Hypnosis and placebo share in phenomenology. 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):49-58. Raz A., Vancouver Coastal Health Research Institute.

Gloria D. Constantas M.A. has been a certified hypnotist for over 10 years. She earned a Master's Degree in Counseling, Human Services, and Guidance in 1995, and then became certified by the National Guild of Hypnotists in 1996. She is also certified as an instructor of professional hypnotists. She has guided her clients to overcome many barriers to success, including phobias, anxiety, poor self-image, and low motivation, using hypnosis. She is the president of the Tampa Bay Chapter of NGH.

For more information, visit www.enlightenedhypnosis.com

In an elaboration on the contribution by Raz (current issue), placebo response is further reviewed in relation to psychotropic drug research. Many therapists are unaware that placebo controlled research documents that antidepressant and anxiolytic drugs on average are only mildly more effective than a placebo. Systematic biases in research design are noted that could account for the small differences. These factors, and turf and financial motivations associated with the rise of "biological psychiatry," are discussed because they impact the practice of clinical hypnosis and psychotherapy. Although placebo research is fascinating and expectancy is certainly an important factor in hypnotic response, thus far, there is little research to support the strong involvement of placebo response as part of hypnotic responsiveness.

Am J Clin Hypn. 2007 Jul;50(1):29-36.

Hammond DC., Physical Medicine & Rehabilitation, University of Utah School of Medicine, 30 No. 1900 East, Salt Lake City, UT 84132-2119, USA. D.C.Hammond@utah.edu

Dr. Raz' speculations about the relation between placebo responsivity and hypnotizability are critically examined. While there is no generally accepted theoretical definition of hypnosis, there is a general consensus that hypnotizability can be reliably measured. In contrast, there seems to be a general consensus about a theoretical definition of placebo (including placebo effect, placebo response and nocebo). There is no widely accepted measure of individual differences in placebo responsivity. Various methodological considerations about how to examine the relation between placebo responsivity and hypnotizability are identified. Studies are identified which indicate that response to treatments which utilize adjunctive hypnosis are superior to placebo treatments. The only study which examined whether placebo responsivity was correlated with hypnotizability seems to indicate that they are only slightly related at best. The possibility that there may be such thing as a "good placebo responder (GPR)" is questioned, while the known clinical value of hypnotizability assessment is reaffirmed. Future directions for empirical research on the relation between placebo responsivity and hypnotizability are identified.

Am J Clin Hypn. 2007 Jul;50(1):29-36.

Frischholz EJ., Loyola University and Rush North Shore Medical Center, USA. amjch@sbcglobal.net

Mary Elizabeth Raines is director of the Academy for Professional Hypnosis Training, as well as a Certified Hypnotherapist, Instructor & Adjunct Faculty Member with the National Guild of Hypnotists. In addition to hypnosis certification classes, she teaches Past-life Regression Counselor Certification and Guided Imagery Specialist Certification courses. She has presented seminars and workshops for the MidAmerica Hypnosis Convention, International Hypnosis Federation, American Board of Hypnotherapy and National Guild of Hypnotists, and taught self-hypnosis in the Continuing Education Dept. of the University of Wisconsin. A professional writer, she has published articles in professional hypnosis magazines and websites, and has been a contributor to three books on hypnosis.

Systemic hypnosis is often seen as equivalent to an Ericksonian approach even though they reflect different epistemologies. Second-order articulations of systems theory emphasize the self-organization and autonomy of living systems: all systemic actions are aimed at the conservation of the system's autonomy; loss of autonomy means death as a system. In human systems verbal and non-verbal language reflects the meanings central to the system's autonomy and its conservation. Previous work has shown how symptomatic behaviour can be seen as linguistic expressions of the conservation of an ambivalent autonomy (Fourie, 1996a, 2003). Such behaviour therefore implies, expresses and even recursively conserves certain meanings that in time have become entrenched in the system. In this view, psychotherapy is aimed at the co-operative deconstruction of such entrenched meanings, helping them to transform into more functional, less ambivalent, understandings and actions. It is the aim of this paper to show how hypnosis can be employed for this purpose in a way which is coherent with a systemic rather than an Ericksonian epistemology.

Am J Clin Hypn. 2007 Jul;50(1):81-4. Fourie DP. University of South Africa, Unisa. fouridp@unisa.ac.za

The purpose of this study was to determine if Reiki energy therapy, level I, was taught as a self-care practice to healthcare providers, would their caring perceptions change? Methodological triangulation technique, including a self-report caring scale and interviews, was used, demonstrating positive changes in perceptions of participants' caring behaviors.

Brathovde A.

Monmouth Medical Center, Long Branch, NJ 07740, USA. abrathovde@sbhcs.com

Holist Nurs Pract. 2006 Mar-Apr;20(2):95-101.

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.

Paediatr Anaesth. 2007 Aug;17(8):800-4.

