Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n=82), or self-hypnotic relaxation (n=78) during their procedures. Patients' self-ratings at 1 min-intervals of pain and anxiety on 0-10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women's anxiety increased significantly in the standard group (logit slope=0.18, p<0.001), did not change in the empathy group (slope=-0.04, p=0.45), and decreased significantly in the hypnosis group (slope=-0.27, p<0.001). Pain increased significantly in all three groups (logit slopes: standard care=0.53, empathy=0.37, hypnosis=0.34; all p<0.001) though less steeply with hypnosis and empathy than standard care (p=0.024 and p=0.018, respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 min/161 dollars for standard care, 43 min/163 dollars for empathy, and 39 min/152 dollars for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management.

Lang EV, Berbaum KS, Faintuch S, Hatsiopoulou O, Halsey N, Li X, Berbaum ML, Laser E, Baum J. Beth Israel Deaconess Medical Center/Harvard Medical School, Department of Radiology, Boston, MA, USA. elang@caregroup.harvard.edu

The purpose of this article is to evaluate research regarding beneficial approaches to smoking cessation interventions during pregnancy. Research about nicotine replacement, nurse-managed counseling sessions, hypnosis, and behavioral modifications are presented. One of the most useful types of program for smoking cessation in pregnancy (as measured by cotinine-validated abstinence) described in the literature thus far has been the nurse-managed smoking cessation program, which includes a 15-minute individualized counseling session combined with a telephone contact 7-10 days after the prenatal visit. More research is needed in this important area of nursing practice.

Barron J, Petrilli F, Strath L, McCaffrey R. Jupiter Medical Center, Jupiter, FL, USA.

The relationship between hypnotizability and somatic illness was measured in 45 college students. Several weeks after completing the Waterloo-Stanford Group C Scale (WSGC), participants filled out a somatic-complaint checklist and measures of psychopathology. Results indicated a positive correlation between hypnotizability and somatic illness, and the relationship was stronger for female participants. In contrast to the quadratic model proposed by Wickramasekera, the current data demonstrated a linear relationship between hypnotizability and somatic complaint. Further analyses showed that somatic complaints were associated with hallucination and imagery items, corresponding to the perceptual-cognitive factor identified in Woody, Barnier, and McConkey's (2005) factor analysis of the Stanford Hypnotic Susceptibility Scale, Form C. The results call into question some claims that high hypnotizability is an adaptive and healthy trait.

Younger JW, Rossetti GC, Borckardt JJ, Smith AR, Tasso AF, Nash MR. Stanford University School of Medicine, Department of Anesthesea, Stanford, California 94304-1573, USA. jyounger@stanford.edu

Currently in Puerto Rico, there are no reliable and valid instruments to assess hypnotic responsiveness. The most widely utilized scales have not been scientifically translated and adapted with Puerto Ricans. In the present study, the Barber Suggestibility Scale (BSS) was translated and adapted using back-translation and decentralization. The translated BSS (the ESB) was individually administered to Puerto Rican college students (N = 85). No significant differences were found among the mean scores for the current sample on the ESB and the 1965 sample on the BSS. Both samples had similar score distributions. The internal consistency of the ESB was adequate, and there were significant correlations among scale items and total scores. The authors conclude that the ESB is an adequate instrument to measure hypnotic response within the Puerto Rican population.

Guzman-Hosta L, Martinez-Taboas A, Rodriguez-Gomez J. Brown Medical School, Providence, Rhode Island, USA. lara_guzmanhosta@mac.com

