To investigate the effectiveness of cognitive hypnotherapy (CH), hypnosis combined with cognitive-behavioral therapy (CBT), on depression, 84 depressives were randomly assigned to 16 weeks of treatment of either CH or CBT alone. At the end of treatment, patients from both groups significantly improved compared to baseline scores. However, the CH group produced significantly larger changes in Beck Depression Inventory, Beck Anxiety Inventory, and Beck Hopelessness Scale. Effect size calculations showed that the CH group produced 6%, 5%, and 8% greater reduction in depression, anxiety, and hopelessness, respectively, over and above the CBT group. The effect size was maintained at 6-month and 12-month follow-ups. This study represents the first controlled comparison of hypnotherapy with a well-established psychotherapy for depression, meeting the APA criteria for a "probably efficacious" treatment for depression
Dermatology
Dermatology. 2002;204(4):287-9
Verrucae vulgares in children: successful simulated X-ray treatment (a suggestion-based therapy).
Meineke V, Reichrath J, Reinhold U, Tilgen W.
Department of Dermatology, University of the Saarland, Homburg/Saar, Germany. Viktor.Meineke@t-online.de
BACKGROUND: Treatment of verrucae vulgares is sometimes difficult. Invasive methods should not be used for young children. OBJECTIVE: Evaluation of a special suggestion therapy for treatment of verrucae vulgares in children. METHODS: Nine children with warts on the hands and/or feet and in the face were treated with a simulated X-ray treatment. RESULTS: Five children showed a complete remission of warts, 3 children a partial remission. For 1 child, there was no response. On average, 3 treatment sessions were needed for children showing a complete remission. CONCLUSION: This therapy offers an easy-to-perform, alternative treatment option. It is noninvasive and does not depend on special psychological techniques for which training is required. Copyright 2002 S. Karger AG, Basel
Am J Clin Hypn. 1992 Jul;35(1):1-10.
Hypnotherapy for warts (verruca vulgaris): 41 consecutive cases with 33 cures.
Ewin DM.
Tulane Medical School, New Orleans, LA.
Published, controlled studies of the use of hypnosis to cure warts are confined to using direct suggestion in hypnosis (DSIH), with cure rates of 27% to 55%. Prepubertal children respond to DSIH almost without exception, but adults often do not. Clinically, many adults who fail to respond to DSIH will heal with individual hypnoanalytic techniques that cannot be tested against controls. By using hypnoanalysis on those who failed to respond to DSIH, 33 of 41 (80%) consecutive patients were cured, two were lost to follow-up, and six did not respond to treatment. Self-hypnosis was not used. Several illustrative cases are presented.
Psychosom Med. 1990 Jan-Feb;52(1):109-14.
Effects of hypnotic, placebo, and salicylic acid treatments on wart regression.
Spanos NP, Williams V, Gwynn MI.
Department of Psychology, Carleton University, Ottawa, Canada.
Subjects with warts on their hands and/or feet were randomly assigned to a hypnotic suggestion, topical salicylic acid, placebo, or no treatment control condition. Subjects in the three treated groups developed equivalent expectations of treatment success. Nevertheless, at the six-week follow-up interval only the hypnotic subjects had lost significantly more warts than the no treatment controls. Theoretical implications are discussed.
Arch Dermatol. 2000 Mar;136(3):393-9
Hypnosis in dermatology.
Shenefelt PD.
Department of Internal Medicine, College of Medicine, University of South Florida, Tampa 33612, USA. pshenefe@hsc.usf.edu
BACKGROUND: Hypnosis is an alternative or complementary therapy that has been used since ancient times to treat medical and dermatologic problems. OBJECTIVE: To describe the various uses for hypnosis as an alternative or complementary therapy in dermatologic practice. METHODS: A MEDLINE search was conducted from January 1966 through December 1998 on key words related to hypnosis and skin disorders. RESULTS: A wide spectrum of dermatologic disorders may be improved or cured using hypnosis as an alternative or complementary therapy, including acne excoriee, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. CONCLUSION: Appropriately trained clinicians may successfully use hypnosis in selected patients as alternative or complementary therapy for many dermatologic disorders.
Dermatol Clin. 2005 Oct;23(4):723-34.
Complementary psychocutaneous therapies in dermatology.
Shenefelt PD.
Division of Dermatology and Cutaneous Surgery, College of Medicine, University of South Florida, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA. pshenefe@hsc.usf.edu
The skin and the nervous system develop side by side in the fetus and remain intimately interconnected and interactive throughout life. Because of the skin-nervous system interactions, there is a significant psychosomatic or behavioral component to many dermatologic conditions. This permits complementary nonpharmacologic psychotherapeutic interventions, such as acupuncture, aromatherapy, biofeedback, cognitive-behavioral therapy, hypnosis, placebo, and suggestion, to have positive impacts on many dermatologic diseases. Complementary pharmacologic psychotherapeutic interventions, such as herbs and supplements, also may help improve some dermatologic disorders.
Dermatol Ther. 2003;16(2):114-22.
Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind?
Shenefelt PD.
Division of Dermatology and Cutaneous Surgery, Department of Internal Medicine, College of Medicine, University of South Florida, Tampa, Florida 33612, USA. pshenefe@hsc.usf.edu
Biofeedback can improve cutaneous problems that have an autonomic nervous system component. Examples include biofeedback of galvanic skin resistance (GSR) for hyperhidrosis and biofeedback of skin temperature for Raynaud's disease. Hypnosis may enhance the effects obtained by biofeedback. Cognitive-behavioral methods may resolve dysfunctional thought patterns (cognitive) or actions (behavioral) that damage the skin or interfere with dermatologic therapy. Responsive diseases include acne excoriee, atopic dermatitis, factitious cheilitis, hyperhidrosis, lichen simplex chronicus, needle phobia, neurodermatitis, onychotillomania, prurigo nodularis, trichotillomania, and urticaria. Hypnosis can facilitate aversive therapy and enhance desensitization and other cognitive-behavioral methods. Hypnosis may improve or resolve numerous dermatoses. Examples include acne excoriee, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Hypnosis can also reduce the anxiety and pain associated with dermatologic procedures.
Dyspepsia
Habits
Gastroenterology. 2002 Dec;123(6):1778-85.
Gastroenterology. 2002 Dec;123(6):2132-5.
Gastroenterology. 2003 Aug;125(2):636; author reply 637.
Rev Gastroenterol Disord. 2003 Summer;3(3):182-4.
Long-term improvement in functional dyspepsia using hypnotherapy.
Calvert EL, Houghton LA, Cooper P, Morris J, Whorwell PJ.
Department of Medicine, Wythenshawe Hospital, Southmoor Road, Manchester, United Kingdom.
BACKGROUND & AIMS: We have shown hypnotherapy (HT) to be effective in irritable bowel syndrome, with long-term improvements in symptomatology and quality of life (QOL). This study aimed to assess the efficacy of HT in functional dyspepsia (FD). METHODS: A total of 126 FD patients were randomized to HT, supportive therapy plus placebo medication, or medical treatment for 16 weeks. Percentage change in symptomatology from baseline was assessed after the 16-week treatment phase (short-term) and after 56 weeks (long-term) with 26 HT, 24 supportive therapy, and 29 medical treatment patients completing all phases of the study. QOL was measured as a secondary outcome. RESULTS: Short-term symptom scores improved more in the HT group (median, 59%) than in the supportive (41%; P = 0.01) or medical treatment (33%; P = 0.057) groups. HT also benefited QOL (42%) compared with either supportive therapy (10% [P < 0.001]) or medical treatment (11% [P < 0.001]). Long-term, HT significantly improved symptoms (73%) compared with supportive therapy (34% [P < 0.02]) or medical treatment (43% [P < 0.01]). QOL improved significantly more with HT (44%) than with medical treatment (20% [P < 0.001]). QOL did improve in the supportive therapy (43%) group, but 5 of these patients commenced taking antidepressants during follow-up. A total of 90% of the patients in the medical treatment group and 82% of the patients in the supportive therapy group commenced medication during follow-up, whereas none in the HT group did so (P < 0.001). Those in the HT group visited their general practitioner or gastroenterologist significantly less (median, 1) than did those in the supportive therapy (median, 4) and medical treatment (median, 4) groups during follow-up (P < 0.001). CONCLUSIONS: HT is highly effective in the long-term management of FD. Furthermore, the dramatic reduction in medication use and consultation rate provide major economic advantages.
Curr Treat Options Gastroenterol. 2003 Aug;6(4):289-297
Treatment of Functional Dyspepsia.
Feinle-Bisset C, Andrews JM.
Department of Medicine, University of Adelaide, Level 6, Eleanor Harrald Building, Frome Road, Adelaide, SA 5000, Australia. christine.feinle@adelaide.edu.au
Because there is currently no universally effective treatment for functional dyspepsia, a stepwise approach is useful. The initial steps should include 1) making a firm clinical diagnosis and providing the patient with appropriate information and reassurance; 2) ascertaining the reason for referral/consultation, as this determines what the patient will regard as a satisfactory outcome; 3) informing the patient that there is no universally effective drug treatment; and 4) giving dietary and general lifestyle advice, such as ingestion of smaller, more frequent meals, a low-fat diet, avoidance of certain foods that may exacerbate symptoms, limiting coffee and alcohol intake, smoking cessation, and stress management techniques. If the initial approach does not provide a satisfactory outcome, the following approaches may be helpful. Psychologic treatment approaches, such as hypnotherapy and/or antidepressants, have shown very encouraging results in recent studies and deserve active consideration. In patients with uninvestigated dyspepsia, the "test and treat" strategy for Helicobacter pylori is a cost-effective approach. Prokinetics are of possible benefit in subjects with delayed gastric emptying; however, the relationship between improvement of gastric emptying and symptom alleviation is weak. Furthermore, it needs to be recognized that treatments directed at acid suppression are generally of little sustained benefit, and that there is ongoing controversy as to whether H. pylori eradication is of direct benefit.
Aliment Pharmacol Ther. 2006 Apr 15;23(8):1241-9.
Prokinetic effect of gut-oriented hypnosis on gastric emptying.
Chiarioni G, Vantini I, DE Iorio F, Benini L.
Department of Gastroenterology, Rehabilitation Hospital of Valeggio s/M, University of Verona, Verona, Italy.
Summary Background No data are available on the effect of hypnosis on gastric emptying. Aim To determine the effect of a hypnosis session on gastric emptying and dyspeptic symptoms. Methods We studied emptying by ultrasonography and epigastric sensations in 11 healthy subjects and in 15 patients affected by functional dyspepsia under three conditions according to a fixed schedule: (a) basal, (b) after cisapride and (c) during a 90 min hypnotic trance. Eight healthy subjects repeated an emptying study listening to relaxing music. Statistical analysis was performed using the Friedman test or RM-anova. Results In dyspeptics, the postprandial increase in the antral area was significantly smaller during the hypnosis trance than under the basal and the cisapride conditions. For the patients gastric emptying was significantly shortened by cisapride, and even more by hypnosis (basal 274 +/- 16.8 min; cisapride 227 +/- 13.2; hypnosis 150 +/- 9.7) whereas for healthy subjects it was shortened only by hypnosis. The repeated study in healthy subjects listening to relaxing music showed no significant difference compared with the basal. Epigastric sensations were improved in dyspeptics by hypnosis, but not by cisapride. Conclusions Gut-oriented hypnosis is effective in shortening gastric emptying both in dyspeptic and in healthy subjects.
Habits
Addiction. 2002 Jan;97(1):87-93.
The urge to smoke depends on the expectation of smoking.
Dols M, van den Hout M, Kindt M, Willems B.