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

Tactile touch is a complementary therapy that is rarely undertaken in intensive care units (ICUs) in Sweden. This study was a part of a larger project that examines whether tactile touch can relieve the suffering of patients in the ICU. The aim of this study was to describe nurses' lived experience of preparation before giving tactile touch in an ICU. Four assistant nurses and one registered nurse, each with diplomas in tactile touch working at three different ICUs in Sweden, participated in the study. A phenomenological approach was chosen to achieve experience-based and person-centred descriptions. Data were collected through interviews and analysed following Giorgi's method. The main finding was that before providing tactile touch, the nurses needed to add the new role as touch therapists, to their professional one. The essential aspect being the transition from nurse to touch therapist. Findings included a general structure, with four constituents; a sense of inner balance, an unconditional respect for the patients' integrity, a relationship with the patient characterised by reciprocal trust, and a supportive environment. Furthermore, the study underlines the difficulties to integrate a complementary caring act, such as tactile touch, in a highly technological environment.

Henricson M, Berglund AL, Segesten K.

University College of BorÂs, School of Health Science, Allegatan, SE-501 90 BorÂs, Sweden. maria.henricson@hb.se

Intensive Crit Care Nurs. 2006 Aug;22(4):239-45. Epub 2006 Mar 15.

CONTEXT: Many medical schools offer electives on complementary medicine, but little is known about the characteristics of students who sign up for such electives compared with those who do not. OBJECTIVE: Compare enrollees to nonenrollees in an elective course on therapeutic touch and healing touch (TTHT). DESIGN: Cross-sectional survey. SETTING: Wake Forest University School of Medicine, second-year course on medicine as a profession. SUBJECTS: Second-year medical students who returned surveys: 22 who signed up for an elective on TTHT and 58 who did not. INSTRUMENT: Anonymous surveys included questions about demographics, attitudes, practices, and the Maslach Burnout Inventory (MBI). RESULTS: Those who signed up for the elective were more likely to be women (73% for TTHT vs 33% for others, P < .01). Nearly all students thought that being centered and compassionate were very important. Students who signed up for TTHT were less likely to report feeling confident in being able to be centered when it was quiet (41% vs 64%, respectively, very confident, P < .04) and less confident in their ability to demonstrate nonverbal comforting behaviors (9% vs 43%, respectively, very confident, P = .02). Only 18% of elective vs 66% of others reported being centered during patient encounters (P < .001). The TTHT students and their classmates reported comparable levels of burnout. CONCLUSIONS: Elective students were no more likely than classmates to believe that it is very important to be centered and to extend compassion toward patients; they reported being less confident and practicing these skills less often than their classmates. Burnout was not less common among those in the elective. Electives may not be "preaching to the choir." Future studies need to determine whether training enhances confidence and skills and whether it protects against developing burnout.

Kemper KJ, Larrimore D, Dozier J, Woods C.

Department of Pediatrics, Family and Community Medicine, and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA. kkemper@wfubmc.edu

Explore (NY). 2005 Nov;1(6):453-8.

Over the past quarter century, hypnosis has been employed in a broad range of pediatric clinical settings; however, its efficacy and feasibility as a treatment approach for children and adolescents remain in question. METHOD: Published studies on the role of clinical hypnosis in the management of specific pediatric medical and psychological conditions were identified and reviewed. RESULTS: Pediatric clinical hypnosis has been employed in diverse medical settings to treat primary conditions (e.g., enuresis), as well as to address factors related to management of the condition (e.g., skills training for asthma) or its treatment (e.g., burn dressing changes). Despite great breadth to the possible applications of pediatric hypnosis and many reported successes, much of the present research comprises case histories and small, uncontrolled group studies. CONCLUSION: To date, research in pediatrics views clinical hypnosis as a promising tool with the potential to help manage a variety of conditions. However, additional research, particularly utilizing randomized, controlled methodologies and adequate sample sizes, is required.

J Child Psychol Psychiatry. 2007 Aug;48(8):744-54.

Gold JI, Kant AJ, Belmont KA, Butler LD. Keck School of Medicine, University of Southern California, Los Angeles, CA 90027-6062, USA. jgold@chla.usc.edu

Complementary and alternative medicine (CAM) has become much in vogue, and CAM practitioners have increased in tandem with this. The trend of using CAM for treating epilepsy does not differ from that in other medical conditions, with nearly one half of patients using CAM. In this article we review the major complementary and alternative medicines used for treatment of epilepsy. They include mind-body medicines such as reiki and yoga; biologic-based medicine such as herbal remedies, dietary supplements, and homeopathy; and manipulative-based medicine such as chiropractic. In the available literature, there is a sense of the merit of these therapies in epilepsy, but there is a paucity of research in these areas. Individualized therapies such as homeopathy and reiki cannot be compared with medicines in a conventional pharmaceutical model. Hence, many studies are inconclusive. In a science of double-blind, randomized controlled trials, appropriate designs and outcome measurements need to be tailored to CAM. This article explains the principles of the major CAM therapies in epilepsy, and discusses peer-reviewed literature where available. More effort needs to be put into future trials, with the assistance of qualified CAM professionals to ensure conformation to their therapeutic principles.

Ricotti V, Delanty N.

Curr Neurol Neurosci Rep. 2006 Jul;6(4):347-53.

