by Tim Brunson, PhD

Frequently I hear or read therapists and members of the media loosely using the terms hypnosis and guided imagery. Rarely do their comments reflect any knowledge of the definition, similarities, or differences between the two. This gives the public the impression that they are two separate concepts. This is partially true and partially false.

Hypnosis has been defined many different ways. Many authorities, such as the American Medical Association, explain that hypnosis is an altered state in which the subject is highly suggestible. Others talk about increased access to the subconscious mind, a term which I often object to as an inaccurate concept. One of the definitions that I prefer is that hypnosis is a state where a person's critical faculty is bypassed and selective thinking can occur. This was David Elman's definition. There is another definition that I like even better – one that is based upon traditional thought as well as recent innovations in mind/body health and neurology. According to this train of thought, hypnosis is the process whereby resistance to change is reduced and selective thought becomes more efficient. It seems that final definition more closely explains why the phenomenon produces results. Note that with this view an altered state may occur. However, it is not a requirement.

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Prenatal maternal stress is associated with adverse birth outcomes and may be reduced by relaxation exercises. The aim of the present study was to compare the immediate effects of two active and one passive 10-min relaxation technique on perceived and physiological indicators of relaxation. 39 healthy pregnant women recruited at the outpatient department of the University Women's Hospital Basel participated in a randomized controlled trial with an experimental repeated measure design. Participants were assigned to one of two active relaxation techniques, progressive muscle relaxation (PMR) or guided imagery (GI), or a passive relaxation control condition. Self-reported relaxation on a visual analogue scale (VAS) and state anxiety (STAI-S), endocrine parameters indicating hypothalamic-pituitary-adrenal (HPA) axis (cortisol and ACTH) and sympathetic-adrenal-medullary (SAM) system activity (norepinephrine and epinephrine), as well as cardiovascular responses (heart rate, systolic and diastolic blood pressure) were measured at four time points before and after the relaxation exercise. Between group differences showed, that compared to the PMR and control conditions, GI was significantly more effective in enhancing levels of relaxation and together with PMR, GI was associated with a significant decrease in heart rate. Within the groups, passive as well as active relaxation procedures were associated with a decline in endocrine measures except epinephrine. Taken together, these data indicate that different types of relaxation had differential effects on various psychological and biological stress systems. GI was especially effective in inducing self-reported relaxation in pregnant women while at the same time reducing cardiovascular activity.

Copyright © 2010 Elsevier Ltd. All rights reserved. Urech C, Fink NS, Hoesli I, Wilhelm FH, Bitzer J, Alder J. University Hospital Basel, Department of Obstetrics and Gynaecology, Switzerland.