Department of Medical, Clinical and Experimental Psychology, Maastricht University, The Netherlands. M.Dols@dep.unimaas.nl
AIMS: An earlier study (Dols et al. 2000) suggested that cue-induced urge to smoke depends on the expectation of smoking. The present study tried to replicate the findings under stringently controlled conditions. DESIGN: A 2 (context) x 2 (cues) x 6 (trial) within-subject design. Each smoker entered two different contexts; one context predicted the future occurrence of smoking (i.e. one puff of a cigarette) and one context predicted the non-occurrence of smoking. In each context smokers were exposed to smoking cues (i.e. cigarettes and lighter) or not. SETTING: Laboratory at Maastricht University. PARTICIPANTS: Thirty-two daily smokers, smoking at least five cigarettes a day for at least 2 years. MEASUREMENTS: Participants reported their urge to smoke in each context in the presence and absence of smoking cues using a computerized visual analogue scale (VAS). FINDINGS: The results revealed that the urge to smoke was higher in a context in which smoking was expected relative to a context in which it was not expected. As in the previous study the urge-inducing effect of smoking cues was larger in the smoking context than in the non-smoking context. Moreover, smoking cues did not have a significant effect in the non-smoking context. CONCLUSIONS: It was shown that smoking cues elicit craving due mainly to a generated expectation of the occurrence of smoking and less due to salience or long history of associative learning. Theoretical and practical implications of the results are discussed.
PMID: 11895274 [PubMed - indexed for MEDLINE]
J Pediatr. 2004 Feb;144(2):213-7.
Childhood habit cough treated with self-hypnosis.
Anbar RD, Hall HR.
Department of Pediatrics, University Hospital, State University of New York Upstate Medical University, Syracuse, New York 13210, USA. Anbar@mail.upstate.edu
OBJECTIVES: To better understand factors associated with the development and persistence of habit cough and to report use of self-hypnosis for this condition. STUDY DESIGN: A retrospective chart review was performed for 56 children and adolescents with habit cough. Interested patients were instructed in self-hypnosis for relaxation and to help ignore the cough-triggering sensation. RESULTS: The patients' mean age was 10.7 years. The cough was triggered by upper respiratory infections in 59%, asthma in 13%, exercise in 5%, and eating in 4%. Onset of the cough occurred as early as 2 years, and its average duration was 13 months (range, 2 weeks to 7 years). There was a high incidence of abdominal pain and irritable bowel syndrome in the 50% of the patients who missed more than 1 week of school because of their cough. Among the 51 patients who used hypnosis, the cough resolved during or immediately after the initial hypnosis instruction session in 78% and within 1 month in an additional 12%. CONCLUSIONS: Habit cough is triggered by various physiologic conditions, related frequently to other diagnoses, and it is associated with significant school absence. Self-hypnosis offers a safe efficient treatment.
J Dev Behav Pediatr. 1996 Oct;17(5):328-34.
Hypnotherapeutic management of pediatric and adolescent trichotillomania.
Kohen DP.
Department of Pediatrics, University of Minnesota, Minneapolis 55454, USA.
Trichotillomania in children is regularly described as analogous to a habit disorder. As such, it is thought at times to be benign in a manner analogous to habits such as thumb sucking and nail biting. It is also considered by some to be an obsessive-compulsive disorder, to be more recalcitrant to intervention, and to be more socially disabling than simple habits, particularly when persistence and intensity eventuate in obvious alopecia. This report presents five cases of trichotillomania in which self-monitoring, dissociative hypnotic techniques, and self-hypnosis (relaxation/mental imagery) practice were used in teaching children successful management of this vexing problem. Specific emphasis is placed on the nature and importance of modifying the described techniques for the personal and specific developmental needs of individual patients.
Ann Allergy. 1991 Dec;67(6):579-82.
Outcome of habit cough in children treated with a brief session of suggestion therapy.
Lokshin B, Lindgren S, Weinberger M, Koviach J.
Pediatric Allergy & Pulmonary Division, University of Missouri Hospital, Columbia.
Nine patients with habit cough, initially misdiagnosed as asthma, were treated during a period of sustained repetitive symptoms with a brief session of suggestion therapy. Symptoms had previously been present for up to 2 years (median = 2 months). Five had been hospitalized for the cough. Evaluation revealed no physiologic or radiologic abnormality. All patients became symptom free during a 15-minute session of suggestion therapy. During the subsequent week, one remained completely asymptomatic and 8 had transient minor relapses that were readily self-controlled. Seven of the 9 could be contacted for determination of long-term outcome at periods up to 9 years (median 2.2 years) after the session. Six were totally asymptomatic; one had occasional minor self-controlled symptoms. A standardized questionnaire assessing psychologic symptoms at the time of follow-up revealed no somatization nor emotional distress. In contrast to this apparent cure, others have reported extended periods of continued symptoms in the absence of a uniform treatment plan for suggestion therapy even though the correct diagnosis was made. We conclude that the classical habit cough syndrome is amenable to immediate relief and long-term cure in most cases with a single session of appropriate suggestion therapy.
Arch Dis Child. 1990 Jun;65(6):626-7.
Self hypnotherapeutic treatment of habitual reflex vomiting.
Sokel BS, Devane SP, Bentovim A, Milla PJ.
Department of Psychological Medicine, Hospital for Sick Children, London.
A 9 year old boy with intractable postprandial reflex vomiting was taught a self hypnotherapy technique incorporating relaxation exercises, mental imagery, and suggestions of symptom relief. The sequence was recorded on a personal stereo cassette tape. Vomiting was completely eliminated within four weeks. At 12 month review vomiting had not recurred.
Am J Clin Hypn. 1989 Oct;32(2):84-9.
Self-injurious behavior as a habit and its treatment.
Orian C.
The definition of self-injurious behavior applies to persons who hurt or harm themselves without the motive of suicide or of sexual deviation. The different aspects of self-injurious behavior and the theories explaining them are reviewed. For 5 years a young, intelligent woman had inflicted injuries upon herself with sharp instruments while ostensibly caring for her face and legs. The short-term hypnobehavioral treatment included keeping daily reports of her self-inflicted injuries and of her thoughts while executing them, finding alternative activities to replace her habit, and practicing self-hypnosis once a day. Increasing the level of understanding of her inner conflict and accenting ways of breaking the habit by means of positive autosuggestion proved very effective. The treatment was successful after 13 sessions.
Impotence
Scand J Urol Nephrol. 1997 Jun;31(3):271-4.
Acupuncture and hypnotic suggestions in the treatment of non-organic male sexual dysfunction.
Aydin S, Ercan M, Caskurlu T, Tasci AI, Karaman I, Odabas O, Yilmaz Y, Agargun MY, Kara H, Sevin G.
Department of Urology, Medical School of Yuzuncu Yil University, Istanbul, Turkey.
We have examined the effects of acupuncture and hypnotic suggestions, and compared them with placebo in the treatment of male sexual dysfunction with no detectable organic cause. The study comprised 15 men (mean age 36.7 +/- 10.43 years) who received acupuncture treatment, 16 men (mean age 38.4 +/- 10.75 years) who underwent hypnosis (mean age 35.3 +/- 11.52 years) and 29 men (mean age 36.2 +/- 11.38 years) who served as controls. They were interviewed periodically; the patients' reports were verified by interviewing their partners. Men who received placebo had a 43-47% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of acupuncture and hypnotic suggestions were 60% and 75% respectively. Although the improvement was not statistically significant, treatment with acupuncture could be used as an adjuvant therapy in non-organic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.
Br J Urol. 1996 Feb;77(2):256-60.
Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of non-organic male sexual dysfunction.
Aydin S, Odabas O, Ercan M, Kara H, Agargun MY.
Department of Urology, Medical School of Yuzuncu Yil University, Van, Turkey.
OBJECTIVE: To examine the effects of hypnotic suggestions or the administration of testosterone or trazodone to impotent men with no detectable organic cause for the impotence. PATIENTS AND METHODS: The study comprised 79 men in whom clinical and laboratory examinations revealed no organic cause for their impotence: 20 men (mean age 38.7 +/- 11.47 years) received testosterone, 21 men (mean age 39.5 +/- 10.73 years) received trazodone, 20 men (mean age 34.2 +/- 11.69 years) underwent hypnosis and 18 men (mean age 39.1 +/- 11.46 years) served as controls. They were assessed by interview 4, 6 and 8 weeks after starting treatment: the patient's reports were verified by interviewing their partners. RESULTS: Men who received a placebo had a 39% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of testosterone and trazodone treatment and hypnotic suggestions were 60%, 67% and 80%, respectively. CONCLUSION: Although the improvement was not statistically significant, treatment with testosterone and trazodone could be used as an adjuvant therapy in nonorganic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.
Va Med. 1977 Jun;104(6):389-92.
The hypnotherapeutic treatment of impotence.
Ward WO.
Fifty cases of primary and secondary impotency are presented. A breakdown of the patients as to age shows that the problem is wide-spread from youth to middle-age; in this study there was a mean age of 29.40 years. All patients who remained in therapy were able to perform sexually at the time of their discharge. In followup of 66% of the patients, all stated they were doing well except for two. Hypnosis used as an uncovering modality is shown to be markedly effective. This, incorporated with ego-strengthening and new self-image suggestions, seems to be the treatment of choice for psychogenic impotence.
Pain Management
Niger Postgrad Med J. 2007 Sep;14(3):238-41.
Hypnosis and its place in modern pain management - review article.
Amadasun FE.
Department of Anaesthesiology, University of Benin Teaching Hospital, Benin City, Nigeria.
This is an evidence-based review of the efficacy of hypnosis in pain management. Hypnosis is as old as mankind. It is reported in the Ebers Papyrus in ancient Egyptian cures. It went into decline in the Middle Ages with the rise of Christianity, being erroneously associated with witchcraft. There was resurgence of interest in the 19th century. In the early 1950s, the British Medical Association endorsed the teaching of hypnosis in all medical schools. The literature is replete with anecdotal and controlled studies of the efficacy of hypnotherapy in pain management. Not much is found of the effectiveness in acute pain conditions. Nevertheless, in spite of some methodological flaws in many reports, there seems to be sufficient clinical evidence of sufficient quality, to conclude that hypnosis has demonstrable efficacy in the treatment of chronic pain.
PMID: 17767210 [PubMed - indexed for MEDLINE]
Pain. 2007 Aug 3
Hypnosis in the management of persistent idiopathic orofacial pain - Clinical and psychosocial findings.
Abrahamsen R, Baad-Hansen L, Svensson P.
Department of Clinical Oral Physiology, School of Dentistry, University of Aarhus, Vennelyst Boulevard 9, DK-8000 Aarhus, Denmark.
This controlled and patient blinded study tested the effect of hypnosis on persistent idiopathic orofacial pain (PIOP) in terms of clinical and psychosocial findings. Forty-one PIOP were randomized to active hypnotic intervention or simple relaxation as control for five individual 1-h sessions. Primary outcome was average pain intensity scored three times daily in a pain diary using visual analogue scale (VAS). Secondary outcome measures were pain quality assessed by McGill pain questionnaire (MPQ), psychological symptoms assessed by symptom check list (SCL), quality of life assessed by SF36, sleep quality, and consumption of analgesic. Data were compared between groups before and after treatment using ANOVA models and paired t-tests. The change in VAS pain scores from baseline to the last treatment (t4) was (33.1+/-7.4%) in the hypnosis group and (3.2+/-5.4%) in the control group (P<0.03). In the hypnosis group, highly hypnotic susceptible patients had greater decreases in VAS pain scores (55.0+/-12.3%) when compared to less susceptible patients (17.9+/-6.7%) (P<0.02). After the last treatment there were also statistically significant differences between groups in perceived pain area (MPQ) and the use of weak analgesics (P<0.03). There were no statistically significant changes in SCL or SF36 scores from baseline to t4. In conclusion, hypnosis seems to offer clinically relevant pain relief in PIOP, particularly in highly susceptible patients. However, stress coping skills and unresolved psychological problems need to be included in a comprehensive management plan in order also to address psychological symptoms and quality of life.