After the diagnosis of cancer in a child is made, many families complement conventional medical care with lifestyle changes including diet, exercise, environment, and mind-body therapies. Biomechanical, bioenergetic, and other therapies are also sometimes sought. These include massage, chiropractic, acupuncture/acupressure, therapeutic touch, Reiki, homeopathy, and prayer. Some of these complementary therapies have well-established roles in cancer therapy for children, whereas others are controversial and require more research.

McLean TW, Kemper KJ.

Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. tmclean@wfubmc.edu

J Soc Integr Oncol. 2006 Fall;4(4):187-93.

Dr. Anthony F. De Marco received his B.A. & L.L.B. from Seton Hall University and Law School, and Ph.D from St. John's University. He is a member of the Board of Directors of the state-funded Council on Compulsive Gambling of New Jersey, a founding member of the Association of Professional Hypnotherapists, chief-advisor to the National Association of Certified Hypnotherapists, Advisory Board Member of the NGH, IACT & NACH, national presenter for the International Association of Counselors & Therapists, the National Guild of Hypnotists, the American Board of Hypnotherapy and the Holistic Alliance, president of the Council of Professional Hypnosis Organizations of the United States (COPHO), and a member of the C.G. Jung Foundation of New York. He is the originator of "HypnoAddictionology", a program of hypnosis treatment for addictions complimented by other methods of self-help.

For more information, visit www.hypnoacademy.com

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.

Pain. 2007 Aug 3.

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.

Biofield therapies form a subcategory of the domain of energy therapies, as defined by the National Center for Complementary and Alternative Medicine. Specific biofield therapies addressed in this article include Therapeutic Touch, Healing Touch, Polarity Therapy, Reiki, and Qigong. This article will identify core concepts in biofield therapies, review controlled trials of the use of biofield therapies with patients with cancer, describe the process of biofield therapies implementation in one cancer center, and suggest research to benefit not only patients with cancer but also family members and oncology professionals.

Pierce B. Suburban Hospital, Bethesda, MD, USA. bpierce@suburbanhospital.org

Clin J Oncol Nurs. 2007 Apr;11(2):253-8.

The purpose of this Cochrane Review was to establish the evidence base for treatment of psychogenic nonepileptic seizures. METHODS: Six hundred eight references were identified using a search strategy designed with the support of the Cochrane Review Epilepsy Group library. The search employed Medline and PsychInfo, and included hand searches of relevant journals (Seizure, Epilepsia, Epilepsy &Behavior, Epilepsy Research). RESULTS: Three studies were found that met the inclusion criteria; two used hypnosis and one used paradoxical therapy. None included detailed reports of improved seizure frequency or quality of life, although reduction in seizure frequency was mentioned. All three studies concluded that the intervention used was beneficial in the treatment of psychogenic nonepileptic seizures. CONCLUSIONS: The limited number of studies and poor methodology preclude these results from being generalizable. There is a need for well-designed clinical trials to identify the most suitable treatments for this population.

Epilepsy Behav. 2007 Aug 24;

Brooks JL, Goodfellow L, Bodde NM, Aldenkamp A, Baker GA. Department of Neuropsychology, Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK.

This report describes the successful treatment of a patient with postherpetic neuralgia using traditional pharmacology in combination with acupuncture. CASE REPORT: A 13-year-old girl developed postherpetic neuralgia following a severe attack of varicella zoster. Despite a 1-week course of intravenous acyclovir initiated at the onset of symptoms, the patient developed persistent left facial pain and constant nausea after lesions were healed. A comprehensive pain treatment regimen, consisting of a stellate ganglia block, medications, transcutaneous electrical nerve stimulation and hypnosis, was administered, but the patient did not gain any incremental pain relief. The acupuncture service was consulted to provide assistance with this patient's pain management. A combination of body and auricular acupuncture as well as related techniques, including acupressure and transcutaneous acupoint electrical stimulation, was added to the pain treatment regimen. After 10 complementary acupuncture treatments over a 2-month period, the patient's nausea disappeared. Her left facial pain continued to decline from a maximum of 10 to 0 as assessed by a visual analog scale over a period of 4 months following self-administered treatments of acupressure and transcutaneous acupoint electrical stimulation. The patient was then gradually weaned off all her medications and the complementary acupuncture treatment. She was discharged from the pediatric pain clinic after 5 months of the combined therapy. CONCLUSIONS: Acupuncture and its related techniques may be an effective adjunctive treatment for symptoms associated with postherpetic neuralgia and deserve further study.

Pain Pract. 2007 Sep;7(3):274-8.

Wang SM., Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA. shu-ming.wang@yale.edu

GOAL OF WORK: Little is known about complementary therapy services (CTs) available in Canadian palliative care settings. MATERIALS AND METHODS: An online survey was e-mailed to multiple Canadian palliative care settings to determine the types and frequency of CTs provided and allowed, who are the CT providers, funding of CT services, and barriers to the provision of CTs. MAIN RESULTS: The response rate was 54% (74/136). Eleven percent of surveyed palliative care settings provided CTs, and 45% allowed CTs to be brought in or to be used by patients. The three most commonly used CTs were music (57%), massage therapy (57%), and therapeutic touch (48%). Less than 25% of patients received CTs in the settings that provided and/or allowed these therapies. CTs were mostly provided by volunteers, and at most settings, limited or no funding was available. Barriers to the delivery of CTs included lack of funding (67%), insufficient knowledge of CTs by staff (49%), and limited knowledge on how to successfully operate a CT service (44%). For settings that did not provide or allow CTs, 44% felt it was important or very important for their patients to have access to CTs. The most common reasons not to provide or allow CTs were insufficient staff knowledge of CTs (67%) and lack of CT personnel (44%). CONCLUSIONS: Overall, these findings were similar to those reported in a US-based hospice survey after which this survey was patterned. Possible reasons for these shared findings and important directions regarding the future of CT service provision in Canadian palliative care setting are discussed.