The under-treatment of postoperative pain has been recognised to delay patient recovery and discharge from hospital. Despite recognition of the importance of effective pain control, up to 70% of patients still complain of moderate to severe pain postoperatively.The mechanistic approach to pain management, based on current understanding of the peripheral and central mechanisms involved in nociceptive transmission, provides newer options for clinicians to manage pain effectively. In this article we review the rationale for a multimodal approach with combinations of analgesics from different classes and different sites of analgesic administration. The pharmacological options of commonly used analgesics, such as opioids, NSAIDs, paracetamol, tramadol and other non-opioid analgesics, and their combinations is discussed. These analgesics have been shown to provide effective pain relief and their combinations demonstrate a reduction in opioid consumption.The basis for using non-opioid analgesic adjuvants is to reduce opioid consumption and consequently alleviate opioid-related adverse effects. We review the evidence on the opioid-sparing effect of ketamine, clonidine, gabapentin and other novel analgesics in perioperative pain management. Most available data support the addition of these adjuvants to routine analgesic techniques to reduce the need for opioids and improve quality of analgesia by their synergistic effect. Local anaesthetic infiltration, epidural and other regional techniques are also used successfully to enhance perioperative analgesia after a variety of surgical procedures. The use of continuous perineural techniques that offer prolonged analgesia with local anaesthetic infusion has been extended to the care of patients beyond hospital discharge.The use of nonpharmacological options such as acupuncture, relaxation, music therapy, hypnosis and transcutaneous nerve stimulation as adjuvants to conventional analgesia should be considered and incorporated to achieve an effective and successful perioperative pain management regimen.

Pyati S, Gan TJ. Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA.

The history of the most enduring experimental design in hypnosis research is reviewed. More than 75 years of research converge to indicate that: (1) all of the phenomena produced in hypnosis by suggestion also can be produced by suggestion without the induction of hypnosis, (2) the induction of hypnosis produces a relatively small increase in responsiveness to suggestion, and (3) hypnotic and waking suggestion are highly correlated, in many cases rivalling the reliability of the suggestibility measure. The importance of these data to both clinical and experimental hypnosis is emphasized.

Kirsch I, Mazzoni G, Montgomery GH. Department of Psychology, University of Hull, Hull, HU6 7RX, United Kingdom. i.kirsch@hull.ac.uk

I believe the paper by Kirsch, Mazzoni and Montgomery (this issue) should surprise about 95% of ASCH members (maybe only 93% of SCEH members) because the three facts espoused in their paper speciously seem to be 100% true. To paraphrase from their abstract: 1) nothing that can be produced by hypnotic induction plus suggestion cannot also be produced by suggestion alone; 2) administration of a hypnotic induction does not produce a meaningful increase in response to suggestion relative to suggestion alone; and 3) responsivity to suggestions are highly correlated to responsivity on the same measure when preceded by a hypnotic induction ceremony. In order to persuade that these propositions are true, several objections to them must be addressed. However, just because one's facts are true does not mean that one's interpretation of the facts and their interrelationships are also true. The ramifications of the above facts and their interrelationships for the future of professional hypnosis (experimental, clinical and forensic) are identified and discussed.

Frischholz EJ. Rush North Shore Medical Center. amjch@sbcglobal.net

Suggestion, both within and outside of hypnosis, can influence many psychological processes, including cognition and emotion. Moreover, suggestion may account for many individual differences and promote the investigation of such mainstream fields as attention and memory. To be sure, exploring the power of suggestion will likely pave the road to a more scientific understanding of such psychological phenomena as motivation, expectation, and the placebo effect.

Raz A. Vancouver Coastal Health Research Institute, Willow Chest Centre, 100-2647 Willow St., Vancouver, BC. Amir.Raz@vch.ca