PMID: 17689192 [PubMed - as supplied by publisher]
Palliat Support Care. 2007 Jun;5(2):147-52.
An exploration of the utility of hypnosis in pain management among rural pain patients.
Thornberry T, Schaeffer J, Wright PD, Haley MC, Kirsh KL.
The Pain Treatment Center of the Bluegrass, Lexington, Kentucky, USA.
OBJECTIVE: Hypnosis is an adjunctive, noninvasive treatment with few side effects that can be useful in the management of chronic pain. However, it has fallen into disfavor in recent years and is often perceived by physicians as simple charlatanism. We evaluated the efficacy of this treatment as used clinically in a large, mostly rural, pain management center. METHODS: We conducted a chart review of 300 pain patients from the Pain Treatment Center of the Bluegrass who had undergone hypnosis for their pain concerns. A chart audit tool was developed consisting of basic demographics, pre- and posthypnosis pain ratings, a rating of relaxation achieved posthypnosis, and scores on the Beck Depression Inventory, Perceived Disability Scale, and the Pain Anxiety Symptom Scale. RESULTS: The sample consisted of 79 men (26.3%) and 221 women (73.7%) with a mean age of 46.3 years (SD = 9.9, range = 19-78). Pain levels recorded pre- and posthypnosis revealed significant improvement as a result of the intervention (mean difference = 2.5, t (1,298) = 25.9, p < .001). Patients reported an average of 49.8% improvement in relaxation level posthypnosis (SD = 24.2%) and had a mean score of 19.0 on the Beck Depression Inventory (SD = 9.9), indicating moderate levels of depression. Also, patients saw themselves as severely disabled regarding their ability to engage in physical (8.3/10) or job-related (7.7/10) activities. Attempts to identify predictors of hypnosis success were not fruitful with one exception. "Poor" responders to hypnosis reported greater levels of perceived dysfunction in their sexual functioning compared to the "good" responders, F(1,187) = 7.2, p < .01. SIGNIFICANCE OF RESULTS: Hypnosis appears to be a viable adjunct for pain management patients, including those from rural and relatively disadvantaged backgrounds. Prospective trials are needed to examine the utility of this modality in end-of-life and palliative care patients.
PMID: 17578065 [PubMed - indexed for MEDLINE]
Psychosom Med. 2007 Mar-Apr;69(2):191-9. Epub 2007 Feb 8.
Effects of age on responsiveness to adjunct hypnotic analgesia during invasive medical procedures.
Lutgendorf SK, Lang EV, Berbaum KS, Russell D, Berbaum ML, Logan H, Benotsch EG, Schulz-Stubner S, Turesky D, Spiegel D.
Department of Psychology, University of Iowa, Iowa City, IA 52242, USA. susan-lutgendorf@uiowa.edu
OBJECTIVES: To assess the effects of age on responsiveness to self-hypnotic relaxation as an analgesic adjunct in patients undergoing invasive medical procedures. MATERIAL AND METHODS: Secondary data analysis from a prospective trial with 241 patients randomized to receive hypnosis, attention, and standard care treatment during interventional radiological procedures. Growth curve analyses, hierarchical linear regressions, and logistic regressions using orthogonal contrasts were used for analysis. Outcome measures were Hypnotic Induction Profile scores, self-reported pain and anxiety, medication use, oxygen desaturation < or =89%, and procedure time. RESULTS: Hypnotizability did not vary with age (p = .19). Patients receiving attention and hypnosis had greater pain reduction during the procedure (p = .02), with trends toward lower pain with hypnosis (p = .07); this did not differ by age. As age increased, patients experienced more rapid pain control with hypnosis (p = .03). There was more rapid anxiety reduction with attention and hypnosis (p = .03). Trends toward lower final anxiety were also observed with attention and hypnosis versus standard care (p = .08), and with hypnosis versus attention (p = .059); these relationships did not differ by age. Patients requested and received less medication and had less oxygen desaturation < or =89% with attention and hypnosis (p < .001); this did not differ by age. However, as age increased, oxygen desaturation was greater in standard care (p = .03). Procedure time was reduced in the attention and hypnosis groups (p = .007); this did not vary by age. CONCLUSIONS: Older patients are hypnotizable and increasing age does not appear to mitigate the usefulness of hypnotic analgesia during invasive medical procedures.
PMID: 17289823 [PubMed - indexed for MEDLINE]
Pain. 1990 Aug;42(2):243-51
Quantitative evaluation of hypnotically suggested hyperaesthesia and analgesia by painful laser stimulation.
Arendt-Nielsen L, Zachariae R, Bjerring P.
Department of Medical Informatics, University of Aalborg, Denmark.
The ability to reduce both clinically and experimentally induced pain by hypnotic suggestion of analgesia is well known. However, the nature of hypnotic analgesia still remains uncertain. Attempts to demonstrate and identify specific psycho physiological mechanisms have, so far, been unsatisfactory. Methodological problems in inducing pain and monitoring physiological responses may be the reason for this lack of success. In the present study, we have attempted to eliminate some of these methodological problems. The sensory and pain thresholds to laser stimulation were determined, and the laser-evoked brain potentials were measured for 8 highly hypnotically susceptible subjects in 3 conditions: (1) waking state, (2) suggestion of hyperesthesia, (3) suggestion of analgesia.
J Behav Med. 2006 Jan 11;:1-30
Hypnotic Treatment of Chronic Pain.
Jensen M, Patterson DR.
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
This article reviews controlled trials of hypnotic treatment for chronic pain in terms of: (1) analyses comparing the effects of hypnotic treatment to six types of control conditions; (2) component analyses; and (3) predictor analyses. The findings indicate that hypnotic analgesia produces significantly greater decreases in pain relative to no-treatment and to some non-hypnotic interventions such as medication management, physical therapy, and education/advice. However, the effects of self-hypnosis training on chronic pain tend to be similar, on average, to progressive muscle relaxation and autogenic training, both of which often include hypnotic-like suggestions. None of the published studies have compared hypnosis to an equally credible placebo or minimally effective pain treatment, therefore conclusions cannot yet be made about whether hypnotic analgesia treatment is specifically effective over and above its effects on patient expectancy. Component analyses indicate that labeling versus not labeling hypnosis treatment as hypnosis, or including versus not including hand-warming suggestions, have relatively little short-term impact on outcome, although the hypnosis label may have a long-term benefit. Predictor analyses suggest that global hypnotic responsivity and ability to experience vivid images are associated with treatment outcome in hypnosis, progressive relaxation, and autogenic training treatments. The paper concludes with a discussion of the implications of the findings for future hypnosis research and for the clinical applications of hypnotic analgesia.
J Vasc Interv Radiol. 2005 Dec;16(12):1585-92
Pain and anxiety during interventional radiologic procedures: effect of patients' state anxiety at baseline and modulation by nonpharmacologic analgesia adjuncts.
Schupp CJ, Berbaum K, Berbaum M, Lang EV.
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, WCC 308, Boston, Massachusetts 02215, USA.
PURPOSE: To assess how patients' underlying anxiety affects their experience of distress, use of resources, and responsiveness toward nonpharmacologic analgesia adjunct therapies during invasive procedures. MATERIALS AND METHODS: Two hundred thirty-six patients undergoing vascular and renal interventions, who had been randomized to receive during standard care treatment, structured empathic attention, or self-hypnotic relaxation, were divided into two groups: those with low state anxiety scores on the State-Trait Anxiety Inventory (STAI, scores < 43; n = 116) and those with high state anxiety scores (> or = 43; n = 120). All had access to patient-controlled analgesia with fentanyl and midazolam. Every 15 minutes during the procedure, patients rated their anxiety and pain on a scale of 0-10 (0, no pain/anxiety at all; 10, worst possible pain/anxiety). Effects were assessed by analysis of variance and repeated-measures analysis. RESULTS: Patients with high state anxiety levels required significantly greater procedure time and medication. Empathic attention as well as hypnosis treatment reduced procedure time and medication use for all patients. These nonpharmacologic analgesia adjunct treatments also provided significantly better pain control than standard care for patients with low anxiety levels. Anxiety decreased over the time of the procedure; patients with high state anxiety levels experienced the most significant decreases in anxiety with nonpharmacologic adjuncts whereas patients with low state anxiety levels coped relatively well under all conditions. CONCLUSION: Patients' state anxiety level is a predictor of trends in procedural pain and anxiety, need for medication, and procedure duration. Low and high state anxiety groups profit from the use of nonpharmacologic analgesia adjuncts but those with high state anxiety levels have the most to gain.
Pain Manag Nurs. 2005 Sep;6(3):105-11
Hypnosis for pain management in the older adult.
Cuellar NG.
University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania 19002, USA. ncuellar@nursing.upenn.edu
Pain is a physical, emotional and psychologic phenomenon that is often ignored in older adults causing depression and poor quality of life. Older adults report the use of complementary and alternative medicine in some form with 80% of these users reporting improvement in their health conditions. Although physical pain in the older adult is usually managed with pharmacologic interventions, methods that may reduce the use of prescription drugs may decrease adverse effects that can compromise the physiologic state of the older adult. Hypnosis has continued to gain acceptance within mainstream medicine as an appropriate treatment and can be integrated safely with conventional medicine as an effective treatment for a variety of conditions in the older adult. It is an intervention that can be used for relaxation and pain control, especially when conventional pharmacologic regimens have failed. The purpose of this article is to review the concepts related to pain in older adults; the use of complementary and alternative medicine in the older adult; hypnosis and the older adult (i.e., background, definition, benefits, research, mechanism of action, hypnotizability, and the process); and the implications of using hypnosis for pain management in the older adult.
J Rheumatol. 1991 Jan;18(1):72-5
Controlled trial of hypnotherapy in the treatment of refractory fibromyalgia.
Haanen HC, Hoenderdos HT, van Romunde LK, Hop WC, Mallee C, Terwiel JP, Hekster GB.
Department of Rheumatology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands.
In a controlled study, 40 patients with refractory fibromyalgia were randomly allocated to treatment with either hypnotherapy or physical therapy for 12 weeks with followup at 24 weeks. Compared with the patients in the physical therapy group, the patients in the hypnotherapy group showed a significantly better outcome with respect to their pain experience, fatigue on awakening, sleep pattern and global assessment at 12 and 24 weeks, but this was not reflected in an improvement of the total myalgic score measured by a dolorimeter. At baseline most patients in both groups had strong feelings of somatic and psychic discomfort as measured by the Hopkins Symptom Checklist. These feelings showed a significant decrease in patients treated by hypnotherapy compared with physical therapy, but they remained abnormally strong in many cases. We conclude hypnotherapy may be useful in relieving symptoms in patients with refractory fibromyalgia.
Psychol Bull. 2003 Jul;129(4):495-521
Hypnosis and clinical pain.
Patterson DR, Jensen MP.
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle 98104, USA. davepatt@u.washington.edu
Hypnosis has been demonstrated to reduce analogue pain, and studies on the mechanisms of laboratory pain reduction have provided useful applications to clinical populations. Studies showing central nervous system activity during hypnotic procedures offer preliminary information concerning possible physiological mechanisms of hypnotic analgesia. Randomized controlled studies with clinical populations indicate that hypnosis has a reliable and significant impact on acute procedural pain and chronic pain conditions. Methodological issues of this body of research are discussed, as are methods to better integrate hypnosis into comprehensive pain treatment.
