Alvaro Pascual-Leone, M.D., Ph.D. is an Associate Professor in Neurology at Harvard Medical School, Director of the Laboratory for Magnetic Brain Stimulation, Attending Neurologist, and Director of Research at the Behavioral Neurology Unit at Beth Israel Deaconess Medical Center. He holds appointments as Adjunct Associate Professor in Psychiatry at Boston University, and as Associate at the Cognitive Neuroscience Section of the Faculty of Arts and Science at Harvard University. Currently, he is also the Associate Director of the General Clinical Research Center at Beth Israel Deaconess Medical Center.

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Two adolescents were hospitalized with incapacitating symptoms: one with headache, back pain, and an inability to walk, while the other had headache, musculoskeletal pain, nausea, and emesis. Medical evaluation did not reveal an etiology for the symptoms of either patient. Consultation with child psychiatry services yielded recommendations that both patients might benefit from counseling. Both demonstrated an immediate improvement of their symptoms with instruction in self-hypnosis-induced relaxation techniques that included favorite place imagery and progressive relaxation. The patients were told that while in hypnosis their "subconscious" might be able to characterize psychological issues that underlay their symptoms through the medium of automatic word processing (AWP). The information identified through AWP helped guide their subsequent therapy. Thus, instruction in self-hypnosis, as well as helping adolescents develop awareness about the cause of their debilitating symptoms can be associated with rapid improvement of their symptoms.

Am J Clin Hypn. 2008 Apr;50(4):323-34. Anbar RD. Department of Pediatrics State University of New York Upstate Medical University, Syracuse 13210, USA. anbarr@upstate.edu

A Book Review by Tim Brunson DCH

Recently I gave a two hour talk at the Louisiana Hypnotherapy Organization conference in New Orleans. Although part of the talk was about research, during the second hour I dared to venture into the mysterious arena of neuroscience and hypnosis. While there were many in the audience who seemed to be able to understand the significance of my comments, unfortunately about one out of every eight members of the audience were politely lost. Nevertheless, my contention still is that the future of hypnosis must consider the recent innovations in brain and cognitive research. I am glad to say that after my presentation I was pleasantly beset by many of my colleagues who enthusiastically wanted to know where I was going with my ideas.

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by Tim Brunson DCH

Often when speaking to groups I refer to guided imagery as "consensual hallucinations." With 70% of the brain's neurons somehow serving the visual system, one cannot help but appreciate the enormous influence of vision on our mental and physical well-being. Therapists who use any form of guided imagery are taking advantage of these facts in their efforts to re-sculpt the inner workings of the mind and brain.

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A Book Review by Tim Brunson DCH

Ever since I enjoyed the multi-phonic chants of the Tibetan monks of the Drepung Loseling monastery, I was not aware of any Westerner equally talented in vocal complexities. That was until I had the opportunity to meet and hear the remarkable Wayne Perry. As a key note speaker and workshop leader at the 2004 American Board of Hypnotherapy convention, Mr. Perry awed the audience with his unusual presentation skills and enthralled us with his unique views concerning the use of the human voice as a tool for mental and physical healing.

Wayne Perry is an unparalleled speaker, workshop leader, and healer. Having availed myself of the opportunity of having a private session with the master and as I cross paths with him usually once or twice a year, I have learned to appreciate his many skills. For those of you who have not had this opportunity, I highly recommend that your purchase and read his latest book: Sound Medicine: The Complete Guide to Healing with the Human Voice. This comprehensive how-to-manual not only explains the intriguing world of sound healing, but gives you a great autobiographical picture of the person who is the living embodiment of this innovative theory.

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This study examined potential psychosocial stressors of 30 children with headaches (mean age, 15 years), and the role of insight generation in the outcome of hypnosis therapy. The mean duration of headache occurrence was 3 years. All of the patients were instructed in how to use hypnosis-induced relaxation and headache-related imagery to improve their symptoms. Thirty-seven percent reported their headaches were associated with fixed stressors, defined as caused by events over which patients had no control, while 63% reported variable stressors, defined as modifiable by the patients' actions. Four patients were lost to follow-up. Overall, 96% (25/26) reported a decrease in headache frequency and/or intensity following use of hypnosis. However, prior to insight generation patients reporting fixed stressors were significantly less likely to improve than those reporting variable stressors (p = 0.018). Thus, insight generation may be more important for achievement of improvement in children whose headaches are associated with fixed stressors.

