This Rogerian study examined how traditional and Ericksonian hypnotherapeutic support groups facilitated self-defined health-promoting goals and power as knowing participation in change for 49 participants with chronic physical illness. The participants were randomly assigned to either a traditional support group or an Ericksonian hypnotherapeutic support group. Measurements of power and self-defined health-promoting goals were obtained seven times over a 10-week period. The results indicated that both the traditional support groups and the Ericksonian hypnotherapeutic support groups experienced significantly enhanced power and progressed significantly toward their health-promoting goals. Correlations for the self-defined health-promoting goals and power progressively and significantly increased through time. This study supports Barrett's claim that power relates to health.

Nurs Sci Q. 2007 Oct;20(4):357-69. Larkin DM. The College of New Rochelle, School of Nursing, New Rochelle, New York, USA.

by Anne Spencer, Ph.D.

One of the most unexpected events in my life was to be doing a regression for weight reduction and find myself involved in an exorcism.

It happened this way. I was asked to work with a national author and speaker who had a weight problem. We'll call her Rose. I first met rose via telephone as I had written her to say how much her book had helped me understand myself and some of my clients. Rose called to thank me and said she would be in my city a few months hence. We met for lunch and the friendship began.

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The recognition and utilization of trance phenomena in clinical pediatrics can energize the practitioner and be therapeutically beneficial for the child. The aim of this paper is to characterize and promote the purposeful inclusion of trance and suggestion in the routine pediatric examination. This includes, but goes beyond, the child-oriented examination skills customarily associated with being a "good," child-friendly pediatrician. While this paper highlights trance recognition from a clinician's perspective, emphasis is placed on utilizing spontaneous hypnotic moments whenever they occur to further the agenda of the encounter, diminish doctor visit anxiety, enhance self empowerment, and improve the milieu for pediatric care.

Am J Clin Hypn. 2007 Oct;50(2):121-9. Berberich FR. Pediatric Medical Group, Berkeley, CA 94705, USA. rberb@sbcglobal.net

In Experiment 1, 6- and 9-year-old children and adults were asked to imagine various types of objects. The experimenter then attempted to change the image of those objects in participants' minds by either suggesting that the objects may change against the participants' will, or by asking participants to change the objects as a favor to the experimenter. Two types of suggestive causation were employed: Magical-suggestion (a magic spell was cast with the aim of changing the imagined objects) and ordinary-suggestion (participants were told that the objects in their minds could alter against their will). Ordinary-suggestion was as effective as magical-suggestion in changing the participants' imagined objects. For adults, a direct request for compliance produced a stronger effect than did magical suggestion. This effect was not found in children. In Experiment 2, the two types of suggestion were tested on an alternative type of imagined objects. Adult participants were asked to imagine their futures. It was then proposed that (a) a magic spell could be cast on their futures with the aim of changing them either for the worse or for the better (magical-suggestion), or (b) changing a numerical pattern on a computer screen could change their futures (ordinary-suggestion). All participants denied that changing a numerical pattern on a computer screen could affect their lives, yet in their actions they demonstrated an element of belief in this possibility. As in Experiment 1, in Experiment 2 ordinary suggestion was as effective as magical suggestion. The hypothesis of an historic contiguity between magical causality and ordinary suggestion is discussed.

Br J Psychol. 2007 Nov;98(Pt 4):547-74. Subbotsky E. Psychology Department, Lancaster University, Lancaster, UK. e.subbotsky@lancaster.ac.uk

Hypnosis involves the manipulation of conscious attentional discrimination. The prepulse inhibition (PPI) paradigm assesses primary unconscious information processing. We investigated the correlation between hypnotizability and PPI of the startle reflex. Forty-eight healthy subjects were evaluated with the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) and acoustic PPI. Subjects were divided into low, medium, and high hypnotizable groups. The low-hypnotizable group showed a significantly higher inhibition of the startle response, at lead intervals 60 ms and 120 ms, than did the medium- and high-hypnotizable groups. We conclude that hypnotizability and PPI may be negatively correlated. These findings lend further support for the role of dopaminergic neurotransmission mechanisms in the determination of hypnotizability levels.

Int J Neuropsychopharmacol. 2007 Nov 30;:1-5 Lichtenberg P, Even-Or E, Bar G, Levin R, Brin A, Heresco-Levy U. Hadassah Medical School of the Hebrew University of Jerusalem, Israel.

A defensive dominant was created in rabbits using rhythmic electrocutaneous stimulation of the left forelimb at a frequency of 0.5 Hz. After stimulation ended, the latent excitation state was tested using sound stimuli. Animals responded either with increases in non-rhythmic paw muscle activity or with rhythmic twitching of the paw at a frequency close to that of the electrocutaneous stimulation. After hypnotization, the incidence of rhythmic responses to the stimulation testing the dominant focus increased, while the incidence of non-rhythmic responses decreased.