Support Care Cancer. 2007 Jul 3; [Epub ahead of print] Related Articles, Links

Oneschuk D, Balneaves L, Verhoef M, Boon H, Demmer C, Chiu L.

Division of Palliative Medicine, Department of Oncology, University of Alberta, Edmonton Palliative Medicine Program, Grey Nuns Hospital, 1100 Youville Drive W, Edmonton, AB, T6L 5X8, Canada, doreen.oneschuk@capitalhealth.ca.

GOALS OF WORK: Therapeutic touch (TT) is a complementary and alternative medicine (CAM) treatment modeled on the ancient practice of "laying on of hands" that has been developed into a contemporary supportive care intervention. Evidence-based support for TT is emerging with increasingly more sophisticated studies; however, flaws in early research contributed to a perception that TT is poor science. Yet TT is a safe CAM treatment that is highly valued by patients and can be integrated into conventional settings. Having offered TT as a supportive care intervention within a provincial cancer agency for 20 years, we have grappled with the issues of evidence and of satisfying both patient demands and administrative needs. Our TT practice evolved in response to changing needs and our experience may be useful to those who are contemplating offering a CAM treatment within a conventional setting. OBJECTIVES: The objectives are to describe TT practice within a conventional cancer agency and to identify the important issues and success factors of this program and, secondly, to discuss TT research and our approach to the issues. MAIN RESULTS AND CONCLUSIONS: TT is a safe and beneficial intervention for cancer patients that can be integrated within a conventional setting, providing that the program evolves with changing patient and organizational needs. Lessons gleaned include (1) positioning TT within the context of research and evidence-based practice, (2) developing and adhering to standards of practice and professionalism, and (3) maintaining a nonpartisan attitude and communicating a plausible rationale.

Support Care Cancer. 2007 Jul 3 Stephen JE, Mackenzie G, Sample S, Macdonald J.

Faculty of Health Sciences, Simon Fraser University, East Academic Annex #1000, 8888 University Drive, Burnaby, British Colombia, V5A 1S6, Canada.

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.

Niger Postgrad Med J. 2007 Sep;14(3):238-41.

Amadasun FE., Department of Anaesthesiology, University of Benin Teaching Hospital, Benin City, Nigeria.

A variety of pulsed electromagnetic fields (PEMFs) have already been experimentally used, in an effort to promote wound healing. The aim of the present study was to investigate the effects of short duration PEMF on secondary healing of full thickness skin wounds in a rat model. Full thickness skin wounds, 2 by 2 cm, were surgically inflicted in two groups of male Wistar rats, 24 animals each. In the first group (experimental group - EG), the animals were placed and immobilized in a special constructed cage. Then the animals were exposed to a short duration PEMF for 20 min daily. In the second group (control group - CG), the animals were also placed and immobilized in the same cage for the same time, but not exposed to PEMF. On days 3, 6, 9, 12, 18, and 22, following the infliction of skin wounds, the size and healing progress of each wound were recorded and evaluated by means of planimetry and histological examination. According to our findings with the planimetry, there was a statistically significant acceleration of the healing rate for the first 9 days in EG, whereas a qualitative improvement of healing progress was identified by histological examination at all time points, compared to the control group.

Bioelectromagnetics. 2007 Jul;28(5):362-8.

Athanasiou A, Karkambounas S, Batistatou A, Lykoudis E, Katsaraki A, Kartsiouni T, Papalois A, Evangelou A.

Laboratory of Experimental Physiology, Ioannina University School of Medicine, Greece. tanasisa@yahoo.gr

The authors conducted two pilot studies that investigated the roles of hypnotizability, absorption (defined as the ability to maintain focused attention on a task or stimulus) and state versus trait anxiety as predictors of dental anxiety. One of the studies also examined the effectiveness of hypnosis in managing dental anxiety. METHODS: Participants in study 1 completed measures of hypnotizability and anxiety, viewed a video of a dental procedure either under hypnosis or not, and completed dental anxiety questionnaires. Participants in study 2 were told either that the video showed major dental work or a routine polishing. All subjects watched the video and then completed measures assessing their perceptions of the video and their anxiety. RESULTS: The authors found a positive relationship between hypnotizability and scores on the Dental Anxiety Scale (DAS) (F(1,290) = 3.45, P = .06), as well as an interaction between hypnotizability and hypnosis (F(1,290) = 6.55, P = .01). An analysis of covariance found a relationship between trait and dental anxiety (F(1,290) = 11.50; P = .001). A two-way analysis of variance found a main effect for hypnosis (F(1,290) = 3.20, P = .07). The authors found an effect for group on the DAS (F(1,228) = 3.67, P = .057), such that subjects in the negative-cognition group scored higher on the DAS. The authors found an interaction between absorption and cognition in perceptions of pain experienced by the patient in the video (F(1,228) = 3.70, P = .05) and in ratings of one's own pain level if in the same situation (F(1,228) = 4.38, P < .05). CONCLUSIONS: Hypnotizability or absorption, pre-existing anxiety and cognitions about dental procedures predict dental anxiety, and hypnosis may be helpful for some, but not all, patients. CLINICAL IMPLICATIONS: Characteristics such as hypnotizability, trait anxiety and negative cognitions predict which people develop dental anxiety and who will be more responsive to hypnosis. The authors provide suggestions for dentists treating anxious patients.

