Depersonalization (DP) is characterized by persistent or recurrent episodes of detachment from one's self with reduced pain perception being a common feature. Alterations in the body schema similar to the cortico-limbic disconnection syndrome of pain asymbolia are suggested to be responsible for DP. In this study we used hypnosis to induce DP in healthy subjects and to examine neural patterns of pain perception in the state of DP by means of functional magnetic resonance imaging (fMRI). Methods: Pain perception was investigated in 7 healthy subjects with high susceptibility to hypnosis in three different mental states: waking state (N-W), hypnotic relaxation (H-R) and hypnotic DP (H-DP). Pain was induced with electrical stimulation to the median nerve at the right wrist. fMRI measurements were performed during all states. Results: Nociceptive stimuli led to an activation of the well described pain network including somatosensory and insular regions and the cerebellum. Activation was markedly reduced in the contralateral somatosensory cortex, parietal cortex (Brodmann area 40, BA40), prefrontal cortex (BA9), putamen and the ipsilateral amygdala during H-DP. Subjects also reported a significant decrease in pain intensity from N-W to H-DP. Conclusion: Pain response during H-DP was reduced in sensory and affective pain-related areas, reflecting the diminished intensity of the perceived pain. Moreover, a network of cortical and subcortical areas that have been implicated in the perception of the own body was less responsive during DP, which might point to a specific neural mechanism underlying the 'out-of-body' experience. Although the small number of subjects does not allow a generalization of our findings, H-DP seems to be a promising tool for the investigation of psychological and biological mechanisms of self-inflicted injuries as well as the mind-body interplay within the realm of psychosomatic disorders.

Department of Psychosomatic Medicine and Psychotherapy, Johann Wolfgang Goethe University, Frankfurt, Germany.

Despite widespread popular use of complementary and alternative medicine (CAM) therapies, a rigorous evidence base about their efficacy for cancer-related pain is lacking. This is a systematic review of randomized controlled trials (RCTs) evaluating CAM therapies for cancer-related pain. METHODS: RCTs using CAM interventions for cancer-related pain were abstracted using Medline, EMBASE, CINAHL, AMED, and Cochrane database. RESULTS: Eighteen trials were identified (eight poor, three intermediate, and seven high quality based on Jadad score), with a total of 1,499 patients. Median sample size was 53 patients, and median intervention duration was 45 days. All studies were from single institutions, four had sample size justification, and none reported any adverse effects. Seven trials reported significant benefit for the following CAM therapies: acupuncture (n = 1), support groups (n = 2), hypnosis (n = 1), relaxation/imagery (n = 2), and herbal supplement/HESA-A (n = 1, but study was of low quality without control data). Seven studies reported immediate postintervention or short-term benefit of the following CAM interventions: acupuncture (n = 2), music (n = 1), herbal supplement/Ai-Tong-Ping (n = 1), massage (n = 1), and healing touch (n = 2). Four studies reported no benefit of CAM interventions (music, n = 2; massage, n = 2) in reducing cancer pain compared with a control arm. CONCLUSION: There is paucity of multi-institutional RCTs evaluating CAM interventions for cancer pain with adequate power, duration, and sham control. Hypnosis, imagery, support groups, acupuncture, and healing touch seem promising, particularly in the short term, but none can be recommended because of a paucity of rigorous trials. Future research should focus on methodologically strong RCTs to determine potential efficacy of these CAM interventions.

Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.

EEG neurofeedback, progressive muscle relaxation and self-hypnosis

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.

Imperial College, London W6 8RP, UK.