Neurosci Behav Physiol. 2008 Jan;38(1):23-30. Galashina AG, Kulikov MA, Bogdanov AV. Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, bogdav@mail.ru.

To provide an understanding of Hong Kong registered nurses' personal and professional use of complementary and alternative medicine. DESIGN. Cross-sectional questionnaire study. PARTICIPANTS. Registered nurses who were members of the Hong Kong College of Nursing were invited to participate. MAIN OUTCOME MEASURES. Demographic data of the respondents, prevalence of personal and professional use of complementary and alternative medicines, including their use for detailed clinical conditions. RESULTS. A total of 187 nurses participated in this study. Nearly four fifths (80%; 95% confidence interval, 74-86%) of the participants had used at least one form of complementary/alternative medicine. In addition to the personal use of such treatment, over two fifths (41%; 95% confidence interval, 34-48%) had recommended at least one form of complementary/alternative medicine to their patients. These included bone-setting (20%), Chinese remedial massage (tuina, 19%), and meditation (19%). Specifically, registered nurses recommended acupuncture or acupressure to patients with musculoskeletal disorders, chronic pain, or headaches/migraines. CONCLUSIONS. Personal use and professional recommendations for complementary and alternative medicine by registered nurses in Hong Kong is substantial. Registered nurses played an active role in advising such treatment for their patients based on their personal knowledge of perceived benefit in specific conditions. Further investigations with a larger sample size should focus on registered nurses' educational needs in respect of complementary and alternative medicine and the advice they recommended.

Hong Kong Med J. 2008 Apr;14(2):110-5. Xue CC, Zhang AL, Holroyd E, Suen LK. Division of Chinese Medicine, School of Health Sciences, The WHO Collaborating Centre for Traditional Medicine, RMIT University, Melbourne, Australia.

Hypnosis is attempting to come to grips with the EST (Empirically Supported Therapy) revolution in mental health practice. However, there are ways to account for outcome outside of simple empirical validation of treatment models. In this light, strategic eclecticism as a broader research-based consideration is used to illustrate empirical principles within Eriksonian hypnotherapeutic approaches.

Am J Clin Hypn. 2008 Jan;50(3):233-45. Amundson JK, Nuttgens SA. Amundson & Associates, 1614 8th Avenue NW, Calgary. aapsych@telus.net

The relationship between metaphor and the practice of utilization in therapy and hypnosis can be seen as dependent on metaphor's role in structuring experience. The work of Gregory Bateson and others is used to illustrate how metaphor functions. Bateson's comparison of two forms of syllogistic logic provides a background for distinguishing between the experiential effects of metaphor in contrast to the categorical thinking inherent in simile and analogy. Clinical examples are given to demonstrate how utilization is structured by metaphor, particularly as Bateson has described it in his analysis of the Syllogism in Grass.

Am J Clin Hypn. 2008 Jan;50(3):247-57. Roffman AE. New York University, Child Study Center, 577 First Avenue, New York, NY 10016, USA. roffma01@med.nyu.edu

Systemic contact dermatitis from nickel has been reported from a number of sources including medical devices and following experimental oral exposure. OBJECTIVE: To identify other potential sources of systemic nickel exposure. METHODS: The internet and published medical literature were searched for complementary and alternative remedies which contain nickel. RESULTS: We identified and evaluated sources of nickel exposure in 4 homeopathic preparations, which are advertised to treat common skin diseases, as well as in a number of other homeopathic remedies, several herbal products and multivitamin mineral complexes. CONCLUSION: Complementary and alternative remedies are an additional source of systemic nickel exposure and at highest doses the potential risk for systemic contact dermatitis in nickel allergic patients should be considered.

Contact Dermatitis. 2008 Feb;58(2):97-100. de Medeiros LM, Fransway AF, Taylor JS, Wyman M, Janes J, Fowler JF Jr, Rietschel RL. Section of Industrial Dermatology, Department of Dermatology (A-61), Cleveland Clinic, Cleveland, OH 44195, USA.

Provide an orientation to psychoneuroimmunology, a rationale for including assessments of immune function in intervention studies of pediatric chronic illness, review the current literature, and provide recommendations for future research. METHODS: Using electronic searches and previous reviews, selected and reviewed published studies in which immunological changes related to psychological interventions were assessed in pediatric samples. RESULTS: Eight studies were identified and included in the review. These utilized a range of interventions (e.g., disclosure and hypnosis) and included a variety of pediatric samples (e.g., those with asthma, HIV infection, or lupus). CONCLUSIONS: Results suggest that psychological intervention can influence immune function in pediatric samples. Recommendations for advancing our knowledge by studying populations for whom the immune system plays an active role in disease pathophysiology, measuring disease-relevant immune mediators, studying pediatric patients under times of stress, and focusing on interventions aimed at altering the stress system are provided.