J Am Dent Assoc. 2007 Sep;138(9):1242-50.

Diclementi JD, Deffenbaugh J, Jackson D.

First reduced to science by Maxwell in 1865, electromagnetic technology as therapy received little interest from basic scientists or clinicians until the 1980s. It now promises applications that include mitigation of inflammation (electrochemistry) and stimulation of classes of genes following onset of illness and injury (electrogenomics). The use of electromagnetism to stop inflammation and restore tissue seems a logical phenomenology, that is, stop the inflammation, then upregulate classes of restorative gene loci to initiate healing. Studies in the fields of MRI and NMR have aided the understanding of cell response to low energy EMF inputs via electromagnetically responsive elements. Understanding protein iterations, that is, how they process information to direct energy, we can maximize technology to aid restorative intervention, a promising step forward over current paradigms of therapy.

J Cell Physiol. 2007 Sep;212(3):579-82.

Gordon GA.

Electromagnetic Research and Education Foundation (EMREF), Port Gamble, Washington.

This review article presents the evidence that the antiinflammatory actions of acupuncture are mediated via the reflexive central inhibition of the innate immune system. Both laboratory and clinical evidence have recently shown the existence of a negative feedback loop between the autonomic nervous system and the innate immunity. There is also experimental evidence that the electrical stimulation of the vagus nerve inhibits macrophage activation and the production of TNF, IL-1beta , IL-6, IL-18, and other proinflammatory cytokines. It is therefore conceivable that along with hypnosis, meditation, prayer, guided imagery, biofeedback, and the placebo effect, the systemic anti-inflammatory actions of traditional and electro-acupuncture are directly or indirectly mediated by the efferent vagus nerve activation and inflammatory macrophage deactivation. In view of this common physiological mediation, assessing the clinical efficacy of a specific acupuncture regimen using conventional double-blind placebo-controlled trials inherently lacks objectivity due to (1) the uncertainty of ancient rules for needle placement, (2) the diffuse noxious inhibitory control triggered by control-needling at irrelevant points, (3) the possibility of a dose-response relationship between stimulation and effects, and (4) the possibility of inadequate blinding using an inert sham procedure. A more objective assessment of its efficacy could perhaps consist of measuring its effects on the surrogate markers of autonomic tone and inflammation. The use of acupuncture as an adjunct therapy to conventional medical treatment for a number of chronic inflammatory and autoimmune diseases seems plausible and should be validated by confirming its cholinergicity.

Integr Cancer Ther. 2007 Sep;6(3):251-7.

Kavoussi B, Ross BE., Southern California University of Health Sciences, College of Acupuncture and Oriental Medicine, Whittier, CA. kavoussi@ucla.edu.

The nervous breakdown of a 22-year-old, young woman was caused by severe sexual abuse in childhood, which was repressed over many years. During therapy, the patient accumulated resources to start the painful integration of these old traumas. Using holistic existential therapy in accordance with the life mission theory and the holistic process theory of healing, she finally was able to confront her old traumas and heal her existence. She seemingly recovered completely (including regaining full emotional range) through holistic existential therapy, individually and in a group. The therapy took 18 months and more than 100 hours of intensive therapy. In the beginning of the therapy, the issues were her physical and mental health; in the middle of the therapy, the central issue was her purpose of life and her love life; and at the conclusion of the therapy, the issue was gender and sexuality. The strategy was to build up her strength for several months, mobilizing hidden resources and motivation for living, before the old traumas could be confronted and integrated. The therapy was based on quality of life philosophy, on the life mission theory, the theory of ego, the theory of talent, the theory of the evil side of man, the theory of human character, and the holistic process theory of healing. The clinical procedures included conversation, philosophical training, group therapeutic tools, extended use of therapeutic touch, holistic pelvic examination, and acceptance through touch was used to integrate the early traumas bound to the pelvis and scar tissue in the sexual organs. She was processed according to 10 levels of the advanced toolbox for holistic medicine and the general plan for clinical holistic psychiatry. The emotional steps she went through are well described by the scale of existential responsibility. The case story of Anna is an example of how even the most severely ill patient can recover fully with the support of holistic medical treatment, making her feel, understand, and let go of her negative beliefs and life-denying decisions.

ScientificWorldJournal. 2006 Feb 2;6:1965-76. Related Articles, Links

Ventegodt S, Clausen B, Merrick J.