Psychotherapy with adjunctive hypnosis is known to be an effective approach for the treatment of viral warts. There is an increasing clinical and scientific literature that illustrates the successful use of psychotherapeutic treatment with and without hypnosis in the reduction or elimination of viral warts (Bloch, 1927; Chandrasena, 1982; Clawson & Swade, 1975; Dreaper, 1978; Ewin, 1992; Ewin, 1995; and Goldstein, 2005; Obermayer & Greenson, 1949; McDowell, 1949; Reid, 1989; Scott, 1960; Spanos, Stenstrom & Johnston, 1988; Spanos, Williams & Gwynn, 1990; Surman et al., 1973; Morris, 1985; Noll, 1994; Noll, 1988; O'Laughlan, 1995; Tasini & Hackett, 1977; Vollmer, 1946; Yalom, 1964). In this case study the veracious area experienced a 100% reduction in five treatment sessions spanning a total of seven weeks. In this case, psychotherapy with hypnotic treatment relied upon an emphasis on two interventions: reduction of wart area with guided imagery and suggestions for the optimization of the client's immune system functioning. Photos illustrate the client's pre-treatment, mid-treatment, and post-treatment state. Causal factors in the client's recovery cannot be easily isolated but the startling results attest to the efficacy of the overall interventions and treatment context compared to prior medical interventions.

Phoenix SL. steve@lankton.com

by John Krukowski, C.H.

History:
The subject a physically fit athletic male 47 suffered a stroke while jogging when he was 41. The resulting paralysis was loss of use of left side. After 4 years of conventional therapy and some holistic therapy he regained a limited 25% use of his left side. It appeared the limits of this therapy for him had been reached with little or no improvement for the next 2.8 years.

Prior to hypnotherapy:
Visual observations; Subject's left foot turned out 45 degrees, Subject's left knee not flexing during walking with compensating movement transferred to hip. Subject's Left arm and hand had only about 3% usage with little more than the ability to make fingers move as a group and not independently. Also the left arm held to his chest with hand in a claw shape typical of many stroke sufferers. Visual muscle spasms in left leg. Subject's physical limitations in mobility were inability to negotiate steps higher that 8 inches(20 cm) or walking more that 150 feet (50 meters) without severe muscle spasms.

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By Judith E. Pearson, Ph.D.

In 1978 Richard Bloch, co-founder of H&R Block, was diagnosed with cancer. The prognosis was that he would be dead in three months. After two years of aggressive therapy he recovered. Wanting to make a difference in the lives of others struggling with cancer, he sold his interest in H&R Block and founded The Cancer Hotline in 1980, and the Block Cancer Support Center in 1986. He sponsored a national computer database, the Physician's Data Query, with the latest research and treatment protocols for every known form of cancer. Today this database is operated by the National Cancer Institute in Bethesda, Maryland.

Richard and his wife, Annette, wrote Fighting Cancer, a book offering self-help advice. Their second book, A Guide for Cancer Supporters1, is for family and friends of those who have cancer. Both books offer inspiration and hope, encouraging cancer patients to fight to live, instead of waiting to die. These books also recommend that cancer patients supplement medical interventions with psychotherapy, guided imagery, and clinical hypnotherapy. In the 1970's the use of such therapies in the treatment of disease was almost unheard of and to suggest such an idea bordered on heresy. Three decades later, supplemental therapies such as hypnotherapy, acupuncture, therapeutic massage, nutritional counseling, and neuro-feedback are widely considered as essentials in the holistic approach to health and the treatment of disease.

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Postpartum depression is experienced by 10-15% of women who give birth (Bloch, Rolenberg, Koren, & Klein, 2006). This disorder causes maternal distress and has been significantly associated with infant and child developmental problems (Carter, Garrity-Rokous, Chazan-Cohen, Little, & Briggs-Gowan, 2001). Once believed to be contraindicated (Crasilneck & Hall, 1985), hypnosis for depressive disorders has been advocated as an effective intervention strategy (Yapko, 2001). Addressing specific symptoms and skill development has been promoted as an effectual hypnotic strategy for depression (Yapko, 2001); however, little empirical evidence of the efficacy of hypnotherapy for postpartum depression or effective hypnotic strategies exists. The present article is a report of a single case in which hypnotherapy was successfully utilized in the treatment of Postpartum Depression by attending to the specific problems presented by the client and developing client skills to resolve existing problems and prevent their recurrence.

Yexley MJ. Human Service Agency. 123 19th St. NE, Watertown, SD 57201, USA. lynyexley@msn.com

by Laurie Nadel, Ph.D.