Am J Clin Hypn. 2008 Apr;50(4):335-41. Anbar RD, Zoughbi GG. Department of Pediatrics, University Hospital, State University of New York Upstate Medical University Syracuse, NY 13110, USA. anbarr@upstate.edu

BACKGROUND: With regard to the management of dental anxiety in general dental practice, it has been considered that general dental practitioners (GDPs) are well placed to treat adults with mild forms of dental anxiety. However, little is known about the specific anxiety management techniques being used by GDPs in the UK.Aim To determine the views and experiences of dental practitioners in their current use of anxiety management techniques, their undergraduate and post-graduation training in these techniques and future training needs. METHODS: A postal questionnaire was sent to a sample of GDPs working in the Midlands region (n = 750) in the UK. Dentists were randomly selected using lists provided by the primary care trusts for each locality. RESULTS: The response rate was 73% (n = 550). Of these, 90 were not included in the final analysis due to exclusion criteria set prior to questionnaire release. This left 460 questionnaires for analysis. Eighty-five percent of respondents agreed that dentists had a responsibility to help dentally anxious patients (n = 391). Dentists were asked their reasons for not using anxiety management techniques in practice. Psychological techniques, sedation (oral, inhalation, or intravenous) and hypnosis were reported as not having been used due to the paucity of time available in practice, a shortage of confidence in using these techniques and the lack of fees available under the NHS regulations. Also, 91% reported feeling stressed when treating anxious patients. When asked about the quality of teaching they had received (undergraduate and postgraduate), 65% considered that the teaching was less than adequate in the use of psychological methods, whereas 44% indicated that they would be interested in further training in psychological methods if financial support was available. CONCLUSION: The need for further training in managing the dentally anxious patient is supported by dentists' lack of confidence and inadequate training in treating such patients, as determined from the results of a postal questionnaire to UK GDPs.

Br Dent J. 2008 Apr 26;204(8):E13; discussion 442-3. Epub 2008 Apr 18. Hill KB, Hainsworth JM, Burke FJ, Fairbrother KJ. University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham, B4 6NN. K.B.Hill@bham.ac.uk

The purpose of this study was to determine whether hypnosis would be more effective in helping smokers quit than standard behavioral counseling when both interventions are combined with nicotine patches (NP). A total of 286 current smokers were enrolled in a randomized controlled smoking cessation trial at the San Francisco Veterans Affairs Medical Center. Participants in both treatment conditions were seen for two 60-min sessions, and received three follow-up phone calls and 2 months of NP. At 6 months, 29% of the hypnosis group reported 7-day point-prevalence abstinence compared with 23% of the behavioral counseling group (relative risk [RR] = 1.27; 95% confidence interval, CI 0.84-1.92). Based on biochemical or proxy confirmation, 26% of the participants in the hypnosis group were abstinent at 6 months compared with 18% of the behavioral group (RR = 1.44; 95% CI 0.91-2.30). At 12 months, the self-reported 7-day point-prevalence quit rate was 24% for the hypnosis group and 16% for the behavioral group (RR = 1.47; 95% CI 0.90-2.40). Based on biochemical or proxy confirmation, 20% of the participants in the hypnosis group were abstinent at 12 months compared with 14% of the behavioral group (RR = 1.40; 95% CI 0.81-2.42). Among participants with a history of depression, hypnosis yielded significantly higher validated point-prevalence quit rates at 6 and 12 months than standard treatment. It was concluded that hypnosis combined with NP compares favorably with standard behavioral counseling in generating long-term quit rates.