The Quality of Life Research Center, Copenhagen K, Denmark. ventegodt@livskvalitet.org

Noise has already been shown to play a constructive role in neuronal processing and reliability, according to stochastic resonance (SR). Here another issue is addressed, concerning noise role in the detectability of an exogenous signal, here representing an electromagnetic (EM) field. A Hodgkin-Huxley like neuronal model describing a myelinated nerve fiber is proposed and validated, excited with a suprathreshold stimulation. EM field is introduced as an additive voltage input and its detectability in neuronal response is evaluated in terms of the output signal-to-noise ratio. Noise intensities maximizing spiking activity coherence with the exogenous EM signal are clearly shown, indicating a stochastic resonant behavior, strictly connected to the model frequency sensitivity. In this study SR exhibits a window of occurrence in the values of field frequency and intensity, which is a kind of effect long reported in bioelectromagnetic experimental studies. The spatial distribution of the modeled structure also allows to investigate possible effects on action potentials saltatory propagation, which results to be reliable and robust over the presence of an exogenous EM field and biological noise. The proposed approach can be seen as assessing biophysical bases of medical applications funded on electric and magnetic stimulation where the role of noise as a cooperative factor has recently gained growing attention.

Biol Cybern. 2006 Feb;94(2):118-27. Epub 2005 Dec 21.

Giannì M, Liberti M, Apollonio F, D'Inzeo G.

ICEmB at Department of Electronic Engineering, La Sapienza University of Rome, 00184 Rome, Italy. gianni@die.uniroma1.it

To systematically review the research evidence on the effectiveness of hypnosis for cancer chemotherapy-induced nausea and vomiting (CINV). A compre-hensive search of major biomedical databases including MEDLINE, EMBASE, ClNAHL, PsycINFO and the Cochrane Library was conducted. Specialist complementary and alternative medicine databases were searched and efforts were made to identify unpublished and ongoing research. Citations were included from the databases' inception to March 2005. Randomized controlled trials (RCTs) were appraised and meta-analysis undertaken. Clinical commentaries were obtained. Six RCTs evaluating the effectiveness of hypnosis in CINV were found. In five of these studies the participants were children. Studies report positive results including statistically significant reductions in anticipatory and CINV. Meta-analysis revealed a large effect size of hypnotic treatment when compared with treatment as usual, and the effect was at least as large as that of cognitive-behavioural therapy. Meta-analysis has demonstrated that hypnosis could be a clinically valuable intervention for anticipatory and CINV in children with cancer. Further research into the effectiveness, acceptance and feasibility of hypnosis in CINV, particularly in adults, is suggested. Future studies should assess suggestibility and provide full details of the hypnotic intervention.

Eur J Cancer Care (Engl). 2007 Sep;16(5):402-12.

Richardson J, Smith JE, McCall G, Richardson A, Pilkington K, Kirsch I., Faculty of Health and Social Work, Portland Square, University of Plymouth, Drake Circus, Plymouth, Devon, UK.

In the biomedical literature there are a number of reports that speculate about possible effects in the body due to the demodulation of electromagnetic fields. However, only few interactions in amplitude-modulated or even pulse-modulated electromagnetic waves are fundamentally plausible and have been demonstrated to occur in humans. The following observations fall into this specific category: thermal effects of amplitude- or pulse-modulated microwaves; demodulation of amplitude- or pulse-modulated electromagnetic waves in cell membranes; and demodulation of amplitude- or pulse-modulated electromagnetic fields in the electronics of implants such as cardiac pacemakers or cardioverter defibrillators. The possible consequences of these effects for the organism, their probability of occurrence in everyday life field conditions, and, consequently, the implications for limiting exposure are very different. Microwave hearing is a harmless effect which is perceived by humans only in strong fields with high peak power densities of more than 100 mW cm(-2). In normal residential or occupational environments the peak power density of even the strongest microwave sources is only around 1 mW cm(-2). Demodulation of pulse-modulated electromagnetic fields in the cell membranes decreases the stimulation threshold of nerves and muscles and can introduce numerous adverse effects ranging from perception of pain to dangerous cardiac fibrillations. The stimulation and demodulation effects are restricted to carrier frequencies up to several MHz. In experiments with 900 and 1,800 MHz packets with lengths of up to 100 ms and applied powers of up to 100 W, neither a direct stimulation of superficial nerves and muscles nor the conditioning of an electrical current stimulus could be confirmed. Pulse-modulated electromagnetic waves are demodulated in the electronic circuits of implants and can inhibit cardiac pacemakers and introduce cardiac arrest in this way. The highest sensitivity results from repetition rates of pulses below 100 Hz. The preceding two implications should be considered in the elaboration of new general guidelines limiting the exposure for healthy as well as for sick persons in the future.

Health Phys. 2007 Jun;92(6):604-8.