Alienation is the feeling that life is 'meaningless', that we do not belong in the world. But alienation is not an inevitable part of the human condition: some people do feel at one with the world as a consequence of the animistic way of thinking which is shared by children and hunter-gatherers. Animism considers all significant entities to have 'minds', to be 'alive', to be sentient agents. The animistic thinker inhabits a world populated by personal powers including not just other human beings, but also important animals and plants, and significant aspects of physical landscape. Humans belong in this world because it is a web of social relationships. Animism is therefore spontaneous, the 'natural' way of thinking for humans: all humans began as animistic children and for most of human evolutionary history would have grown into animistic adults. It requires sustained, prolonged and pervasive formal education to 'overwrite' animistic thinking with the rationalistic objectivity typical of the modern world. It is this learned abstraction that creates alienation - humans are no longer embedded in a world of social relations but become estranged, adrift in a world of indifferent things. Methods used to cure alienation and recover animistic modes of thinking involve detachment from the social systems that tend to maintain objectivity and rationality: for example, solitude, leisure, unstructured time and direct contact with nature. Many people also achieve similar results by deliberately inducing altered states of consciousness. Animistic thinking may emerge in meditation or contemplation, lucid dreaming, from self-hypnosis, when drowsy, in 'trance states' induced by repetitious rhythm or light, or when delirious due to illness, brain injury, psychoses, or intoxication with 'entheogenic' drugs - which is probably one reason for the perennial popularity of inducing intoxicated states. However, intoxication will typically damage memory processes making it harder to learn from any spiritual experiences; and even mild states of cognitive impairment may be dangerous in situations where skilled or responsible behaviour is required. Despite these constraints and limitations, recovering animism through seeking altered states of consciousness could already be considered a major world spiritual practice.

Newcastle University, NE1 7RU, UK.

Little information is available regarding the prevalence of use and interest in future use of complementary and alternative medicine (CAM) for tobacco cessation among tobacco users. We conducted a self-administered anonymous survey among 1,175 patients seen at a midwestern outpatient tobacco treatment specialty clinic between November 2003 and July 2005. Patient use of CAM for tobacco cessation, perceived efficacy of these treatments, and interest in future use of CAM were ascertained. Data were summarized using descriptive statistics, and logistic regression models were used to determine the characteristics associated with past CAM use or interest in future use of CAM for tobacco cessation. All of the patients who received the survey completed it. A total of 27% of patients reported previous use of CAM for tobacco cessation. The interventions most commonly used were hypnosis, relaxation, acupuncture, and meditation. CAM treatments most commonly perceived to be efficacious were yoga, relaxation, meditation, and massage therapy. A total of 67% of the patients reported interest in future use of CAM for tobacco cessation. The treatments of greatest interest for use in the future were hypnosis, herbal products, acupuncture, relaxation, and massage therapy. Female gender, previous use of conventional tobacco cessation products, previous use of CAM treatments, and a higher level of education were significantly associated with interest in future CAM use. The high level of interest in CAM among tobacco users underscores the need to conduct further research in this field.

Mayo Clinic College of Medicine, Rochester, MN 55905, USA. sood.amit@mayo.edu

Postural control in subjects with high (Highs) and low (Lows) susceptibility to hypnosis is differentially affected by changes in visual and neck tactile/proprioceptive input. The aim of the present experiment was to investigate whether imagery of the visual and tactile sensory modalities also induces different modulation of postural control in Highs and Lows. Fourteen Highs and 16 Lows were included in the study; they were recorded while standing upright with eyes closed during visual and tactile imagery tasks and during mental computation. Their posture and movement were recorded with an Elite System and their experience was assessed after each task in a structured interview. Visual imagery was judged "easier" than tactile imagery by Lows, while Highs performed both tasks easily and judged the tactile imagery less effortful and more vivid than Lows. No difference was observed for the mental computation. The Highs' body sway was not affected by the cognitive tasks, while Lows showed a task-related modulation of body sway. The results are in line with the hypothesis of lower vulnerability of Highs to the effects of tasks interfering with postural control and of different sensory-motor integration in Highs and Lows.

Department of Physiology, University of Siena, Siena, Italy.