Proc Natl Acad Sci U S A. 2005 Sep 6;102(36):12950-5
The subjective experience of pain: where expectations become reality.
Koyama T, McHaffie JG, Laurienti PJ, Coghill RC.
Department of Neurobiology and Anatomy, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1010, USA.
Our subjective sensory experiences are thought to be heavily shaped by interactions between expectations and incoming sensory information. However, the neural mechanisms supporting these interactions remain poorly understood. By using combined psychophysical and functional MRI techniques, brain activation related to the intensity of expected pain and experienced pain was characterized. As the magnitude of expected pain increased, activation increased in the thalamus, insula, prefrontal cortex, anterior cingulate cortex (ACC) and other brain regions. Pain-intensity-related brain activation was identified in a widely distributed set of brain regions but overlapped partially with expectation-related activation in regions, including the anterior insula and ACC. When expected pain was manipulated, expectations of decreased pain powerfully reduced both the subjective experience of pain and activation of pain-related brain regions, such as the primary somatosensory cortex, insular cortex, and ACC. These results confirm that a mental representation of an impending sensory event can significantly shape neural processes that underlie the formulation of the actual sensory experience and provide insight as to how positive expectations diminish the severity of chronic disease states.
Clin J Pain. 2004 Jan-Feb;20(1):27-32
Mind-body therapies for the management of pain.
Astin JA.
California Pacific Medical Center Research Institute, San Francisco, CA, USA. john@integrativearts.com
This paper reviews the evidence for mind-body therapies (eg, relaxation, meditation, imagery, cognitive-behavioral therapy) in the treatment of pain-related medical conditions and suggests directions for future research in these areas. Based on evidence from randomized controlled trials and in many cases, systematic reviews of the literature, the following recommendations can be made: 1) multi-component mind-body approaches that include some combination of stress management, coping skills training, cognitive restructuring and relaxation therapy may be an appropriate adjunctive treatment for chronic low back pain; 2) multimodal mind-body approaches such as cognitive-behavioral therapy, particularly when combined with an educational/informational component, can be an effective adjunct in the management of rheumatoid and osteoarthritis; 3) relaxation and thermal biofeedback may be considered as a treatment for recurrent migraine while relaxation and muscle biofeedback can be an effective adjunct or stand alone therapy for recurrent tension headache; 4) an array of mind-body therapies (eg, imagery, hypnosis, relaxation) when employed pre-surgically, can improve recovery time and reduce pain following surgical procedures; 5) mind-body approaches may be considered as adjunctive therapies to help ameliorate pain during invasive medical procedures.
Pain. 2005 Dec 5;118(3):306-18. Epub 2005 Nov 14
Pain-related emotions modulate experimental pain perception and autonomic responses.
Rainville P, Bao QV, Chretien P.
Departement de Stomatologie, Faculte de medecine dentaire, Universite de Montreal, CP. 6128, Succ. Centre-ville, Montreal, Que., Canada H3C 1J7. pierre.rainville@umontreal.ca
The effect of emotions on pain perception is generally recognized but the underlying mechanisms remain unclear. Here, emotions related to pain were induced in healthy volunteers using hypnosis, during 1-min immersions of the hand in painfully hot water. In Experiment 1, hypnotic suggestions were designed to induce various positive or negative emotions. Compared to a control condition with hypnotic-relaxation, negative emotions produced robust increases in pain. In Experiment 2, induction of pain-related anger and sadness were found to increase pain. Pain increases were associated with increases in self-rated desire for relief and decreases in expectation of relief, and with increases in arousal, negative affective valence and decreases in perceived control. In Experiment 3, hypnotic suggestions specifically designed to increase and decrease the desire for relief produced increases and decreases in pain, respectively. In all three experiments, emotion-induced changes in pain were most consistently found on ratings of pain unpleasantness compared to pain intensity. Changes in pain-evoked cardiac responses (R-R interval decrease), measured in experiments 2 and 3, were consistent with changes in pain unpleasantness. Correlation and multiple regression analyses suggest that negative emotions and desire for relief influence primarily pain affect and that pain-evoked autonomic responses are strongly associated with pain affect. These results confirm the hypothesized influence of the desire for relief on pain perception, and particularly on pain affect, and support the functional relation between pain affect and autonomic nociceptive responses. This study provides further experimental
South Med J. 1999 May;92(5):521-3
What if your patient prefers an alternative pain control method? Self-hypnosis in the control of pain.
Nickelson C, Brende JO, Gonzalez J.
Department of Psychiatry and Behavioral Sciences, Mercer University School of Medicine, Macon, GA 31207, USA.
Despite the availability of specialized treatments for chronic pain, including biofeedback training, relaxation training, and hypnotic treatment, most physicians rely on the traditional approaches of surgery or pharmacotherapy. The patient in this case study had severe and chronic pain but found little relief from pain medications that also caused side effects. She then took the initiative to learn and practice self-hypnosis with good results. Her physician in the resident's internal medicine clinic supported her endeavor and encouraged her to continue self-hypnosis. This patient's success shows that self-hypnosis can be a safe and beneficial approach to control or diminish the pain from chronic pain syndrome and can become a useful part of a physician's therapeutic armamentarium.
Phobias
Paediatr Anaesth. 2007 Aug;17(8):800-4.
Brief hypnosis for severe needle phobia using switch-wire imagery in a 5-year old.
Cyna AM, Tomkins D, Maddock T, Barker D.
Department of Paediatric Anaesthesia, Women's and Children's Hospital, Adelaide, SA, Australia. allan.cyna@cywhs.sa.gov.au
We present a case of severe needle phobia in a 5-year-old boy who learned to utilize a self-hypnosis technique to facilitate intravenous (i.v.) cannula placement. He was diagnosed with Bruton's disease at 5 months of age and required monthly intravenous infusions. The boy had received inhalational general anesthesia for i.v. cannulation on 58 occasions. Initially, this was because of difficult venous access but more recently because of severe distress and agitation when approached with a cannula. Oral premedication with midazolam or ketamine proved unsatisfactory and hypnotherapy was therefore considered. Following a 10-min conversational hypnotic induction, he was able to use switch--wire imagery to dissociate sensation and movement in all four limbs in turn. Two days later the boy experienced painless venepuncture without the use of topical local anesthetic cream. There was no movement in the 'switched-off' arm during i.v. cannula placement. This report adds to the increasing body of evidence that hypnosis represents a useful, additional tool that anesthetists may find valuable in everyday practice.
PMID: 17596226 [PubMed - indexed for MEDLINE]
Mil Med. 1999 Jan;164(1):71-2.
Hypnosis using a communication device to increase magnetic resonance imaging tolerance with a claustrophobic patient.
Simon EP.
Clinical Psychology Department, Tripler Army Medical Center, Honolulu, HI 96859, USA.
This is a case report of a patient who prematurely terminated two previous magnetic resonance imaging procedures because of his highly claustrophobic condition. The patient was induced into a hypnotic trance twice before his third magnetic resonance imaging examination and he was given posthypnotic suggestions for decreased anxiety and increased physiologic control. Using a communication device with headphones on the patient, he was induced into a trance as he entered the magnet. This patient was successfully able to cope with this procedure and reported great satisfaction with treatment.
J Dev Behav Pediatr. 1996 Oct;17(5):335-41.
Hypnobehavioral approaches for school-age children with dysphagia and food aversion: a case series.
Culbert TP, Kajander RL, Kohen DP, Reaney JB.
Alexander Center for Child Development and Behavior, Park Nicollet Clinic HealthSystem Minnesota, Bloomington 55437, USA.
The purpose of this article is to describe hypnobehavioral treatment of five school-age children with maladaptive eating behaviors, including functional dysphagia, food aversion, globus hystericus, and conditioned fear of eating (phagophobia). The unique treatment approach described emphasizes the successful use of self-management techniques, particularly hypnosis, by all five children. Common etiological factors, treatment strategies, and proposed mechanisms of change are discussed. To the authors' knowledge, this is the first such case series in the mainstream pediatric literature describing the use of a hypnobehavioral approach for children with these maladaptive eating problems.
Am J Clin Hypn. 1990 Oct;33(2):80-4.
Magnetic resonance imaging: improved patient tolerance utilizing medical hypnosis.
Friday PJ, Kubal WS.
Shadyside Hospital, Pittsburgh, PA 15232.
Magnetic Resonance Imaging (MRI) is a medical diagnostic procedure which requires a patient to be placed supine into the cylindrical bore of a powerful magnet for approximately one hour. The patient's arms are usually against the sides of the magnet bore with a 3" to 10" space between the patient's face and the top of the magnet bore. This enclosure induces panic and claustrophobic responses in 1% to 10% of the patients undergoing the MRI procedure. There have been many failed diagnostic studies due to patient intolerance, and there are reports of procedure-induced claustrophobia. We describe the hypnotic procedure utilized to reduce anxiety and panic for successful completion of MRI scans. Medical hypnosis has been an effective intervention in ten patients, permitting completion of their diagnostic procedure.
Dent Clin North Am. 1988 Oct;32(4):745-61.
Hypnosis in the treatment of dental fear and phobia.
Forgione AG.
Gelb Craniomandibular Pain Center, Tufts University School of Dental Medicine, Boston, Massachusetts.
The term hypnosis is currently used to define an area of research and treatment that employs suggestion. Within this area, suggestion refers to the induction of expectancies by implicit or explicit means, usually involving concentration and the expectancy that the suggested results are possible. This use of suggestion differs from the common use of the term suggestion, which is a logical offering for a change in behavior or thought. The long history of hypnosis is testimony to its effectiveness, although there has been controversy as to why it works. Patient selection is important. Further, fear must be distinguished from phobia. Combined with other treatment techniques, such as systematic desensitization, it is a powerful behavior modification method. To prevent accidental delivery of suggestions that may be counterproductive to treatment, the study of hypnosis is important even to those health care professionals who have no intention of employing it in their practice.
Pre and Postoperative
Lancet. 1988 Aug 27;2(8609):491-3.
Improved recovery and reduced postoperative stay after therapeutic suggestions during general anaesthesia.
Evans C, Richardson PH.
Department of Academic Psychiatry, United Medical School, Guy's Hospital, London.
The clinical value of therapeutic suggestions during general anaesthesia was assessed in a double-blind randomised placebo-controlled study. 39 unselected patients were allocated to suggestion (n = 19) or control (n = 20) groups who were played either recorded therapeutic suggestions or a blank tape, respectively, during hysterectomy. The patients in the suggestion group spent significantly less time in hospital after surgery, suffered from a significantly shorter period of pyrexia, and were generally rated by nurses as having made a better than expected recovery. Patients in the suggestion group, unlike those in the control group, guessed accurately that they had been played an instruction tape.
Am J Clin Hypn. 2003 Apr;45(4):333-51.
Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical trial.
Ginandes C, Brooks P, Sando W, Jones C, Aker J.