Silny J.

femu-Research Center for Bioelectromagnetic Interaction, University Hospital RWTH, Aachen University, 30 Pauwelsstrasse, Aachen, Germany. silny@femu.rwth-aachen.de

External gigong emitted by a quartz crystal upon application of electric current was evaluated by its biological effects, such as changes in frequency-analyzed electroencephalograms (EEG) in rabbits and spontaneous electrical activity of the rat pineal gland. Physical properties of this external gigong cannot be evaluated by currently available physical means. Three types of EEG changes were produced depending on the intensity of current applied to the crystal. These changes corresponded fairly well to the dose-dependent EEG changes after intravenous administration of 5-hydroxytryptophan. A gigong-containing medal also produced similar EEG changes depending on threshold to gigong. Human gigong similarly influenced EEG. All EEG changes disappeared after pinealectomy or after application of methysergide (10 mg/kg), a serotonin antagonist. The rate of spontaneous electrical activity of the pineal gland was depressed by reorientation of the rat to the north or to the south, by gigong emitted by a quartz crystal, or by application of a gigong-containing medal. Human gigong also depressed this electrical activity. The EEG changes produced by external gigong might be caused by increased serotonin concentration in the pineal gland, since the pineal gland is responsive to gigong as well as the earth's magnetic field, which is known to inhibit N-acetyltransferase by increasing serotonin concentration in the pineal gland. Hence, the finding that current-intensity-dependent EEG changes induced by quartz crystal-emitted gigong were analogous to dose-dependent EEG changes produced by 5-hydroxytryptophan might be attributed to increased serotonin levels by current-intensity-dependent inhibition of N-acetyltransferase by external gigong.

Acupunct Electrother Res. 1994 Jun-Sep;19(2-3):89-106.

Takeshige C, Aoki T.

Dept. of Physiology, Showa University School of Medicine, Tokyo, Japan.

Breast cancer surgery is associated with side effects, including postsurgical pain, nausea, and fatigue. We carried out a randomized clinical trial to test the hypotheses that a brief presurgery hypnosis intervention would decrease intraoperative anesthesia and analgesic use and side effects associated with breast cancer surgery and that it would be cost effective. METHODS: We randomly assigned 200 patients who were scheduled to undergo excisional breast biopsy or lumpectomy (mean age 48.5 years) to a 15-minute presurgery hypnosis session conducted by a psychologist or nondirective empathic listening (attention control). Patients were not blinded to group assignment. Intraoperative anesthesia use (i.e., of the analgesics lidocaine and fentanyl and the sedatives propofol and midazolam) was assessed. Patient-reported pain and other side effects as measured on a visual analog scale (0-100) were assessed at discharge, as was use of analgesics in the recovery room. Institutional costs and time in the operating room were assessed via chart review. RESULTS: Patients in the hypnosis group required less propofol (means = 64.01 versus 96.64 microg; difference = 32.63; 95% confidence interval [CI] = 3.95 to 61.30) and lidocaine (means = 24.23 versus 31.09 mL; difference = 6.86; 95% CI = 3.05 to 10.68) than patients in the control group. Patients in the hypnosis group also reported less pain intensity (means = 22.43 versus 47.83; difference = 25.40; 95% CI = 17.56 to 33.25), pain unpleasantness (means = 21.19 versus 39.05; difference = 17.86; 95% CI = 9.92 to 25.80), nausea (means = 6.57 versus 25.49; difference = 18.92; 95% CI = 12.98 to 24.87), fatigue (means = 29.47 versus 54.20; difference = 24.73; 95% CI = 16.64 to 32.83), discomfort (means = 23.01 versus 43.20; difference = 20.19; 95% CI = 12.36 to 28.02), and emotional upset (means = 8.67 versus 33.46; difference = 24.79; 95% CI = 18.56 to 31.03). No statistically significant differences were seen in the use of fentanyl, midazolam, or recovery room analgesics. Institutional costs for surgical breast cancer procedures were $8561 per patient at Mount Sinai School of Medicine. Patients in the hypnosis group cost the institution $772.71 less per patient than those in the control group (95% CI = 75.10 to 1469.89), mainly due to reduced surgical time. CONCLUSIONS: Hypnosis was superior to attention control regarding propofol and lidocaine use; pain, nausea, fatigue, discomfort, and emotional upset at discharge; and institutional cost. Overall, the present data support the use of hypnosis with breast cancer surgery patients.

J Natl Cancer Inst. 2007 Sep 5;99(17):1304-12.

Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH., Department of Oncological Sciences, Mount Sinai School of Medicine, Box 1130, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA. guy.montgomery@mssm.edu

Research on touch therapies is still in the early stages of development. Studies of Therapeutic Touch, Healing Touch, and Reiki are quite promising; however, at this point, they can only suggest that these healing modalities have efficacy in reducing anxiety; improving muscle relaxation; aiding in stress reduction, relaxation, and sense of well-being; promoting wound healing; and reducing pain. The multidimensional aspects of healing inherent in patient care continue to be expanded and facilitated by our understanding and application of energy therapies.

Nurs Clin North Am. 2007 Jun;42(2):243-59.

Engebretson J, Wardell DW.

Department of Target Populations, School of Nursing, University of Texas Health Science Center-Houston, 6901 Bertner Avenue, Room 764, Houston, TX 77030, USA.

OBJECTIVE: 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. 2007 Sep 10;

Nassau JH, Tien K, Fritz GK., Bradley Hasbro Children's Research Center, Rhode Island Hospital and The Walter Alpert Medical School of Brown University, Providence, RI.