Do you find yourself losing concentration during certain times of the day? Perhaps it comes as a sudden touch of fatigue, or a subtle mental fuzziness. All of a sudden, you feel droopy. Your eyes may tear. You can't stop yawning, your you sigh. Maybe you find yourself staring out the window, your mind faraway from the tasks at hand. If somebody speaks to you, you find yourself startled by the sound of his voice. Or you don't understand what was said the first time and ask the speaker to repeat himself.

These are signs that your body is entering an ultradian rest response. If you observe yourself carefully during the day, you will find that this pattern recurs approximately every hour and a half. Noticing this pattern can help you tap into your intuition during the times when your physiology is naturally attuned to it. During those periods when you lose concentration or get tired, the four main regulatory systems that link mind and body realign.

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Psychogenic non-epileptic seizures (NES) have the outward appearance of epilepsy in the absence of physiological or electroencephalographic correlates. Non-epileptic seizures can occur in isolation or in combination with epileptic seizures. The development and maintenance of non-epileptic seizures has been well documented and there is a growing literature on the treatment of NES which includes non-psychological (including anti-anxiety and antidepressant pharmacological treatment) and psychological therapies (including cognitive behavioural therapy (CBT), hypnotherapy and paradoxical therapy). Various treatment methodologies have been tried with variable success. The purpose of this Cochrane review was to establish the evidence base for the treatment of NES. To assess whether treatments for NES result in a reduction in frequency of seizures and/or improvement in quality of life, and whether any treatment is significantly more effective than others. We searched the Cochrane Epilepsy Group's Specialised Register (September 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2005), MEDLINE (1966 to July 2005), and PsycINFO (1806 to July 2005). No language restrictions were imposed. We checked the reference lists of retrieved studies for additional reports of relevant studies Randomised or quasi-randomised studies were included that assessed one or more types of psychological or non-psychological interventions for the treatment of NES. Studies of childhood NES were excluded from our review. Three review authors independently assessed the trials for inclusion and extracted data. Outcomes included reduction in seizure frequency and improvements in quality of life. Three small studies met our inclusion criteria and were of poor methodological quality. Two assessed hypnosis and the other paradoxical therapy. There were no detailed reports of improved seizure frequency or quality of life outcomes, and these trials provide no reliable evidence of a beneficial effect of these interventions. In view of the methodological limitations and the small number of studies, we have no reliable evidence to support the use of any treatment including hypnosis or paradoxical injunction therapy in the treatment of NES. Randomised studies of these and other interventions are needed.

Baker G, Brooks J, Goodfellow L, Bodde N, Aldenkamp A.

Four- to 7-year-olds' ability to answer repeated questions about body touch either honestly or dishonestly was examined. Children experienced a play event, during which one third of the children were touched innocuously. Two weeks later, they returned for a memory interview. Some children who had not been touched were instructed to lie during the interview and say that they had been touched. Children so instructed were consistent in maintaining the lie but performed poorly when answering repeated questions unrelated to the lie. Children who were not touched and told the truth were accurate when answering repeated questions. Of note, children who had been touched and told the truth were the most inconsistent. Results call into question the common assumption that consistency is a useful indicator of veracity in children's eyewitness accounts.

Quas JA, Davis EL, Goodman GS, Myers JE. University of California, Irvine, CA 92697-7085, USA. jquas@uci.edu

Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care. METHODS: We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future. RESULTS: Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%). There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life.

Kemper KJ, Dirkse D, Eadie D, Pennington M. Department of Pediatrics, Wake Forest University Baptist Medical Center, Winston-Salem, NC 27157, USA. kkemper@wfubmc.edu

Green, J. P. (2004). The five factor model of personality and hypnotizability: Little variance in common. Contemporary Hypnosis, 21(4), 161-168. In 285 undergraduates, this study compared the NEO-PI-R and the Harvard Group Scale of Hypnotic Susceptibility (HGSHS). Gender and personality test scores were accounted for by approximately 8% (6% adjusted) of the variance in hypnotizability scores. The scores on individual facets on the NEO-PI-R accounted for about 21% (12% adjusted) of the variance on the HGSHS:A. These results are consistent with previous studies that attempted to correlate hypnotizability with a measure of the five factor model of personality.