J Pediatr Psychol. 2008 Mar;33(2):195-207. Epub 2007 Sep 10. Nassau JH, Tien K, Fritz GK. Bradley Hasbro Children's Research Center, CORO Center West - Suite 204, 1 Hoppin Street, Providence, RI 02903, USA. jack_nassau@brown.edu

Conventional suggestion-based tests of hypnotizability have been criticized because they confound hypnotic and nonhypnotic suggestibility. One way around this might be to measure hypnotizability in terms of differences in suggestibility before and after hypnotic induction. However, analysis of data from a 1966 classic study by Hilgard and Tart confirms that difference scores are subject to statistical and methodological problems. Simple verbal hypnotic depth scales are presented as a useful alternative. They correlate well with conventional suggestion-based measures and enable the presence of hypnosis to be indexed independently of formal hypnotic induction procedures. Criticisms of depth scales are addressed, and normative data for the Long Stanford Scale of hypnotic depth are presented, along with data lending empirical support for the construct validity of depth reports.

Int J Clin Exp Hypn. 2008 Apr;56(2):119-42. Wagstaff GF, Cole JC, Brunas-Wagstaff J. University of Liverpool, Liverpool, UK.

This study assessed the relationship of age and hypnotic suggestibility in an effort to partially update the findings of Morgan and Hilgard (1973). A total of 2,660 undergraduates were administered the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A; Shor & Orne, 1962) over a 7 year period. Consistent with Morgan and Hilgard's results, we found a general trend for hypnotic suggestibility scores to decrease from age 17 to 40, and then increase thereafter. We also found that female participants scored higher on the HGSHS: A compared with males across the various age ranges that we sampled.

Am J Clin Hypn. 2007 Apr;49(4):283-7. Page RA, Green JP. Ohio State University, 4240 Campus Drive, Lima, Ohio 45804, USA. page.6@osu.edu

The placebo is much more than a control medicine in a clinical trial. The placebo response is the largest component of any allergy treatment and consists of two components: nonspecific effects (eg, natural recovery) and a "true placebo effect" that is the psychological therapeutic effect of the treatment. Belief in the beneficial nature of the treatment is a key component of the true placebo effect, and can be enhanced by factors such as interaction with the physician and the sensory impact of the treatment. Negative beliefs can generate a nocebo effect that may explain some psychogenic illnesses; this is the basis of much research in psychoneuroimmunology. An understanding of the placebo and nocebo effects is important for general allergy practice, and harnessing the power of the true placebo effect is a major challenge to modern medicine.

Curr Allergy Asthma Rep. 2007 May;7(2):100-4. Eccles R. Common Cold Centre, Cardiff School of Biosciences, Cardiff University, Cardiff CF10 3US, UK. eccles@cardiff.ac.uk

In a multistage experiment, twelve 4- and 9-year-old children participated in a triad rating task. Their ratings were mapped with multidimensional scaling,from which euclidean distances were computed to operationalize semantic distance between items in target pairs. These children and age-mates then participated in an experiment that employed these target pairs in a story, which was followed by a misinformation manipulation. Analyses linked individual and developmental differences in suggestibility to children's representations of the target items. Semantic proximity was a strong predictor of differences in suggestibility: The closer a suggested distractor was to the original item's representation, the greater was the distractor's suggestive influence. The triad participants' semantic proximity subsequently served as the basis for correctly predicting memory performance in the larger group. Semantic proximity enabled a priori counterintuitive predictions of reverse age-related trends to be confirmed whenever the distance between representations of items in a target pair was greater for younger than for older children.

Psychol Sci. 2007 Jun;18(6):503-9. Ceci SJ, Papierno PB, Kulkofsky S. Department of Human Development, Cornell University, NY 14853, USA. sjc9@cornell.edu

While hypnosis-like phenomena have a documented history going back thousands of years, accounts of placebo effects span several centuries. With the rise of biological psychiatry and the "pharmacological revolution," drug trials have taken a central place in clinical research. These clinical trials increasingly incorporate placebo-controlled conditions as part of their paradigms and may even involve an element of deception. In contrast, the therapeutic effects of hypnosis do not require deception. As researchers begin to identify genetic and neural correlates of hypnotizability, these findings may further elucidate placebo phenomena. Whereas identifying highly hypnotizable individuals may be of limited interest, identifying good placebo responders may revolutionize both basic research and clinical science, offer insights into transcultural psychiatry and elucidate individual differences.

Am J Clin Hypn. 2007 Jul;50(1):29-36. Hypnobo: perspectives on hypnosis and placebo.Raz A. Vancouver Coastal Health Research Institute.