Pain is one of the most feared consequences of cancer. Pain is a major symptom in 75% of hospitalized cancer patients. Poorly relieved pain contributes to the suffering of the patient and family, which may motivate them to seek additional complementary and alternative therapies. Evidence-based complementary therapies are being used for symptom control and to improve quality of life. There is recent research on several complementary therapies-acupuncture, mind-body therapies, massage, reflexology, and Reiki--that provides evidence for pain management. These therapies are not well utilized due to a lack of information on benefits, risks, and resources. There is a call for education to alert patients, families, nurses, and physicians to the benefits of evidence-based complementary therapies and to the dangers of "unproven" cancer therapies. Oncology nurses are ideally positioned to assess patients' pain, to educate patients, to determine with the patient and physician the most appropriate and safe complementary therapy for pain, to refer patients to appropriate resources, and in some cases to provide the therapy itself. This article will discuss specific complementary therapies for pain control and will arm nurses with the confidence to intervene with knowledge, referrals, and ideas for hands-on implementation.

Oncology (Williston Park). 2007 Apr;21(4 Suppl):10-22; discussion 22. Related Articles, Links

Memorial Sloan-Kettering Cancer Center, Integrative Medicine Service New York, New York, USA.

Severe forms of dissociation or conversion can lead to events clinically often described as pseudo-seizures. Borderline personality disorder is a clinical condition which is often accompanied by a high susceptibility for dissociation and dissociative states are characterized by memory disturbance and perceptual alterations. We report a case of a patient with a complete anaesthesia, paralysis and amnesia for about 1 h. Within this time period we measured a bispectrum EEG index called BIS. Deepest recorded BIS value was 47. The described pattern of short but deep BIS reductions is completely discongruent to the findings during physiological sleep, during general anaesthesia, but very similar (and even more pronounced) to those during self-hypnosis. This makes former assumptions plausible that hypnosis and severe forms of dissociation (or conversion) may share common aetiologies.

World J Biol Psychiatry. 2007 Sep 12;:1-3

Sartorius A, Schmahl C., Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.

Kinesiology is a holistic and complete methodology. Having great applications in sub-clinical situations and to get rid of stress, kinesiology has proven to be of great help in pathological cases, given its possibility to activate innate health mechanisms and through its capacity to reduce stress. kinesiology is very effective, since it is applied by means of the interested person's own muscles and at the same moment when information professionals work with is received. Besides being excellent therapy, its corrective techniques, by themselves, can improve the energetic and psychic state of a patient, thereby optimizing the resources people have in any situation.

Rev Enferm. 2005 Dec;28(12):19-22.

[Article in Spanish]

Simeón F, Monge JC.

After centuries of dualism in science it has become more evident now that our mental experiences are linked to processes in various parts of the organism. There appear to exist strict and most probably bidirectional relationships between psychic processes and the biology and chemistry of the physical sphere. To answer the question "Why hope?" it would be more reasonable to look for a better quality of life with illness emphasizing the comfort of freedom in coping with disease, and in spite of disease. Hope may serve as a catalyst for positive transformations, as an accelerating factor in healing processes, as a trigger of the specific energy of personal existence in such a way that the program of intentional optimism is carried beyond the mind as an order for extraordinary mobilization in various systems and parts of the body. Hope in this sense presents itself as a self-active element of therapy producing effects that are similar or greater to those of chemical substances introduced into the body. One should expect that the physician will fulfill the difficult obligation of causing the patient to believe in the success of therapy and in the sense of life. The front for the creation of hope should be as wide as possible, but also internally coherent. The greatest value should be attached to words of good, warm climate of meetings, an aura of unselfishness, and to physical--almost touchable --proximity.

Ann Acad Med Stetin. 2006;52(3):147-50. Related Articles, Links

Lipiec J.

Instytut Filozofii Uniwersytetu Jagiellonskiego, ul. Grodzka 52, 31-044 Kraków.

Modulating visceral sensation of the body is important to the understanding of emotion formation. Molecules that act during hypnosis and modify visceral pain perception are not known. We tested our hypothesis that hypnotic suggestion changes electrophysiological processing of visceroafferent signals in the human brain and that these conditions are in part dependent on histaminergic neurons. Twelve healthy male subjects were studied on two separate days: a day of treatment with histamine H(1) receptor antagonist (d-chlorpheniramine 100 mug kg(-1), intravenously) and another day of that with placebo (saline, the same amount) in a randomized order. We recorded cortical evoked potentials to 100 rectal electrical stimuli after neutral, hyperalgesic or analgesic hypnotic suggestions as given to modulate the visceral perception. Analgesic suggestion reduced the amplitude of the deepest positive peak of viscerosensory evoked potential. Administration of histamine H(1) antagonist diminished the attenuation of viscerosensory evoked potential by analgesic suggestion. Our results suggest that central pain modulatory system in the brain is activated by hypnotic suggestion and that brain histamine is a mediator in the hypnotic modulation of visceral sensory pathway as well as in the control of consciousness level. These findings lead us to possible new treatment for control of visceral perception.

Neurogastroenterol Motil. 2007 Oct;19(10):831-8.

Watanabe S, Hattori T, Kanazawa M, Kano M, Fukudo S. Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.