The individual and combined effects of posthypnotic suggestion (PHS) and virtual reality distraction (VRD) on experimentally induced thermal pain were examined using a 2 x 2, between-groups design. After receiving baseline thermal pain, each participant received hypnosis or no hypnosis, followed by VRD or no VRD during another pain stimulus. Consistent with the hypothesis that hypnosis and VRD work via different mechanisms, results show that posthypnotic analgesia was moderated by hypnotizability but VRD analgesia was not. The impact of PHSs for analgesia was specific to high hypnotizables, whereas VRD was effective independent of hypnotizability. Results also show a nonsignificant but predicted pattern for high hypnotizables: Audio hypnosis combined with VRD reduced worst pain 22% more and pain unpleasantness 25% more than did VRD alone.

Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98104-9740, USA. davepatt@u.washington.edu

by Marilyn Gordon, BCH, CI

What Does Transformation Mean? Transformation is a process of moving from darkness into light. It's a darkness-into-light shift in consciousness that can happen at any moment. Through it you can make dynamic shifts in understanding to move pain, grief, anger, sadness, and trauma into new ways of being. Everything that has happened in life contains the seeds of dynamic transformation. Ultimately, you can move into the true essence of strength, love, healing, and positive redirection. There is emotional and physical healing as well as support for spiritual transformation. It's about first paying attention to the difficulties, experiencing how they feel or sound or what they look like, and then releasing and transforming them by making this connection with a more transcendent state of consciousness. This helps us to view our difficulties differently by shifting our level of awareness. There is truly a temple of healing that exists within. The healing process is a movement from darkness into light, from the unreal to the real, and from the deepest to the highest states of consciousness.

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As demonstrations of clinical efficacy, cases reported by Freud and Bernheim reveal an intrinsic advantage of hypnotic symptom removal over therapies requiring extended periods to achieve significant outcomes. They also lend support to Weitzenhoffer's survey of therapeutic results achieved during the classical (pre-1900) period.

orocue@earthlink.net

It is commonly believed that direct suggestibility, referring to overt influence, and indirect suggestibility, in which the intention to influence is hidden, correlate poorly. This study demonstrates that they are substantially related, provided that they tap similar areas of influence. Test results from 103 students, 55 women and 48 men, were entered into regression analyses. Indirect suggestibility, as measured by the Sensory Suggestibility Scale for Groups, and compliance, measured by the Gudjonsson Compliance Scale, were predictors of direct suggestibility, assessed with the Barber Suggestibility Scale. Spectral analyses showed that indirect suggestibility is more related to difficult tasks on the BSS, but compliance is more related to easy tasks on this scale.

Institute of Psychology, Jagiellonian University, Krakow, Poland. polczyk@apple.phils.uj.edu.pl

In an investigation of the role of cognitive effort in hypnotic responding, high and low hypnotizable participants produced emotionally neutral imagery in response to effortful versus effortless hypnotic suggestions. Heart-rate increase served as an objective index of cognitive effort, and subjective ratings of imagery vividness, absorption, effort, and control were collected. Compared to lows, high hypnotizable participants experienced their imagery as more vivid and absorbing, yet their heart rates indicated no higher level of cognitive effort than lows. Compared to effortless wording, effortful wording of suggestions increased cognitive effort in lows, as indexed by heart-rate increase, but had no effect on the effort expended by highs. Ratings of subjective control were strongly correlated with subjective effort for lows but unrelated for highs. These results support the dissociated-control theory of hypnosis rather than the dissociated-experience or social-cognitive theories.

Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada. psadler@wlu.ca

During hypnosis it is easy to induce hallucinations having, for the hypnotized subject, the characteristics and the concreteness of reality. This study was performed to put in evidence the physical effects of hypnotic suggestion of warm tub bathing. 18 volunteers screened for high hypnotizability were studied. They underwent suggestion of forearm in warm water (30 min), suggestion of body in warm water (30 min), and hypnosis without any thermal suggestion (30 min), while blood pressure, heart rate, body temperature, forearm flow and resistance, stroke volume, cardiac index and total peripheral resistance were monitored. During suggestion of forearm in warm water, local vasodilation was recorded, with decrease of forearm resistance (-18%, P<0.01) and increase of forearm blood flow (+43%, P<0.01) like in real local passive warming. During suggestion of whole-body in a warm water tub, there was a systemic vasodilation with decrease of total peripheral resistance (-29%, P<0.01) and increase of cardiac index (+54%, P<0.01), like in real total-body passive warming. Body temperature, arterial blood pressure and heart rate were unchanged. During simple hypnosis (sham procedure) no haemodynamic variations were observed. These results are in keeping with the possibility to induce through hypnotic suggestion of heat a physical pattern that is typical of hyperthermia, even without increase in body temperature.

Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani No. 2, Padova, Italy. edoardo.casiglia@unipd.

Clinical hypnosis is a technique for helping patients achieve an altered state of consciousness and is similar to guided imagery and other relaxation and focusing techniques. Clinicians can use it to help patients face powerful emotions such as those evoked during grief. This article describes the way clinical hypnosis can be used to help bereaved patients understand and gain control over their feelings.

Suggestion for hypnotic analgesia aimed at a specific body area is termed "focused hypnotic analgesia". It is not clear, however, whether this analgesia is limited to a specific body location or spread all over the body. Focused hypnotic analgesia was studied, in response to ascending electrical stimuli, when analgesia and stimulation were applied to the same area (local), and when analgesia was applied to one location and stimulation was delivered to a different area (remote). The face or leg served alternately as the local or remote areas, and the effect was tested in 12 high-hypnotizable (HH) and 13 low-hypnotizable (LH) subjects. Hypnotic analgesia in the local site produced a significant pain reduction compared to the remote site in HH subjects (P<0.0001) but not in LH subjects (P=0.68). As stimuli increased in intensity the reduction in pain as a result of hypnosis was larger both in HH and LH subjects (P<0.0001). Nevertheless, significant analgesia occurred in the 3 highest intensities in the local and remote location of HH subjects, but only in 2 highest intensities in the local and 1 in the remote of LH subjects. We conclude that in HH subjects focused hypnotic analgesia is mostly confined to the area aimed at, but some spread of analgesia to remote areas cannot be dismissed all together. Alternatively, this "spread" of analgesia could be due to a placebo effect in the remote area. Focused hypnotic analgesia requires increased attention to the body area aimed at, unlike analgesia achieved by distraction of attention.

Department of Oral Medicine, School of Dental Medicine, The Hebrew University-Hadassah, Jerusalem, Israel. sharav@cc.huji.ac.il

Alternative therapies hold potential promise for the treatment of urinary incontinence in the elderly. Assessment and comparisons of the efficacies of such therapies have been hindered by a lack of standardized definitions of urinary incontinence in the study populations, lack of standardization of treatment protocols, inadequate sample sizes, and lack of blinding and appropriate controls. Biofeedback has been the most extensively studied therapy and may provide appropriate adjunctive or primary therapy for select individuals. Other potential therapies, such as acupuncture, hypnosis, and herbal therapies, have not been sufficiently examined to make definitive recommendations.

Division of Geriatrics and Gerontology, Leonard M. Miller School of Medicine, University of Miami and the Miami VA Health Care System. Correspondence address: Room 1D200, Miami VA Medical Center, 1201 NW 16 St, Miami, FL 33125 Email: evan.cherniack@med.va.gov.

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.

School of Psychology, University of New South Wales, NSW 2052, Sydney, Australia. r.bryant@unsw.edu.au