Many skin disorders have a significant psychosomatic component. Focused history-taking coupled with hypnoanalysis using ideomotor finger signals to detect positive responses to one or more of 7 common triggering or exacerbating factors permits systematic diagnosis of the presence or absence of a significant psychosomatic component. If no factor is positive, a psychosomatic component to the skin disorder can likely be excluded. If one or two of the 7 factors are positive and it is possible to identify the initiating event, treatment by reframing with suggestions in hypnosis may succeed in defusing the associated negative emotional impact associated with the psychosomatic component of the skin disorder. This may be sufficient to uproot and weed out the problem.

However, if a multiple of the 7 factors are positive as in the included case report, referral to an appropriate psychotherapist is recommended.

Am J Clin Hypn. 2007 Oct;50(2):131-6. Shenefelt PD. Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida 33612, USA. pshenefe@health.usf.edu

For many years Western Medicine has considered the immune system to be separate and independent from the central nervous system. However, significant scientific advances and research discoveries that occurred during the past 50 years have presented additional facts that the immune system does interact with the central nervous system with mutual influence. This article provides a systematic review of the literature on the connection between the brain and the immune system and its clinical implications. It then provides a rational foundation for the role of using hypnosis and imagery to therapeutically influence the immune system. Five case examples are provided with illustrated instructions for clinicians on how hypnosis and imagery may be utilized in the treatment of patients with auto-immune disorders. Suggestions for future research in this field are included.

Am J Clin Hypn. 2007 Oct;50(2):157-70. Torem MS. North East Ohio Universities College of Medicine, USA. mtorem@agmc.org

Neuroscience and bioinformatics research on activity-dependent gene expression and brain plasticity in memory and learning are used to reconceptualize a fundamental question of therapeutic hypnosis, "What is a suggestion?" John Kihlstrom's cognitive-behavioral perspective of implicit (unconscious) and explicit (conscious) memory and Eric Kandel's Nobel Prize winning neurobiological research are integrated for a 30-year update of Milton H. Erickson's "neuro-psycho-physiology" of therapeutic hypnosis. Implicit processing heuristics are proposed as a more general framework for Erickson's concept of permissive indirect suggestions in therapeutic hypnosis and psychotherapy. These perspectives are illustrated by utilizing implicit processing heuristics to facilitate the four-stage creative process in converting implicit to explicit memory in a brain-damaged patient.

Am J Clin Hypn. 2007 Apr;49(4):267-81. Rossi EL, Rossi KL. Ernest@ErnestRossi.com

Context: Placebo and nocebo effects, the therapeutic and adverse effects, respectively, of inert substances or sham procedures, represent serious confounds in the evaluation of therapeutic interventions. They are also an example of cognitive processes, particularly expectations, capable of influencing physiology.

Objective: To examine the contribution of 2 different neurotransmitters, the endogenous opioid and the dopaminergic (DA) systems, to the development of placebo and nocebo effects.

Design and Setting: Using a within-subject design, subjects twice underwent a 20-minute standardized pain challenge, in the absence and presence of a placebo with expected analgesic properties. Studies were conducted in a university hospital setting.

Participants: Twenty healthy men and women aged 20 to 30 years recruited by advertisement.

Main Outcome Measures: Activation of DA and opioid neurotransmission by a pain stressor with and without placebo (changes in the binding potential of carbon 11 [11C]?labeled raclopride and [11C] carfentanil with positron emission tomography) and ratings of pain, affective state, and anticipation and perception of analgesia.

Results: Placebo-induced activation of opioid neurotransmission was detected in the anterior cingulate, orbitofrontal and insular cortices, nucleus accumbens, amygdala, and periaqueductal gray matter. Dopaminergic activation was observed in the ventral basal ganglia, including the nucleus accumbens. Regional DA and opioid activity were associated with the anticipated and subjectively perceived effectiveness of the placebo and reductions in continuous pain ratings. High placebo responses were associated with greater DA and opioid activity in the nucleus accumbens. Nocebo responses were associated with a deactivation of DA and opioid release. Nucleus accumbens DA release accounted for 25% of the variance in placebo analgesic effects.

Conclusions: Placebo and nocebo effects are associated with opposite responses of DA and endogenous opioid neurotransmission in a distributed network of regions. The brain areas involved in these phenomena form part of the circuit typically implicated in reward responses and motivated behavior.

David J. Scott, BS; Christian S. Stohler, DDS, PhD; Christine M. Egnatuk, BS; Heng Wang, PhD; Robert A. Koeppe, PhD; Jon-Kar Zubieta, MD, PhD Author Affiliations: Department of Psychiatry and Molecular and Behavioral Neuroscience Institute (Mr Scott, Ms Egnatuk, and Drs Wang and Zubieta) and Department of Radiology (Drs Koeppe and Zubieta), University of Michigan, Ann Arbor; and School of Dentistry, University of Maryland, Baltimore (Dr Stohler).