Address for reprints: Joseph P. Green, Ph.D., Psychology Department, Ohio State University, Lima, OH 45804, USA. E-mail: green.301@osu.edu

Hammond, D. C. (2005). EEG patterns and hypnotizability. Biofeedback, 33(1), 35-37. Provides a brief review of the relationship of hypnotizability and EEG activity, followed by a discussion of how modifying EEG activity with neurofeedback may have potential to increase hypnotic responsiveness, for example, in working with pain patients. This is followed by a brief summary of the relationship of hypnotizability to clinical symptoms.

Address for reprints: D. Corydon Hammond, Ph.D., University of Utah School of Medicine, PM&R, 30 No. 1900 East, Salt Lake City, UT 84132-2119. E-mail: D. C. Hammond®m.cc.utah.edu

When a hypnotist appears on screen, expect evil. If his induction features 'magnetic' hand passes, he's probably about to compel someone to commit a crime. Ifhe hypnotizes with an intense stare, his intent is likelier seduction-in fact many screen inductions are identical to the eye contact ethologists have labeled "the copulatory gaze." This paper explores to role of hypnosis in more than 230 films in which it has been depicted and categorizes the--mostly negative--stereotypes about it. A handful of exceptions in which hypnosis is positive and/or realistic are examined. The discussion compares this to the role of psychotherapy and dreams in cinema. It discusses why hypnosis is so maligned and whether there is anything practitioners can do to alter the stereotype.

Harvard Medical School, USA. Deirdre_Barrett@hms.Harvard.edu

Gruzelier, J., De Pascalis, V., Jamieson, G., Laidlaw, T., Naito, A., Bennett, B., & Dwivdei, P. (2004). Relations between hypnotizability and psychopathology revisited. Contemporary Hypnosis, 21(4), 169-175. The authors were inspired to examine relations between schizotypy and hypnotizability by seeing a first episode of schizophrenia that occurred within a week of being a participant in stage hypnosis. They found positive associations with 15 items consisting of positive aspects of schizotypy with the Harvard Group Scale of Hypnotic Susceptibility. This study re-examined this finding in two further samples. The more cognitively loaded Stanford Hypnotic Susceptibility Scale, Form C, was administered to female Italian psychology students in the first study. Then the HGSHS was given to British medical students in a stress reduction study. In the first replication study, 12 correlations were found, all with positive features of schizotypy, none associated with unreality experiences, and 6 items related to psychic experiences. In the second replication study, of 13 positive associations, 7 were negative items associated to the withdrawal syndrome, and 6 items were associated with social anxiety (a nonspecific feature of schizotypy). Across the series of studies, all but one item was interpreted by the authors as being consistent with associations between hypnotizability and positive schizotypy and social anxiety. The actual items that correlated are provided in appendices. Although the items varied from study to study, and that there were sampling and scale differences, the outcome merits larger studies to investigate further the relationship between hypnotic susceptibility and psychopathology.

Address for reprints: John Gruzelier, Ph.D., Division of Neuroscience & Psychological Medicine, Imperial College London, Charing Cross Campus, St. Dunstan's Road, London W6 8RP, United Kingdom. E-mail: j.gruzelier@imperial.ac.uk

By Judith E. Pearson, Ph.D.

Scientific research shows hypnotherapy to be effective for weight reduction when used in conjunction with behavioral therapy. Studies recommend that effective hypnotherapy programs for weight control consist of at least six sessions of group or individual hypnotherapy. This article summarizes representative studies conducted between 1985 and 1998 on hypnosis for weight control. The abstracts are presented in alphabetical order, according to the last name of the lead author.