Complementary and alternative medicine (CAM) use among cancer patients varies according to geographical area, gender, and disease diagnosis. The prevalence of CAM use among cancer patients in the United States has been estimated to be between 7% and 54%. Most cancer patients use CAM with the hope of boosting the immune system, relieving pain, and controlling side effects related to disease or treatment. Only a minority of patients include CAM in the treatment plan with curative intent. This review article focuses on practices belonging to the CAM domains of mind-body medicine, CAM botanicals, manipulative practices, and energy medicine, because they are widely used as complementary approaches to palliative cancer care and cancer symptom management. In the area of cancer symptom management, auricular acupuncture, therapeutic touch, and hypnosis may help to manage cancer pain. Music therapy, massage, and hypnosis may have an effect on anxiety, and both acupuncture and massage may have a therapeutic role in cancer fatigue. Acupuncture and selected botanicals may reduce chemotherapy-induced nausea and emesis, and hypnosis and guided imagery may be beneficial in anticipatory nausea and vomiting. Transcendental meditation and the mindfulness-based stress reduction can play a role in the management of depressed mood and anxiety. Black cohosh and phytoestrogen-rich foods may reduce vasomotor symptoms in postmenopausal women. Most CAM approaches to the treatment of cancer are safe when used by a CAM practitioner experienced in the treatment of cancer patients. The potential for many commonly used botanical to interact with prescription drugs continues to be a concern. Botanicals should be used with caution by cancer patients and only under the guidance of an oncologist knowledgeable in their use.

National Center for Complementary and Alternative Medicine, National Institutes of Health, DHHS, Bethesda, Maryland 20892, USA. manskyp@mail.nih.gov

Surgeons have conducted placebo-controlled double-blind investigations to determine the value of surgical procedures by comparing the results of real operations with sham operations. The sham operation served as a placebo control, permitting analysis of the alleged benefit of the real operation by eliminating the effect caused by the rest of the surgical experience. A modern operation starts with a series of events resembling ritualistic practices used by shamans. Shamans are traditional healers in cultures that believe communication with the gods and spirits influences health and well being. Shamanistic healing measures include: journeying to a healing place, fasting, wearing ritual garb, ingesting psychotrophic substances, anointment with purifying liquid, an encounter with a masked healer, and inhaling stupefactive vapors. These steps are followed by a central ritual activity that may include extracorporeal, surface, and penetrative components. Postoperative ritual activities reinforce the suggestive value of the healing. These experiences increase a patient's suggestibility, thereby enhancing the likelihood of a favorable outcome. Any research on the effectiveness of surgical procedures, especially those designed to relieve pain, must consider the strongly suggestive effect of the elaborate perioperative ritual.

Department of Orthopaedic Surgery, School of Medicine, University of California-Irvine, UCI Medical Center, 101 The City Drive, Orange, CA 92868, USA. sgreen@uci

In this "Reply" paper, the arguments and experimental findings by Pockett, Pollen, and Haggard et al. are analyzed. It had been shown () that a 0.5s duration of repetitive activations of sensory cortex is required to produce a threshold of sensation. The view that this is due to a facilitatory buildup in excitatory state to finally elicit neuronal firing is shown to be incompatible with several lines of evidence. Objections to the phenomenon of subjective referral backwards in time (for the delayed sensation) are also untenable. report that a self-initiated act can, under hypnotic suggestion, appear to the subject to be "involuntary." The act under hypnosis is better viewed as one initiated unconsciously, not as an act of conscious will.

Center for Neuroscience, University of California, Davis, 95616, USA.

Chronic abdominal pain is a common feature of most functional gastrointestinal disorders in children, including functional abdominal pain (FAP) and irritable bowel syndrome (IBS). FAP can impair a child's life and often leads to significant school absences. Although the underlying mechanism is likely multifactorial, early pain experiences during a vulnerable period in the developing nervous system can cause long-term changes in the brain-gut axis and ultimately may result in altered pain pathways and visceral hyperalgesia. Care providers often feel uncomfortable managing patients with chronic abdominal pain, as the pathophysiology is poorly understood, and limited data exist regarding safety and efficacy of therapeutic options in children. The primary goal of therapy in FAP is to alleviate pain symptoms and to help the child return to normal daily activities. Treatment should be individualized and chosen based on the severity of symptoms, the existence of comorbid psychological disorders, and the impact the disorder has on the child's school attendance and normal functioning. Various psychological interventions, such as cognitive-behavioral therapy, hypnosis, and guided imagery, have been successfully used in children with chronic abdominal pain. Pharmacologic therapies such as H(2) blockers, proton-pump inhibitors, tricyclic antidepressants, and various serotonergic drugs have been used, but good controlled trials are lacking. More studies are clearly needed to investigate the benefits and safety of pharmacologic therapy in children. Newer pharmacologic agents that target specific receptors involved in nociception, stress, and neurogenic inflammation currently are being developed. Future targets for visceral hyperalgesia should not only be aimed at alleviating symptoms but also should include prevention, particularly in cases with a suspected sensitizing event such as neonatal pain and postinfectious IBS.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. amiranda@mail.mcw.edu.

