Hypnosis has been shown to be efficacious in a range of clinical conditions, including the management of chronic pain. However, not all individuals are able to enter a hypnotic state, thereby limiting the clinical utility of this technique. We sought to determine whether hypnotic susceptibility could be increased using three methods thought to facilitate relaxation, with particular interest in an EEG neurofeedback protocol which elevated the theta to alpha ratio. This was compared with progressive muscle relaxation and self-hypnosis. Ten subjects with moderate levels of susceptibility (2-7/12) were randomly assigned to each condition and assessed for hypnotic susceptibility prior to and upon completion of 10 sessions of training. Hypnotic susceptibility increased post-training in all groups, providing further evidence that operant control over the theta/alpha ratio is possible, but contrary to our predictions, elevation of the theta/alpha ratio proved no more successful than the other interventions. Nonetheless, all three techniques successfully enhanced hypnotic susceptibility in over half of the participants (17/30), a similar incidence to that reported using other methods. As previously reported, the majority who were not susceptible to modification were at the lower levels of susceptibility, and the greater increases tended to occur in the more susceptible subjects. However, here enhancement was disclosed in some at low levels, and capability was found of reaching high levels, both features not typically reported. Further research is warranted.

Brain Res Bull. 2006 Dec 11;71(1-3):83-90. Batty MJ, Bonnington S, Tang BK, Hawken MB, Gruzelier JH. Imperial College, London W6 8RP, UK.

In this EEG study we sought to examine the neuronal underpinnings of short-term plasticity as a top-down guided auditory learning process. We hypothesized, that (i) auditory imagery should elicit proper auditory evoked effects (N1/P2 complex) and a late positive component (LPC). Generally, based on recent human brain mapping studies we expected (ii) to observe the involvement of different temporal and parietal lobe areas in imagery and in perception of acoustic stimuli. Furthermore we predicted (iii) that temporal regions show an asymmetric trend due to the different specialization of the temporal lobes in processing speech and non-speech sounds. Finally we sought evidence supporting the notion that short-term training is sufficient to drive top-down activity in brain regions that are not normally recruited by sensory induced bottom up processing. Methods: 18 non-musicians partook in a 30 channels based EEG session that investigated spatio-temporal dynamics of auditory imagery of "consonant-vowel" (CV) syllables and piano triads. To control for conditioning effects, we split the volunteers in two matched groups comprising the same conditions (visual, auditory or bimodal stimulation) presented in a slightly different serial order. Furthermore the study presents electromagnetic source localization (LORETA) of perception and imagery of CV- and piano stimuli. Results: Our results imply that auditory imagery elicited similar electrophysiological effects at an early stage (N1/P2) as auditory stimulation. However, we found an additional LPC following the N1/P2 for auditory imagery only. Source estimation evinced bilateral engagement of anterior temporal cortex, which was generally stronger for imagery of music relative to imagery of speech. While we did not observe lateralized activity for the imagery of syllables we noted significantly increased rightward activation over the anterior supratemporal plane for musical imagery. Conclusion: Thus, we conclude that short-term top-down training based auditory imagery of music and speech prompts involvement of distinct neural circuits residing in the perisylvian cortex.

Restor Neurol Neurosci. 2007;25(3-4):411-31. Meyer M, Elmer S, Baumann S, Jancke L. Institute of Neuroradiology, University Hospital of Zurich, Switzerland.

There has been a growing emphasis on evaluating and improving the experience of the hospitalized patient. In 2004, the Cardiovascular Surgery team at Mayo Clinic Rochester, though achieving a high level of technical expertise and clinical outcomes, recognized that patients were not rating their overall hospital experience as highly as was expected. After a systematic evaluation of the hospital experience, tension, stress, pain, and anxiety were identified as key challenges for patients. A multidisciplinary team was created to evaluate pain management practices and explore methods for reducing pain, anxiety, and tension. An extensive review of the literature and site visits to other institutions provided the foundation for the program. The term "Healing Enhancement" was coined to identify the goals of this emerging paradigm that focused on all aspects of the patient's experience-mind, body, and spirit. Integrated therapies such as music, massage, guided imagery, and relaxation training were explored to measure their role in patient care.

Complement Ther Clin Pract. 2007 Nov;13(4):217-23. Cutshall SM, Fenske LL, Kelly RF, Phillips BR, Sundt TM, Bauer BA. Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.