Department of Psychology, Harvard Medical School, McLean Hospital, 115 Mill Street Belmont, MA 02478, USA. carol_ginandes@hms.harvard.edu
Although medical hypnosis has a long history of myriad functional applications (pain reduction, procedural preparation etc.), it has been little tested for site-specific effects on physical healing per se. In this randomized controlled trial, we compared the relative efficacy of an adjunctive hypnotic intervention, supportive attention, and usual care only on early post-surgical wound healing. Eighteen healthy women presenting consecutively for medically recommended reduction mammaplasty at an ambulatory surgery practice underwent the same surgical protocol and postoperative care following preoperative randomization (n = 6 each) to one of the three treatment conditions: usual care, 8 adjunctive supportive attention sessions, or 8 adjunctive hypnosis sessions targeting accelerated wound healing. The primary outcome data of interest were objective, observational measures of incision healing made at 1,7 weeks postoperatively by medical staff blind to the participants' group assignments. Data included clinical exams and digitized photographs that were scored using a wound assessment inventory (WAI). Secondary outcome measures included the participants' subjectively rated pain, perceived incision healing (VAS Scales), and baseline and post-surgical functional health status (SF-36). Analysis of variance showed the hypnosis group's objectively observed wound healing to be significantly greater than the other two groups', p < .001, through 7 postoperative weeks; standard care controls showed the smallest degree of healing. In addition, at both the 1 and 7 week post-surgical observation intervals, one-way analyses showed the hypnosis group to be significantly more healed than the usual care controls, p < 0.02. The mean scores of the subjective assessments of postoperative pain, incision healing and functional recovery trended similarly. Results of this preliminary trial indicate that use of a targeted hypnotic intervention can accelerate postoperative wound healing and suggest that further tests of using hypnosis to augment physical healing are warranted.
Int J Clin Exp Hypn. 2002 Jan;50(1):17-32.
Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients.
Montgomery GH, Weltz CR, Seltz M, Bovbjerg DH.
Ruttenberg Cancer Center, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. guy.montgomery@mssm.edu
Each year, hundreds of thousands of women undergo excisional breast biopsies for definitive diagnosis. Not only do these patients experience pain associated with the procedure, but they also endure distress associated with the threat of cancer. Hypnosis has been demonstrated as effective for controlling patients' pain in other surgical settings, but breast surgery patients have received little attention. To determine the impact of brief presurgical hypnosis on these patients' postsurgery pain and distress and to explore possible mediating mechanisms of these effects, 20 excisional breast biopsy patients were randomly assigned to a hypnosis or control group (standard care). Hypnosis reduced postsurgery pain and distress. Initial evidence suggested that the effects of hypnosis were mediated by presurgery expectations.
Altern Ther Health Med. 1999 Mar;5(2):67-75.
Using hypnosis to accelerate the healing of bone fractures: a randomized controlled pilot study.
Ginandes CS, Rosenthal DI.
Department of Psychiatry, Harvard Medical School, USA.
CONTEXT: Hypnosis has been used in numerous medical applications for functional and psychological improvement, but has been inadequately tested for anatomical healing. OBJECTIVE: To determine whether a hypnotic intervention accelerates bodily tissue healing using bone fracture healing as a site-specific test. DESIGN: Randomized controlled pilot study. SETTING: Massachusetts General Hospital, Boston, Mass, and McLean Hospital, Belmont, Mass. PATIENTS: Twelve healthy adult subjects with the study fracture were recruited from an orthopedic emergency department and randomized to either a treatment (n = 6) or a control group (n = 6). One subject, randomized to the treatment group, withdrew prior to the intervention. INTERVENTION: All 11 subjects received standard orthopedic care including serial radiographs and clinical assessments through 12 weeks following injury. The treatment group received a hypnotic intervention (individual sessions, audiotapes) designed to augment fracture healing. MAIN OUTCOME MEASURES: Radiological and orthopedic assessments of fracture healing 12 weeks following injury and hypnotic subjects' final questionnaires and test scores on the Hypnotic Induction Scale. RESULTS: Results showed trends toward faster healing for the hypnosis group through week 9 following injury. Objective radiographic outcome data revealed a notable difference in fracture edge healing at 6 weeks. Orthopedic assessments showing trends toward better healing for hypnosis subjects through week 9 included improved ankle mobility; greater functional ability to descend stairs; lower use of analgesics in weeks 1, 3, and 9; and trends toward lower self-reported pain through 6 weeks. CONCLUSION: Despite a small sample size and limited statistical power, these data suggest that hypnosis may be capable of enhancing both anatomical and functional fracture healing, and that further investigation of hypnosis to accelerate healing is warranted.
Obes Surg. 2001 Oct;11(5):589-93.
Assessment of the effects of a taped cognitive behavior message on postoperative complications (therapeutic suggestions under anesthesia).
Cowan GS Jr, Buffington CK, Cowan GS 3rd, Hathaway D.
Department of Surgery, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. owcinc@mindspring.com
BACKGROUND: The authors studied whether playing a taped cognitive-behavior message during and immediately following bariatric surgery will improve performance of a postoperative regimen designed to enhance recovery. METHODS: The double-blinded placebo-controlled study consisted of 27 morbidly obese bariatric surgical patients randomly assigned to listen to either a blank (Controls) or a positive therapeutic message audiotape (Tape). A Postoperative Regimen Checklist (PRC) quantified different parts of the postoperative recovery regimen. RESULTS: The data showed that patients in the Tape group, compared to the Controls: 1) achieved better scores at most PRC assessment points (p < 0.05), 2) required less encouragement to perform tasks (p < 0.05), and 3) were discharged from the hospital a mean of 1.6 days earlier. CONCLUSIONS: A taped cognitive-behavioral message, played to patients repetitively during and immediately following bariatric surgery, is effective in enhancing postoperative compliance and reducing in-patient length of stay.
J Dev Behav Pediatr. 1996 Oct;17(5):307-10
The effects of hypnosis/guided imagery on the postoperative course of children.
Lambert SA.
University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106, USA.
Hypnosis, guided imagery, and relaxation have been shown to improve the postoperative course of adult surgical patients. Children have successfully used hypnosis/guided imagery to significantly reduce the pain associated with invasive procedures and to improve selected medical conditions. The purpose of this study was to examine the effect of hypnosis/guided imagery on the postoperative course of pediatric surgical patients. Fifty-two children (matched for sex, age, and diagnosis) were randomly assigned to an experimental or control group. The experimental group was taught guided imagery by the investigator. Practice of the imagery technique included suggestions for a favorable postoperative course. Significantly lower postoperative pain ratings and shorter hospital stays occurred for children in the experimental group. State anxiety was decreased for the guided imagery group and increased postoperatively for the control group. This study demonstrates the positive effects of hypnosis/guided imagery for the pediatric surgical patient.
Acta Anaesthesiol Scand. 1997 Sep;41(8):1028-32.
Preoperative hypnosis reduces postoperative vomiting after surgery of the breasts. A prospective, randomized and blinded study.
Enqvist B, Bjorklund C, Engman M, Jakobsson J.
Dept. of Health Sciences, Karolinska Institute, Stockholm, Sweden.
BACKGROUND: Postoperative nausea and vomiting (PONV) after general anesthesia and surgery may have an incidence as high as 70% irrespective of antiemetic drug therapy. The use of preoperative hypnosis and mental preparation by means of an audio tape was investigated in the prophylaxis of nausea and vomiting before elective breast reduction surgery. Similar interventions have not been found in the literature. METHODS: Fifty women were randomized to a control group or a hypnosis group; the latter listened to an audio tape daily 4-6 days prior to surgery. A hypnotic induction was followed by suggestions as to how to relax and experience states incompatible with nausea and vomiting postoperatively (e.g. thirst and hunger). There was a training part on the tape where the patients were asked to rehearse their own model for stress reduction. Premedication and anesthetic procedures were standardized. RESULTS: Patients in the hypnosis group had significantly less vomiting, 39% compared to 68% in the control group, less nausea and less need of analgesics postoperatively. CONCLUSIONS: Preoperative relaxation and/or hypnotic techniques in breast surgery contribute to a reduction of both PONV and postoperative analgesic requirements
Acta Chir Belg. 1999 Aug;99(4):151-8.
Hypnosis with conscious sedation instead of general anaesthesia? Applications in cervical endocrine surgery.
Meurisse M, Defechereux T, Hamoir E, Maweja S, Marchettini P, Gollogly L, Degauque C, Joris J, Faymonville ME.
Department of Surgery, University of Liege, Belgium.
Between April 1994 and June 1997, 197 thyroidectomies and 21 cervical explorations for hyperparathyroidism were performed under hypnosedation (HYP) and compared to the operative data and postoperative courses of a closely-matched population (n = 121) of patients operated on under general anaesthesia (GA). Conversion from hypnosis to GA was needed in two cases (1%). All surgeons reported better operating conditions for cervicotomy using HYP. All patients having HYP reported a very pleasant experience and had significantly less postoperative pain while analgesic use was significantly reduced in this group. Hospital stay was also significantly shorter, providing a substantial reduction of the medical care costs. The postoperative convalescence was significantly improved after HYP and full return to social or professional activity was significantly shortened. We conclude that HYP is a very efficient technique providing physiological, psychological and economic benefits to the patient.
Anaesth Intensive Care. 2007 Oct;35(5):784-7.
Preoperative hypnotherapy in the management of a child with anticipatory nausea and vomiting.
Mackenzie A, Frawley GP.
Department of Paediatric Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, Victoria, Australia.
A six-year-old boy with oesophageal strictures secondary to neonatal repair of oesophageal atresia and requiring six to eight weekly oesophageal dilatations by bouginage developed anticipatory nausea and vomiting. This was effectively managed by a course of preoperative hypnotherapy over four sessions. Resolution of anticipatory nausea and vomiting occurred along with cessation of postoperative nausea and vomiting. This case supports early intervention with preoperative hypnotherapy in children with anticipatory nausea and vomiting that has not responded to other measures.
PMID: 17933170 [PubMed - indexed for MEDLINE]
Sports Improvment
Percept Mot Skills. 1994 Oct;79(2):963-73.
Hypnosis in sport: an Isomorphic Model.
Robazza C, Bortoli L.
Istituto Italiano Studi di Ipnosi Clinica e Psicoterapia H. Bernheim Scuola di ricerca e formazione, Verona, Italia.
Hypnosis in sport can be applied according to an Isomorphic Model. Active-alert hypnosis is induced before or during practice whereas traditional hypnosis is induced after practice to establish connections between the two experiences. The fundamental goals are to (a) develop mental skills important to both motor and hypnotic performance, (b) supply a wide range of motor and hypnotic bodily experiences important to performance, and (c) induce alert hypnosis before or during performance. The model is based on the assumption that hypnosis and motor performance share common skills modifiable through training. Similarities between hypnosis and peak performance in the model are also considered. Some predictions are important from theoretical and practical points of view.
Med Sci Sports Exerc. 1992 Apr;24(4):475-82.
Psychological state and running economy.
Crews DJ.
University of North Carolina, Department of Exercise and Sport Science, Greensboro 27412-5001.
The primary purpose of the present review was to critique studies that examined the influence of psychological state (i.e., affect, perception, and cognition) on running economy (RE). However, only six studies included measures of oxygen consumption at a given workload (i.e., economy) and used running as the mode of exercise. Two of the six studies indicated that increased tension was highly correlated (r = 0.81) with increased oxygen cost and that reductions in tension, using stress management techniques, improved RE. Because of the sparsity of studies in this area, a secondary purpose of this review was to examine the influence of psychological state on the physiological and behavioral response to varying modes of exercise. Affect, induced through hypnosis and imagery, was effective in changing the response to exercise (i.e., heart rate, performance). Altered perception through the use of hypnosis or through personality characteristics did not alter the physiological response to exercise, perhaps because of the passive role of the exerciser in these situations. Lastly, cognition (i.e., mental strategy, coping, and biofeedback) elicited changes in the physiological and behavioral responses to exercise. Despite these physiological alterations, there were not changes in oxygen consumption in the majority of the studies. It is possible that changes in selected physiological responses (i.e., respiratory frequency) may be altered (e.g., biofeedback) without changes in oxygen consumption because of accommodation in other areas of the body (i.e., a-VO2 difference). Changes in economy possibly occur when these accommodation effects are overridden by the physiological adaptations resulting from longer training periods. In conclusion, psychological state can influence the physiological and behavioral response to exercise. Furthermore, this review supports the use of a multidisciplinary approach to examine the interactional effects of physiology, biomechanics, psychology, and neurophysiology to adequately determine mechanisms underlying changes in RE.