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The following brief report describes the experiences of a hand and arm amputee following the administration of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHSiA) of Shor and Orne, 1962. The participant passed two of the three motor items involving his missing limb. This report discusses the results of a postsession interview regarding our participant's experiences during hypnosis and briefly discusses phantom limb sensations in general.

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Procedures for estimating hypnotic depth have been used for more than 70 years. This study predicted self-reported hypnotic depth from the phenomenological and behavioral variables of the Phenomenology of Consciousness Inventory-Hypnotic Assessment Procedure (PCI-HAP). Participants were divided into 2 groups; 1 was used to generate regression equations, and the other group was used for cross-validation. Both imagery vividness during hypnosis (imagoic suggestibility) and the PCI pHGS measure of hypnotic depth (hypnoidal state) accounted for most of the variance in self-reported hypnotic depth. The above results, further supported by correlational and 3-D visual analyses, are consistent with other researchers' observations that ratings of hypnotic depth are a function of: (a) alterations in subjective experience, and (b) the perception of responsiveness to suggestions. The findings are also congruent with J. Holroyd's hypothesis that suggestibility and altered-state effects interact to produce hypnotic effects.

Pekala RJ, Kumar VK, Maurer R, Elliott-Carter NC, Moon E. Coatesville Veterans Administration Medical Center, Coatesville, Pennsylvania, USA. Ronald.Pekala@med.va.gov

Santarcangelo, E. L. & Sebastiani, L. (2004). Hypnotizability as an adaptive trait. Contemporary Hypnosis, 21, 3-13. This paper reviews our studies on the hypnotizability/hypnosis-related modulation of the mind-body connection during relaxation and mental stress, considered as the extremes of the wakefulness cognitiveautonomic arousal.

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A new study from the National Institute on Aging finds that guided imagery helps elderly patients to remember to take their medicine. Researchers Linda Liu, Ph.D., of the University of Michigan, and Denise Park, Ph.D., of the University of Illinois found that older adults who spent a few minutes imagining and picturing how they would test their blood sugar were 50 percent more likely to actually do these tests on a regular basis than those who used other memory techniques requiring far more conscious effort.

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This randomized, controlled clinical trial from Concord Hospital, New Hampshire, tests the effect of two mind-body-spirit nursing interventions - guided imagery and music therapy - on postoperative pain, postoperative nausea and vomiting (PONV), and length of stay, in 84 patients undergoing gynecologic laparoscopy.

During the perioperative period, patients were randomly assigned to one of 3 interventions: guided imagery audiotapes (GI), music audiotapes (MU), or standard care (C), and outcome measures were evaluated.

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Effects of a 28-day inpatient multimodal treatment concept measured by Tinnitus-Questionnaire and Health Survey SF-36.

For the first time, the therapeutic effects on subacute and chronic tinnitus of an inpatient multimodal treatment concept based on principles of Ericksonian hypnosis (EH) were examined by standardized criteria of the Tinnitus Questionnaire (TQ) and Health Survey (SF-36) within a controlled prospective, longitudinal study. A total of 393 patients were treated within an inpatient closed-group 28-day-setting based on a resource-oriented, hypnotherapeutic concept. The severity of tinnitus was assessed by TQ at times of admission, discharge and also at a 6- and 12-month follow-up. Health-related quality of life was evaluated before and after therapy using the SF-36. After therapy, a decrease in TQ score was seen in 90.5% of the patients with subacute tinnitus and in 88,3% of those with chronic tinnitus. Assessment of the TQ score at the end of therapy revealed highly significant improvements of 15.9/14.1 points in mean. Effect sizes in the treatment groups (0.94/0.80) were superior to those in the waiting-list controls (0.14/0.23). The TQ score remained stable in the follow-up controls. Significant improvement in health-related quality of life has been observed within the treatment groups depending on initial level of tinnitus serverity I-IV according to TQ. Using a multimodal treatment concept with emphasis on resource-activating approaches of EH the annoyance of tinnitus can be significantly reduced while health-related quality of life is enhanced within a comparatively short treatment period of 28 days.