The main aims of this experimental study are: (1) to compare the relative effects of analgesia suggestions and relaxation suggestions on clinical pain, and (2) to compare the relative effect of relaxation suggestions when they are presented as "hypnosis" and as "relaxation training". Forty-five patients with fibromyalgia were randomly assigned to one of the following experimental conditions: (a) hypnosis with relaxation suggestions; (b) hypnosis with analgesia suggestions; (c) relaxation. Before and after the experimental session, the pain intensity was measured using a visual analogue scale (VAS) and the sensory and affective dimensions were measured with the McGill Pain Questionnaire. The results showed: (1) that hypnosis followed by analgesia suggestions has a greater effect on the intensity of pain and on the sensory dimension of pain than hypnosis followed by relaxation suggestions; (2) that the effect of hypnosis followed by relaxation suggestions is not greater than relaxation. We discuss the implications of the study on our understanding of the importance of suggestions used in hypnosis and of the differences and similarities between hypnotic relaxation and relaxation training.

Pain Clinic and UFISS Palliative Care. Hospital Universitari de Tarragona Joan XXIII and Gestio i Prestacio de Serveis de Salut, C/Doctor Mallafre Guasch 4, 43007 Tarragona, Spain.

A conceptual replication of the link between self-reported dissociative alterations in body-image under experimental conditions and the reporting of prior out-of-body experiences in a recent data set was undertaken. Also examined was whether this relationship would hold for experiences reported during the experimental context and whether it is independent of self-reported New Age belief. Data from mostly undergraduates (N= 40; M age = 33.5, SD = 12.5; 27 women) in a mirror-gazing study were retrospectively analyzed. The 9 individuals who reported prior out-of-body experiences, relative to those 31 who did not, exhibited significantly greater self-reported dissociative alterations in body-image during the mirror-gazing task, even when the influence of scores on New Age belief was controlled for statistically. The same differential relationship was not found between 6 individuals who did and 34 who did not report out-of-body experiences during the task.

Division of Psychiatry, Boston University School of Medicine, 85 East Newton St., Suite M918E, Boston, MA 02118, USA. devin.terhune@gmail.com

In addition to exacerbating morbidity in male coronary artery bypass surgery (CABS) patients, their plight can also impose considerable strain on their female spouses' mood states, resulting in compromised quality of life. The current study was aimed at determining the impact of pre postoperative hypnotherapeutic ego strengthening (HES) on anxiety and depression in female spouses. It was conducted simultaneously with a recently published study of their CABS husbands' response to HES. Spouses whose husbands had been randomly assigned to an experimental group, were designated the experimental spouse group (n = 25) and spouses whose husbands constituted the control group, likewise comprised the control spouse group (n = 25). Assessment occurred preoperatively, on the day of discharge and at six week follow-up. Spouses in the experimental group (n = 25) were introduced to hypnotherapeutic ego strengthening (HES), pre and postoperatively. In the postoperative assessment experimental female spouses showed significantly reduced morbidity levels, which were maintained at follow-up. In contrast, females in the control group (n = 25) showed no change. The results supported the value of brief hypnotherapy as a means of psychologically empowering spouses whose husbands' were undergoing CABS.