J Appl Physiol. 2001 Apr;90(4):1392-9
Hypnotic manipulation of effort sense during dynamic exercise: cardiovascular responses and brain activation.
Williamson JW, McColl R, Mathews D, Mitchell JH, Raven PB, Morgan WP.
Department of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8876, USA. jon.williamson@utsouthwestern.edu
The purpose of this investigation was to hypnotically manipulate effort sense during dynamic exercise and determine whether cerebral cortical structures previously implicated in the central modulation of cardiovascular responses were activated. Six healthy volunteers (4 women, 2 men) screened for high hypnotizability were studied on 3 separate days during constant-load exercise under three hypnotic conditions involving cycling on a 1) perceived level grade, 2) perceived downhill grade, and 3) perceived uphill grade. Ratings of perceived exertion (RPE), heart rate (HR), blood pressure (BP), and regional cerebral blood flow (rCBF) distributions for several sites were compared across conditions using an analysis of variance. The suggestion of downhill cycling decreased both the RPE [from 13 +/- 2 to 11 +/- 2 (SD) units; P < 0.05] and rCBF in the left insular cortex and anterior cingulate cortex, but it did not alter exercise HR or BP responses. Perceived uphill cycling elicited significant increases in RPE (from 13 +/- 2 to 14 +/- 1 units), HR (+16 beats/min), mean BP (+7 mmHg), right insular activation (+7.7 +/- 4%), and right thalamus activation (+9.2 +/- 5%). There were no differences in rCBF for leg sensorimotor regions across conditions. These findings show that an increase in effort sense during constant-load exercise can activate both insular and thalamic regions and elevate cardiovascular responses but that decreases in effort sense do not reduce cardiovascular responses below the level required to sustain metabolic needs.
J Appl Physiol. 2002 Mar;92(3):1317-24.
Brain activation by central command during actual and imagined handgrip under hypnosis.
Williamson JW, McColl R, Mathews D, Mitchell JH, Raven PB, Morgan WP.
Department of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8876, USA. jon.williamson@utsouthwestern.edu
The purpose was to compare patterns of brain activation during imagined handgrip exercise and identify cerebral cortical structures participating in "central" cardiovascular regulation. Subjects screened for hypnotizability, five with higher (HH) and four with lower hypnotizability (LH) scores, were tested under two conditions involving 3 min of 1) static handgrip exercise (HG) at 30% of maximal voluntary contraction (MVC) and 2) imagined HG (I-HG) at 30% MVC. Force (kg), forearm integrated electromyography, rating of perceived exertion, heart rate (HR), mean blood pressure (MBP), and differences in regional cerebral blood flow distributions were compared using an ANOVA. During HG, both groups showed similar increases in HR (+13 +/- 5 beats/min) and MBP (+17 +/- 3 mmHg) after 3 min. However, during I-HG, only the HH group showed increases in HR (+10 +/- 2 beats/min; P < 0.05) and MBP (+12 +/- 2 mmHg; P < 0.05). There were no significant increases or differences in force or integrated electromyographic activity between groups during I-HG. The rating of perceived exertion was significantly increased for the HH group during I-HG, but not for the LH group. In comparison of regional cerebral blood flow, the LH showed significantly lower activity in the anterior cingulate (-6 +/- 2%) and insular cortexes (-9 +/- 4%) during I-HG. These findings suggest that cardiovascular responses elicited during imagined exercise involve central activation of insular and anterior cingulate cortexes, independent of muscle afferent feedback; these structures appear to have key roles in the central modulation of cardiovascular responses.
Am J Clin Hypn. 1993 Jan;35(3):190-7.
Enhancing the visualization of gymnasts.
Liggett DR, Hamada S.
Stanford University.
Visualizations under hypnosis enabled nationally ranked Stanford male gymnasts to execute for the first time several complex tricks that they had been working on for over a year. The gymnasts were able to eliminate timing errors in the tricks, to increase flexibility, and, possibly, to concentrate strength. The rationale for the effectiveness of trance visualizations, the induction and deepening strategies used, and the effects are described. Also included is an example of the use of a translator for the induction of a subject with a minimal fluency in English. Implications for further use of hypnosis with athletes are suggested.
North American Journal of Psychology 2007 Vol 9(1) pp. 189-200
Mind Over Matter: Mental Training Increases Physical Strength
Sheckell, E.
This study tested whether mental training alone can produce a gain in muscular strength. Thirty male university athletes, including football, basketball and rugby players, were randomly assigned to perform mental training of their hip flexor muscles, to use weight machines to physically exercise their hip flexors, or to form a control group, which received neither mental nor physical training. The hip strength of each group was measured before and after training. Physical strength was increased by 24% through mental practice (p= .008). Strength was increased with physical training by 28%, but did not change significantly in the control group. The strength gain was greatest among football players given mental training. Mental and physical training produced similar decreases in heart rate, and both yielded a marginal reduction in systolic blood pressure. The results support the related findings of Ranganathan, Siemionow, Liu, Sahgal, and Yue (2004).
Stress Management
J Clin Psychol. 2002 Aug;58(8):947-59
Psychosocial treatment of posttraumatic stress disorder: a practice-friendly review of outcome research.
Solomon SD, Johnson DM.
Office of Behavioral and Social Science Research, National Institutes of Health, Bethesda, MD 20892, USA
A review of the treatment research indicates that several forms of therapy appear to be useful in reducing the symptoms of posttraumatic stress disorder (PTSD). Strongest support is found for the treatments that combine cognitive and behavioral techniques. Hypnosis, psychodynamic, anxiety management, and group therapies also may produce short-term symptom reduction. Still unknown is whether any approach produces lasting effects. Imaginal exposure to trauma memories and hypnosis are techniques most likely to affect the intrusive symptoms of PTSD, while cognitive and psychodynamic approaches may address better the numbing and avoidance symptoms. Treatment should be tailored to the severity and type of presenting PTSD symptoms, to the type of trauma experience, and to the many likely co morbid diagnoses and adjustment problems. Copyright 2002 Wiley Periodicals, Inc.
ASDC J Dent Child. 2000 Jul-Aug;67(4):263-7, 231
The use of imagery suggestions during administration of local anesthetic in pediatric dental patients.
Peretz B, Bimstein E.
Department of Pediatric Dentistry, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.
The aim of this study was to evaluate the effects of suggestion before and during the administration of local anesthesia to children. These effects were then observed and correlated with social, behavioral and dentally related variables. Eighty children between the ages of three and sixteen years and who required at least one injection of local anesthesia were monitored. Retrospective examinations of their dental records provided the information regarding the behavior and dental treatment histories of the patients. All other data were provided through observation during the dental treatment phase. During the first treatment session, before the injection, each child was asked to select a favorite, pleasant memory or image. Where children had difficulty in identifying an image, one was proposed by the dentist. After an image had been chosen, the patients were asked to concentrate on the image and to visualize it during the procedure. The majority of children had chosen their own images, and significantly visualized the same images throughout the injection procedures. Image selection and visualization had no association with gender, age, the parent's assessment of the child's behavior, previous dental experience, behavior (both past and present) or, management techniques (both past and present). We conclude that imaging techniques may be successfully utilized in the administration of local anesthesia to young children (from three years of age) in an effort to mitigate untoward, pain-related stress.
Psychosom Med. 1996 May-Jun;58(3):249-63
Psychosocial and immune effects of self-hypnosis training for stress management throughout the first semester of medical school.
Whitehouse WG, Dinges DF, Orne EC, Keller SE, Bates BL, Bauer NK, Morahan P, Haupt BA, Carlin MM, Bloom PB, Zaugg L, Orne MT.
Institute of Pennsylvania Hospital, University of Pennsylvania Medical School, Philadelphia, USA.
This study was a 19-week prospective conducted to determine the effectiveness of a self-hypnosis/relaxation intervention to relieve symptoms of psychological distress and moderate immune system reactivity to examination stress in 35 first-year medical students. Twenty-one subjects were randomly selected for training in the use of self-hypnosis as a coping skill and were encouraged to practice regularly and to maintain daily diary records related to mood, sleep, physical symptoms, and frequency of relaxation practice. An additional 14 subjects received no explicit training in stress-reduction strategies, but completed similar daily diaries. Self-report psychosocial and symptom measures, as well as blood draws, were obtained at four time points: orientation, late semester, examination period, and postsemester recovery. It was found that significant increases in stress and fatigue occurred during the examination period, paralleled by increases in counts of B lymphocytes and activated T lymphocytes, PHA-induced and PWM-induced blastogenesis, and natural killer cell (NK) cytotoxicity. No immune decreases were observed. Subjects in the self-hypnosis condition reported significantly less distress and anxiety than their nonintervention counterparts, but the two groups did not differ with respect to immune function. Nevertheless, within the self-hypnosis group, the quality of the exercises (ie, relaxation ratings) predicted both the number of NK cells and NK activity. It was concluded that stress associated with academic demands affects immune function, but immune suppression is not inevitable. Practice of self-hypnosis reduces distress, without differential immune effects. However, individual responses to the self-hypnosis intervention appear to predict immune outcomes.
Paediatr Anaesth. 2005 Apr;15(4):275-81
Premedication in children: hypnosis versus midazolam.
Calipel S, Lucas-Polomeni MM, Wodey E, Ecoffey C.
Department of Anesthesiology and Surgical Intensive Care 2, Hopital Pontchaillou, Universite de Rennes 1, Rennes, France.
BACKGROUND: The main objectives of premedication in children are to facilitate the separation from the parents, to reduce preoperative anxiety, to smooth the induction of anesthesia and to lower the risk of postoperative behavioral disorders. The most common technique is sedative premedication with midazolam. Hypnosis enables a state of relaxation to be achieved and has never been evaluated as a premedication technique. The aim of the present study was to evaluate the efficacy of hypnosis on anxiety and perioperative behavioral disorders versus midazolam. METHODS: Fifty children from 2 to 11 years of age were randomized into two groups: group H received hypnosis as premedication; group M were given 0.5 mg x kg(-1) midazolam orally, 30 min before surgery. Preoperative anxiety was evaluated using the Modified Yale Preoperative Anxiety Scale (mYPAS) score when arriving in the department (T1), when entering the operating room (T2), and when fitting the facemask (T3). Postoperative behavioral disorders were evaluated using the Posthospitalization Behavioral Questionnaire (PHBQ) at days 1, 7 and 14. RESULTS: The two groups showed no significant difference preoperatively with the PHBQ: (M) 21 (17-25) vs (H) 20 (8-25) and mYPAS score: (M) 28 (23-75) vs (H) 23 (23-78). The number of anxious children was less during induction of anesthesia in the hypnosis group (T3: 39% vs 68%) (P < 0.05). Postoperatively, hypnosis reduced the frequency of behavior disorders approximately by half on day 1 (30% vs 62%) and day 7 (26% vs 59%). CONCLUSIONS: Hypnosis seems effective as premedication in children scheduled for surgery. It alleviates preoperative anxiety, especially during induction of anesthesia and reduces behavioral disorders during the first postoperative week.