Practice for Otorhinolaryngology and Psychotherapy, Luisenstrasse 6, 79098, Freiburg, Germany, Dr-Ross@web.

Hypnosis has been given many definitions over the years, and many authors have debated whether it even exists. These debates and definitions themselves are evidence of what I consider to be the most basic and profound form of hypnosis. My definition identifies the discursive thinking mind (what most of us identify with as our ordinary sense of self) as an ongoing hypnotic process. From this perspective, the ordinary conscious mind contains all the process elements of what traditionally have been called "trance phenomena." And although the conscious mind approximates reality and makes its constructs seem workable, the mind itself is never accurately in touch with reality. More and more people are now beginning to subscribe to this view, as quantum physics continues to bear out scientific evidence that the nature of reality as described by spiritual masters throughout the ages is not merely metaphor, but actual truth. In fact, this approach to hypnotherapy could as appropriately be called "quantum hypnotherapy" as well as "transpersonal hypnotherapy."

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Cortex functional connectivity associated with hypnosis was investigated in a single highly hypnotizable subject in a normal baseline condition and under neutral hypnosis during two sessions separated by a year. After the hypnotic induction, but without further suggestions as compared to the baseline condition, all studied parameters of local and remote functional connectivity were significantly changed. The significant differences between hypnosis and the baseline condition were observable (to different extent) in five studied independent frequency bands (delta, theta, alpha, beta, and gamma). The results were consistent and stable after 1 year. Based on these findings we conclude that alteration in functional connectivity of the brain may be regarded as a neuronal correlate of hypnosis (at least in very highly hypnotizable subjects) in which separate cognitive modules and subsystems may be temporarily incapable of communicating with each other normally.

BM-SCIENCE - Brain and Mind Technologies Research Centre, P.O. Box 77, FI-02601, Espoo, Finland

: Complementary and alternative medicines (CAM) use among cancer patients is becoming more prevalent; however, our understanding of factors contributing to patients' decisions to participate in CAM is limited. This study examined correlates of CAM use among colorectal cancer (CRC) survivors, an understudied population that experiences many physical and psychological difficulties. MATERIALS AND METHODS: The sample was 191, predominantly white, CRC survivors (mean age = 59.9 +/- 12.6) who were members of a colon disease registry at a NYC metropolitan hospital. Participants completed assessments of sociodemographic characteristics, psychosocial factors [e.g., psychological functioning, cancer specific distress, social support (SS), quality of life (QOL)], and past CAM use (e.g., chiropractic care, acupuncture, relaxation, hypnosis, and homeopathy). MAIN RESULTS: Seventy-five percent of participants reported using at least one type of CAM; most frequently reported was home remedies (37%). Younger (p < 0.01) or female patients (p < 0.01) were more likely to participate in CAM than their older male counterparts. Among psychosocial factors, poorer perceived SS (p = 0.00), more intrusive thoughts (p < 0.05), and poorer overall perceived QOL (p < 0.05) were associated to CAM use. In a linear regression model (including age, gender, SS, intrusive thoughts, and perceived QOL), only age remained a significant predictor of CAM use. CONCLUSION: These findings demonstrate that CAM use is prevalent among CRC survivors and should be assessed routinely by providers. CAMs may serve as a relevant adjunct to treatment among CRC patients as well as an indication of need for additional SS, especially among younger patients.