Unitas Hospital, Pretoria, Sinoville. itsoft@mweb.co.za

Little Progress Seen Since 1999 IOM Report on Medical Errors

Patient Safety Incidents In Hospitals Account for $6 Billion per Year in Extra Costs

Lakewood, Colo. (July 27, 2004) – An average of 195,000 people in the U.S. died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a new study of 37 million patient records that was released today by HealthGrades, the healthcare quality company.

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by Katherine Zimmerman CHT

Darcy, an attractive woman in her mid-30s, came to me to overcome her fear of public speaking, specifically in her French class. She reported that even though she knew the proper words her mind would go blank, she would cry, feel flustered, and her face became red.

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Special Conference Recognition to Be Awarded

by Daniel F. Cleary

As most readers are already aware, the leadership of IACT has transferred to Robert and Linda Otto. As the new directors, Robert and Linda feel that, the members and their vision for the future, is paramount. "We are looking to completely involve our members in creating the future of the organization and have decided to honor our Lifetime Members in a special way at the awards banquet this year" says Linda Otto, the new Executive Director.

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Italian researchers at the Dept. of Obstetrics and Gynecology at The University of Torino reviewed the literature to see how migraine headaches are treated during pregnancy, when hormones exacerbate the condition, while many standard drugs are contra-indicated.

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by Bryan M. Knight. MSW, PhD.

Hypnosis, self-hypnosis and hypnotherapy can heal you from the harm inflicted on you by a woman when you were a child.

You Can Heal The Rage

Anyone can become enraged once in a while. But if you feel rage boiling within almost constantly, or rage erupts from you frequently, you may have an organic illness.

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by Anne Spencer Ph.D.

The term metaphysics as used by philosophers is generally defined as the branch of philosophy that is concerned with investigating the reality that lies beyond the physical realm. The study of metaphysics is involved with asking the fundamental questions: "What is the nature of being?" "What is the nature of the universe" "What is the nature of knowledge"? This information may help us to understand that any philosophy or religion that engages in the study of a reality beyond the physical senses has its own metaphysics. For example, in a traditional theological seminary one may study the metaphysics of Aristotle. At a college or university one may learn about the metaphysics of Alfred North Whitehead. In a course of religions in America one may become familiar with the metaphysics of the Mormon faith. In all three of these examples the study of metaphysics is involved. Yet, each one understands the nature of reality in a unique and different way. It becomes clear then that all metaphysical perspectives are not necessarily the same.

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Lewis Mehl-Madrona MD at the Program in Integrative Medicine of the University of Arizona in Tucson, compared a combination of CAM therapies to conventional treatment for uterine fibroids. Thirty-seven menstruating women, aged 24 to 45 years, with palpable uterine fibroids were enrolled in the study. Half received weekly traditional Chinese medicine, body therapy (somatic therapy, bodywork), and guided imagery for up to 6 months. The other half, matched controls, received standard care. The women were checked for changes in fibroid size, changes in bothersome symptoms, and general level of patient satisfaction.

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by Don L. Price

Unquestionably when the word hypnosis pops-up in a conversation or in the mainstream press, nostrils flair, minds conjure up strong reactions of parlor tricks and pictures of late night scary movies where starry-eyed maidens are seduced to carry out satanic acts.

Here we are, in modern times, where we have set foot on the moon, (ops – better watch my words – there are people who still think the earth is flat) broke the sound barrier, communicate wireless with the most modern technology and still people see hypnosis has a hoax. Even the well educated are not off the hook from such lack of knowledge and ignorant responses.

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A recent meta-analysis by the Department of Women's Anaesthesia of Women's and Children's Hospital in Adelaide, South Australia looked at the effects of hypnosis for pain relief during childbirth. 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. There were no language restrictions.

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by A.L. Ward

I became a hypnotherapist more than fifty-years ago. At that time you could count the known hypnotists on your ten fingers. Today there are thousands involved in its practice. I doubt that there are very many hypnotists still living that can claim fifty-years in this business. Even among the professionals there are many different opinions about reincarnation, good and evil spirits, religion, the nature of God, and the approach to the process of hypnotherapy.

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