J Natl Cancer Inst. 2005 Dec 7;97(23):1760-7
Chronic stress and susceptibility to skin cancer.
Saul AN, Oberyszyn TM, Daugherty C, Kusewitt D, Jones S, Jewell S, Malarkey WB, Lehman A, Lemeshow S, Dhabhar FS.
Colleges of Medicine and Public Health, The Ohio State University, Columbus, OH, USA.
BACKGROUND: Studies have shown that chronic stress or UV radiation independently suppress immunity. Given their increasing prevalence, it is important to understand whether and how chronic stress and UV radiation may act together to increase susceptibility to disease. Therefore, we investigated potential mediators of a stress-induced increase in emergence and progression of UV-induced squamous cell carcinoma. METHODS: SKH1 mice susceptible to UV-induced tumors were unexposed (naive, n = 4) or exposed (n = 16) to 2240 J/m2 of UVB radiation three times a week for 10 weeks. Half of the UVB-exposed mice were left nonstressed (i.e., they remained in their home cages) and the other half were chronically stressed (i.e., restrained during weeks 4-6). UV-induced tumors were measured weekly from week 11 through week 34, blood was collected at week 34, and tissues were collected at week 35. mRNA expression of interleukin (IL)-12p40, interferon (IFN)-gamma, IL-4, IL-10, CD3epsilon, and CCL27/CTACK, the skin T cell-homing chemokine, in dorsal skin was quantified using real-time polymerase chain reaction. CD4+, CD8+, and CD25+ leukocytes were counted using immunohistochemistry and flow cytometry. All statistical tests were two-sided. RESULTS: Stressed mice had a shorter median time to first tumor (15 versus 16.5 weeks, difference = 1.5 weeks, 95% confidence interval [CI] = -3.0 to 3.3 weeks; P = .03) and reached 50% incidence earlier than controls (15 weeks versus 21 weeks). Stressed mice also had lower IFN-gamma ( mean = 0.03 versus mean = 0.07, difference = 0.04, 95% CI = 0.004 to 0.073; P = .02), CCL27/CTACK (mean = 101 versus mean = 142, difference = 41, 95% CI = 8.1 to 74.4; P = .03), and CD3epsilon (mean = 0.18 versus mean = 0.36, difference = 0.18, 95% CI = 0.06 to 0.30; P = .007) gene expression and lower numbers of infiltrating CD4+ cells (mean = 9.40 versus mean = 13.7, difference = 4.3, 95% CI = 2.36 to 6.32; P = .008) than nonstressed mice. In addition, stressed mice had more regulatory/suppressor CD25+ cells infiltrating tumors and more CD4+ CD25+ cells in circulation (mean = 0.36 versus mean = 0.17, difference = 0.19, 95% CI = 0.005 to 0.38; P = .03) than nonstressed mice. CONCLUSIONS: Chronic stress increased susceptibility to UV-induced squamous cell carcinoma in this mouse model by suppressing type 1 cytokines and protective T cells and increasing regulatory/suppressor T cell numbers
Brain Behav Immun. 2005 Dec
Stress susceptibility predicts the severity of immune depression and the failure to combat bacterial infections in chronically stressed mice.
Kiank C, Holtfreter B, Starke A, Mundt A, Wilke C, Schutt C.
Department of Immunology, University of Greifswald, Germany.
Chronic psychological stress has been suggested to play a role in disorders in which the immune system unexpectedly fails to respond in a protective manner. Chronic combined acoustic and restraint stress compromises the anti-bacterial defense mechanisms of female BALB/c mice. The immunodeficiency is characterized by an apoptotic loss of lymphocytes, reduced ex vivo-inducibility of TNF but increased inducibility of IL10, reduced T-cell proliferation, and impaired phagocyte functions. Stressed mice develop depression-like behavior that was monitored by a stress severity score (SSS). Besides a strain (BALB/c>CBA) and gender (male>female) dependent susceptibility to chronic stress, inbred mice have an individual coping ability. Importantly, the individual SSS strongly correlates with Escherichia coli dissemination after infection as well as with IL10-inducibility and circulating corticosterone levels of each animal.
J Occup Health. 2005 Sep;47(5):378-83
A cross-sectional study on the relationship of job stress with natural killer cell activity and natural killer cell subsets among healthy nurses.
Morikawa Y, Kitaoka-Higashiguchi K, Tanimoto C, Hayashi M, Oketani R, Miura K, Nishijo M, Nakagawa H.
Department of Public Health, Kanazawa Medical University, Ishikawa, Japan. ymjr@kanazawa-med.ac.jp
The present study investigated the effects of job stress on cellular immune function, such as NK cell activity and NK cell subsets. The participants were 61 female nurses aged 23-59, who worked in a public psychiatric hospital in Ishikawa, Japan. Each subject completed the Nursing Job Stressor Scale (NJSS) and their NK cell activity and lymphocyte surface antigens (CD16+56+) were evaluated as immune system parameters. The NJSS has seven subscales: conflict with other nursing staff, nursing role conflict, conflict with physicians or autonomy, conflict with death or dying, quantitative work load, qualitative work load and conflict with patients. Factors influencing NK cell activity, and the proportion and cell counts of CD16+56+ lymphocytes were evaluated. Increase in quantitative work load significantly decreased NK cell activity. Conversely, no linear relationship was observed between qualitative work load and immunological variables, with the highest percentage of CD16+56+ lymphocytes observed among participants in the medium work load group. The other five NJSS subscales did not relate to immune parameters. In conclusion, the results suggest that perceived job strains, particularly quantitative work load, decreased NK cell function.
Pharmacol Biochem Behav. 2006 Mar 8
Gender specific effects of a mild stressor on alcohol cue reactivity in heavy social drinkers.
Nesic J, Duka T.
Department of Psychology, School of Life Sciences, University of Sussex, Falmer, Brighton BN1 9QG, UK.
RATIONALE: Stress plays an important role in the development and maintenance of alcohol-abuse. Some of the effects of stress on alcohol-related behaviours, however, appear to be gender-dependent. AIM: The present study set out to examine the effects of stress on feelings of desire for alcohol, skin conductance response and alcohol consumption in the presence of alcohol-related cues in relation to gender. Participants were heavy non-dependent alcohol drinkers. METHODS: Thirty-two (16 males) participants drinking more than 21 units of alcohol per week were randomly allocated to undergo the experimental stress (based on the 'Trier Social Stress' Test) or the non-stress procedure before the alcohol cue exposure procedure, during which participants handled and smelled their preferred drink. Mood and saliva cortisol level changes were used as indices of the stress effects, while alcohol craving, skin conductance and alcohol consumption were the cue reactivity measures. RESULTS: Self ratings of anxiety and tension increased and cortisol levels remained high in the stress compared to the non-stress condition; no gender differences were found. Stress induced gender-specific effects with regard to skin conductance response and alcohol consumption measurements. Stressed females did not show an increase from baseline in the skin conductance response during the alcohol cue-exposure session, which was observed in the non-stressed females; they also consumed less alcohol than males under stress. CONCLUSION: Female participants respond less to alcohol-related cues when in a negative mood state. Such a finding suggests that females when in a negative mood may be less sensitive to positive incentive processes mediating cue reactivity compared to males.
Behav Res Ther. 2005 Dec 17
Hypnotherapy and cognitive behaviour therapy of acute stress disorder: A 3-year follow-up.
Bryant RA, Moulds ML, Nixon RD, Mastrodomenico J, Felmingham K, Hopwood S.
School of Psychology, University of New South Wales, NSW 2052, Sydney, Australia.
The long-term benefits of cognitive behaviour therapy (CBT) for trauma survivors with acute stress disorder were investigated by assessing patients 3 years after treatment. Civilian trauma survivors (n=87) were randomly allocated to six sessions of CBT, CBT combined with hypnosis, or supportive counselling (SC), 69 completed treatment, and 53 were assessed 2 years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician-Administered PTSD Scale. In terms of treatment completers, 2 CBT patients (10%), 4 CBT/hypnosis patients (22%), and 10 SC patients (63%) met PTSD criteria at 2-years follow-up. Intent-to-treat analyses indicated that 12 CBT patients (36%), 14 CBT/hypnosis patients (46%), and 16 SC patients (67%) met PTSD criteria at 2-year follow-up. Patients who received CBT and CBT/hypnosis reported less re-experiencing and less avoidance symptoms than patients who received SC. These findings point to the long-term benefits of early provision of CBT in the initial month after trauma.
Am J Clin Hypn. 2005 Oct-2006 Jan;48(2-3):183-9
Hypnotic treatment of PTSD in children who have complicated bereavement.
Iglesias A, Iglesias A.
PhDALEX@aol.com
Although conceptualized as a normal reaction to loss and not classified as a mental disorder, grief can be considered a focus of treatment. When grief complicates and becomes pathological by virtue of its duration, intensity, and absence or by bizarre or somatic manifestation, a psychiatric diagnosis is in order. Childhood PTSD in Complicated Bereavement is a condition derived from the loss of a loved one when the nature of death is occasioned through traumatic means. The traumatic nature of the loss engenders trauma symptoms, which impinge on the child's normal grieving process and his/ her ability to negotiate the normal grieving system. The 2 cases presented herein constitute single session treatment with clinical hypnosis of PTSD, a result of the traumatic loss of the paternal figures. The setting in which these cases took place was rural Guatemala. Treatment consisted of single session hypnosis with the Hypnotic Trauma Narrative, a tool designed to address the symptomatology of PTSD. Follow-up a week later and telephone follow-up 2 months later demonstrated the resolution of traumatic manifestations and the spontaneous beginning of the normal grief process.
Study Skills
Am J Clin Hypn. 1996 Apr;38(4):277-87.
Teaching college students better learning skills using self-hypnosis.
Wark DM.
University Counseling and Consulting Services, University of Minnesota, Minneapolis 55455, USA.
This paper reports the effects of self-hypnosis used by 51 college students enrolled in a 10-week course on efficient learning skills. All students were administered the Creative Imagination Scale. Subsequently, they learned to enter and deepen alert self-hypnosis. They gave themselves personal suggestions and then studied in hypnosis. They reported their depth of hypnosis and satisfaction with each session. Grades were collected the quarter before, during and after the course. Satisfaction and depth data indicated the students were involved all through the course. Statistical testing showed that students who scored highest on the CIS had the lowest initial GPA, improved most during the course, and significantly increased their GPA in the quarter after.
1995 May E. H. Schreiber, K.N. Schreiber
Using Relaxation Techniques And Positive Self-Esteem To Improve Academic Achievement Of College Students
Rowan College of New Jersey ,University of Delaware
This study examined whether after 20 sessions over 10 weeks of Jacobson's muscle relaxation accompanied by encouragement of positive self-esteem academic examination scores of 22 undergraduate college students would improve by comparison with those of a control group of 30 students. The relaxation group had significantly higher examination grades than the control group, but there was no significant mean difference between the groups on the Cattell and Scheier Anxiety Scale or a two-item measure of self-esteem.
Addiction
Tobacco Cessation
J Dent Educ. 2001 Apr;65(4):340-7
Hypnosis, behavioral theory, and smoking cessation.
Covino NA, Bottari M.
Department of Psychology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. ncovino@caregroup.harvard.edu
Although nicotine replacement and other pharmacological treatments head the list of popular interventions for smoking cessation, approaches based on psychology can also assist smokers. Hypnosis, suggestion, and behavior therapies have been offered to patients and studied experimentally for several decades. Although no single psychological approach has been found to be superior to others, psychological interventions contribute significantly to successful treatment outcome in smoking cessation. This article describes common hypnotic and behavioral approaches to smoking cessation and critically reviews some of the findings from clinical and experimental research studies. The authors also offer suggestions regarding treatment and future research.