Department of Oncological Sciences, Mount Sinai School of Medicine, 1425 Madison Avenue, P.O. Box 1130, New York, NY, 10029, USA, Catalina.Lawsin@mssm.edu

This report describes an open randomized study that aims to determine whether a brief hypnotic intervention during first-trimester surgical abortion reduces requests for pain medication. METHODS: Thirty women undergoing first-trimester surgical abortion at the family planning clinics of a large hospital in Quebec City were randomized into a control group that received standard care and a hypnosis group that received, in addition to standard care, an intervention of hypnosis, including analgesia suggestions 20 min before and throughout the surgical procedure. Patients in both groups were given the option to control their pain with nitrous oxide (N(2)O) sedation administered through a nose mask as often and for as long as they wanted during the procedure. N(2)O sedation as the primary outcome was assessed at each step of the procedure. The patient's self-reported anxiety and pain were also assessed during the procedure as secondary outcomes. RESULTS: Thirty-six percent of patients in the hypnosis group requested N(2)O sedation during the procedure versus 87% in the control group (p<.01). No differences between the groups were found in reports of pain and anxiety during the procedure. CONCLUSION: These results suggest that hypnosis can be integrated into standard care and reduces the need for N(2)O in patients undergoing first-trimester surgical abortion. This reduction in N(2)O consumption did not lead to significant changes in pain or anxiety, and a larger sample size is required to assess the possible effects of hypnosis on those variables.

Chaire Lucie et Andre Chagnon pour l'avancement d'une approche integree en sante, Hopital St-Francois d'Assise, CHUQ, Universite Laval, Quebec City, PQ, Canada G1L 2G1.

The literature suggests that aspects of hypnotizability may be involved in the etiology and maintenance of self-defeating eating. However, interpretation of the published research findings has been complicated by the use of instruments that appear to have measured different or, at best, only related facets of the underlying constructs. This article reports relationships between weight, shape, dietary concerns, hypnotizability, dissociative capacity, and fantasy proneness. Implications for a key role for hypnosis in the treatment of eating behaviors, attitudes, and concerns are discussed.

Queensland University of Technology, Brisbane, Australia.

The present study investigates the effectiveness of hypnosis in reducing mild essential hypertension. Thirty participants were randomly assigned to hypnosis (standardized, individual 8-session hypnosis treatment) or to a control group (no treatment). Results show that hypnosis is effective in reducing blood pressure in the short term but also in the middle and long terms. We did not find any relationship between the practice of self-hypnosis and the evolution of blood pressure or between anxiety, personality factors, and therapeutic results. The implications of the results of the psychological treatment of hypertension are discussed.

University of Paris 10, France.

Hypnosis is a potentially valuable cognitive tool for neuroimaging studies. However, understandable concern that Magnetic Resonance Imaging (MRI) in particular may adversely affect hypnotic procedures remains. Measurements of hypnotic depth and responsiveness to suggestions were taken using a standardized procedure that met all the requirements for functional MRI (fMRI). Testing outside the scanning environment showed reliable and stable changes in subjective hypnotic depth, with no carryover once the hypnosis had been terminated. Within-subject comparisons showed that the magnitude and pattern of these changes and the degree of responsiveness to hypnotic suggestion were not discernibly affected by the fMRI environment. It is concluded that hypnosis can be employed as a discrete and reliable cognitive tool within fMRI neuroimaging settings.

University College London, UK.

Fractal analysis was applied to study the trends of EEG signals in the hypnotic condition. The subjects were 19 psychiatric outpatients. Hypnotizability was measured with the Hypnotic Induction Profile (HIP). Fifty-four sets of EEG data were analyzed by detrended fluctuation analysis (DFA), a well-established fractal analysis technique. The scaling exponents, which are the results of fractal analysis, are reduced toward white noise during the hypnotic condition, which differentiates the hypnotic condition from the waking condition. Further, the decrease in the scaling exponents during hypnosis was solely associated with the eye-roll sign within specific cortical areas (F3, C4, and O1/2) closely related to eye movements and attention. In conclusion, the present study has found that the application of the fractal analysis technique can demonstrate the electrophysiological correlations with hypnotic influence on cerebral activity.

Kwandong University College of Medicine, Myongji Hospital, Gyunggi, Korea.