Addiction. 2002 Jan;97(1):87-93.
The urge to smoke depends on the expectation of smoking.
Dols M, van den Hout M, Kindt M, Willems B.
Department of Medical, Clinical and Experimental Psychology, Maastricht University, The Netherlands. M.Dols@dep.unimaas.nl
AIMS: An earlier study (Dols et al. 2000) suggested that cue-induced urge to smoke depends on the expectation of smoking. The present study tried to replicate the findings under stringently controlled conditions. DESIGN: A 2 (context) x 2 (cues) x 6 (trial) within-subject design. Each smoker entered two different contexts; one context predicted the future occurrence of smoking (i.e. one puff of a cigarette) and one context predicted the non-occurrence of smoking. In each context smokers were exposed to smoking cues (i.e. cigarettes and lighter) or not. SETTING: Laboratory at Maastricht University. PARTICIPANTS: Thirty-two daily smokers, smoking at least five cigarettes a day for at least 2 years. MEASUREMENTS: Participants reported their urge to smoke in each context in the presence and absence of smoking cues using a computerized visual analogue scale (VAS). FINDINGS: The results revealed that the urge to smoke was higher in a context in which smoking was expected relative to a context in which it was not expected. As in the previous study the urge-inducing effect of smoking cues was larger in the smoking context than in the non-smoking context. Moreover, smoking cues did not have a significant effect in the non-smoking context. CONCLUSIONS: It was shown that smoking cues elicit craving due mainly to a generated expectation of the occurrence of smoking and less due to salience or long history of associative learning. Theoretical and practical implications of the results are discussed.
J Dent Educ. 2001 Apr;65(4):340-7.
Hypnosis, behavioral theory, and smoking cessation.
Covino NA, Bottari M.
Department of Psychology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. ncovino@caregroup.harvard.edu
Although nicotine replacement and other pharmacological treatments head the list of popular interventions for smoking cessation, approaches based on psychology can also assist smokers. Hypnosis, suggestion, and behavior therapies have been offered to patients and studied experimentally for several decades. Although no single psychological approach has been found to be superior to others, psychological interventions contribute significantly to successful treatment outcome in smoking cessation. This article describes common hypnotic and behavioral approaches to smoking cessation and critically reviews some of the findings from clinical and experimental research studies. The authors also offer suggestions regarding treatment and future research.
Tinnitus
Eur Arch Otorhinolaryngol. 2007 May;264(5):483-8. Epub 2007 Jan 6.
Erratum in:
Eur Arch Otorhinolaryngol. 2007 May;264(5):573-4.
Ericksonian hypnosis in tinnitus therapy: effects of a 28-day inpatient multimodal treatment concept measured by Tinnitus-Questionnaire and Health Survey SF-36.
Ross UH, Lange O, Unterrainer J, Laszig R.
Practice for Otorhinolaryngology and Psychotherapy, Freiburg, Germany. Dr-Ross@web.de
For the first time, the therapeutic effects on subacute and chronic tinnitus of an inpatient multimodal treatment concept based on principles of Ericksonian hypnosis (EH) were examined by standardized criteria of the Tinnitus Questionnaire (TQ) and Health Survey (SF-36) within a controlled prospective, longitudinal study. A total of 393 patients were treated within an inpatient closed-group 28-day-setting based on a resource-oriented, hypnotherapeutic concept. The severity of tinnitus was assessed by TQ at times of admission, discharge and also at a 6- and 12-month follow-up. Health-related quality of life was evaluated before and after therapy using the SF-36. After therapy, a decrease in TQ score was seen in 90.5% of the patients with subacute tinnitus and in 88,3% of those with chronic tinnitus. Assessment of the TQ score at the end of therapy revealed highly significant improvements of 15.9/14.1 points in mean. Effect sizes in the treatment groups (0.94/0.80) were superior to those in the waiting-list controls (0.14/0.23). The TQ score remained stable in the follow-up controls. Significant improvement in health-related quality of life has been observed within the treatment groups depending on initial level of tinnitus serverity I-IV according to TQ. Using a multimodal treatment concept with emphasis on resource-activating approaches of EH the annoyance of tinnitus can be significantly reduced while health-related quality of life is enhanced within a comparatively short treatment period of 28 days.
PMID: 17206402 [PubMed - indexed for MEDLINE]
Weight Management
J Clin Psychol. 1985 Jan;41(1):35-41
Effectiveness of hypnosis as an adjunct to behavioral weight management.
Bolocofsky DN, Spinler D, Coulthard-Morris L.
This study examined the effect of adding hypnosis to a behavioral weight-management program on short- and long-term weight change. One hundred nine subjects, who ranged in age from 17 to 67, completed a behavioral treatment either with or without the addition of hypnosis. At the end of the 9-week program, both interventions resulted in significant weight reduction. However, at the 8-month and 2-year follow-ups, the hypnosis clients showed significant additional weight loss, while those in the behavioral treatment exhibited little further change. More of the subjects who used hypnosis also achieved and maintained their personal weight goals. The utility of employing hypnosis as an adjunct to a behavioral weight-management program is discussed.
Am J Clin Hypn. 1994 Apr;36(4):248-57
The (limited) possibilities of hypnotherapy in the treatment of obesity.
Vanderlinden J, Vandereycken W.
University Center St.-Jozef, Kortenberg, Belgium.
In this paper we review the possibilities and limitations of hypnotherapeutic techniques in the treatment of obesity. In spite of some promising reports, the findings and opinions about the effectiveness of hypnosis in the treatment of obesity vary greatly. We provide a brief overview of specific hypnotherapeutic techniques--such as teaching relaxation, increasing self-control, encouraging physical exercise, altering self-esteem and body image, strengthening motivation, and exploring ambivalence for change--that can be involved in a multidimensional approach to obesity. Case reports illustrate the use of these techniques.
Psychol Rep. 1996 Oct;79(2):659-68
Participation in multicomponent hypnosis treatment programs for women's weight loss with and without overt aversion.
Johnson DL, Karkut RT.
Studies of hypnotic, covert and overt aversive techniques have yielded equivocal results when each has been examined for a singular effect on weight lost. Some have advocated study of effective combinations of techniques before investing in other applications. Two programs of hypnosis, imagery, diet, tape, behavior management and support but differing in the overt use of aversion (electric shock, disgusting tastes smells) were examined. A total of 172 overweight adult women were treated, 86 in a hypnosis only and 86 in an overt aversion and hypnosis program. Both programs achieved significant weight losses. Although subjects who received overt aversion attained somewhat more desired goals and lost more weight than subjects recovering only hypnosis, the differences were not significant.
Hypnotherapy in weight loss treatment.
by Cochrane, Gordon; Friesen, John
from Journal of Consulting and Clinical Psychology. 1986 Aug Vol 54(4) 489-492
Investigated the effects of hypnosis as a treatment for weight loss among women. The sample consisted of 60 women (aged 20-65 yrs) who were at least 20% overweight and were not in any other treatment program. Six client variables (suggestibility, self-concept, quality of family origin, age of obesity onset, education level, and socioeconomic status [SES]) and 1 process variable (multimodal imagery) were analyzed in relation to the dependent variable (weight loss). Two experimental groups, hypnosis plus audiotapes and hypnosis without audiotapes, and the control group were investigated for weight loss immediately after treatment and again after a 6-mo follow-up. The primary hypothesis that hypnosis is an effective treatment for weight loss was confirmed, but the 7 concomitant variables and the use of audiotapes were not significant contributors to weight loss. (26 ref) (PsycINFO Database Record (c) 2005 APA, all rights reserved)
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003818.
Psychological interventions for overweight or obesity.
Shaw K, O'Rourke P, Del Mar C, Kenardy J.
Public and Environmental Health Unit, Department of Health and Human Services, Public Health Unit, 3 / 90 Davey Street, Hobart, Tasmania, Australia, 7000. kelly.shaw@dhhs.tas.gov.au
BACKGROUND: Overweight and obesity are global health problems which are increasing throughout the industrialised world. If left unchecked, they will continue to contribute to the ever increasing noncommunicable disease burden. OBJECTIVES: To assess the effects of psychological interventions for overweight or obesity as a means of achieving sustained weight loss. SEARCH STRATEGY: Studies were obtained from searches of multiple electronic bibliographic databases. The date of the latest search was June 2003. SELECTION CRITERIA: Trials were included if the fulfilled the following criteria: 1) they were randomised controlled clinical trials of a psychological intervention versus a comparison intervention, 2) one of the outcome measures of the study was weight change measured by any method, 3) participants were followed for at least three months, 4) the study participants were adults (18 years or older) who were overweight or obese (BMI > 25 kg/m(2)) at baseline. DATA COLLECTION AND ANALYSIS: Two people independently applied the inclusion criteria to the studies identified and assessed study quality. Disagreement was resolved by discussion or by intervention of a third party. Meta-analyses were performed using a fixed effect model. MAIN RESULTS: A total of 36 studies met the inclusion criteria and were included in the review. Overall, 3495 participants were evaluated. The majority of studies assessed behavioural and cognitive-behavioural weight reduction strategies. Cognitive therapy, psychotherapy, relaxation therapy and hypnotherapy were assessed in a small number of studies. Behaviour therapy was found to result in significantly greater weight reductions than placebo when assessed as a stand-alone weight loss strategy (WMD -2.5 kg; 95% CI -1.7 to -3.3). When behaviour therapy was combined with a diet / exercise approach and compared with diet / exercise alone, the combined intervention resulted in a greater weight reduction. Studies were heterogeneous however the majority of studies favoured combining behaviour therapy with dietary and exercise interventions to improve weight loss. Increasing the intensity of the behavioural intervention significantly increased the weight reduction (WMD -2.3 kg; 95% CI -1.4 to - 3.3). Cognitive-behaviour therapy, when combined with a diet / exercise intervention, was found to increase weight loss compared with diet / exercise alone (WMD -4.9 kg; 95% CI -7.3 to - 2.4). No data on mortality, morbidity or quality of life were found. AUTHORS' CONCLUSIONS: People who are overweight or obese benefit from psychological interventions, particularly behavioural and cognitive-behavioural strategies, to enhance weight reduction. They are predominantly useful when combined with dietary and exercise strategies. The bulk of the evidence supports the use of behavioural and cognitive-behavioural strategies. Other psychological interventions are less rigorously evaluated for their efficacy as weight loss treatments.
Proc Natl Acad Sci U S A. 2005 Sep 27;102(39):13724-31. Epub 2005 Aug 3.
False beliefs about fattening foods can have healthy consequences.
Bernstein DM, Laney C, Morris EK, Loftus EF.
University of Washington and Kwantlen University College, Department of Psychology, Box 351525, Seattle, WA 98195-1525, USA.
We suggested to 228 subjects in two experiments that, as children, they had had negative experiences with a fattening food. An additional 107 subjects received no such suggestion and served as controls. In Experiment 1, a minority of subjects came to believe that they had felt ill after eating strawberry ice cream as children, and these subjects were more likely to indicate not wanting to eat strawberry ice cream now. In contrast, we were unable to obtain these effects when the critical item was a more commonly eaten treat (chocolate chip cookie). In Experiment 2, we replicated and extended the strawberry ice cream results. Two different ways of processing the false suggestion succeeded in planting the false belief and producing avoidance of the food. These findings show that it is possible to convince people that, as children, they experienced a negative event involving a fattening food and that this false belief results in avoidance of that food in adulthood. More broadly, these results indicate that we can, through suggestion, manipulate nutritional selection and possibly even improve health.
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