Nicotine Tob Res. 2008 May;10(5):811-8. Carmody TP, Duncan C, Simon JA, Solkowitz S, Huggins J, Lee S, Delucchi K. San Francisco Veterans Affairs Medical Center, University of California, San Francisco, CA.

Edward J Longo - ABH CCH RBT: This renowned Hypnotherapist has provided hypnosis and hypnotherapy services for depression, ADHD, panic attacks, and major disorders such as Alzheimer's. Amazingly, through the process of advanced hypnotherapy, empowerment becomes a most effective tool. When clients learn to incorporate the power of the subconscious mind, even their elusive, desirable dreams seem to manifest as if By MAGIC.

As an ABH Certified Hypnotherapist, Edward J Longo administers alternative methods that are designed to help subjects transform their minds.

For more information visit: www.AffinityZone.com

In management of metabolic syndrome, the traditional Chinese medicine (TCM) is an excellent representative in alternative and complementary medicines with a complete theory system and substantial herb remedies. In this article, basic principle of TCM is introduced and 25 traditional Chinese herbs are reviewed for their potential activities in the treatment of metabolic syndrome. Three herbs, ginseng, rhizoma coptidis (berberine, the major active compound) and bitter melon, were discussed in detail on their therapeutic potentials. Ginseng extracts made from root, rootlet, berry and leaf of Panax quinquefolium (American ginseng) and Panax ginseng (Asian ginseng), are proved for anti-hyperglycemia, insulin sensitization, islet protection, anti-obesity and anti-oxidation in many model systems. Energy expenditure is enhanced by ginseng through thermogenesis. Ginseng-specific saponins (ginsenosides) are considered as the major bioactive compounds for the metabolic activities of ginseng. Berberine from rhizoma coptidis is an oral hypoglycemic agent. It also has anti-obesity and anti-dyslipidemia activities. The action mechanism is related to inhibition of mitochondrial function, stimulation of glycolysis, activation of AMPK pathway, suppression of adipogenesis and induction of low-density lipoprotein (LDL) receptor expression. Bitter melon or bitter gourd (Momordica charantia) is able to reduce blood glucose and lipids in both normal and diabetic animals. It may also protect beta cells, enhance insulin sensitivity and reduce oxidative stress. Although evidence from animals and humans supports the therapeutic activities of ginseng, berberine and bitter melon, multi-center large-scale clinical trials have not been conducted to evaluate the efficacy and safety of these herbal medicines.

Endocr Metab Immune Disord Drug Targets. 2008 Jun;8(2) Yin J, Zhang H, Ye J. Pennington Biomedical Research Center, Louisana State University System, Baton Rouge, LA 70808, USA.

OBJECTIVE: To evaluate a battery of biofield awareness tasks that address bioelectromagnetic and consciousness related mechanisms of action, and examine individual differences in integrative biofield awareness (IBA). METHODS: Six (6) biofield awareness tasks were designed: 2 involved the experimenter placing his or her hands near the subject, 2 involved intense staring with associated eye movements approximately 3' from the subject, and 2 involved gentle intention with virtually no movement. Each task required a binary response from the subject. There were 10 trials per task for a total of 60 trials; blocks of 6 trials contained one of each task. Subjects were 165 undergraduate psychology students at the University of Arizona Tucson, AZ. Subjects were also assessed on their awareness of their own biofields, and they filled out various questionnaires, including estimates of how well they thought they would do and their openness to spiritual beliefs and experiences. RESULTS: Percent IBA accuracy for the entire sample (n = 165) was 57.7 +/- 10.3% and was significantly above chance (50%) performance (t = 9.58, p < 0.0000001). Each of the 6 tasks was individually significant. Subjects significantly (t = -2.72; p < 0.007) underestimated their IBA performance below chance (mean, 46.1 +/- 18.4%). However, higher estimates predicted higher IBA (r = 0.26, n = 164, p < 0.0008). Measures of subjects' self-awareness of their own biofields, as well as belief in, and experience of, extrasensory perception (ESP) also predicted higher IBA. CONCLUSIONS: The findings support claims of energy healers that biofield awareness can be modulated both bioelectromagnetically (locally) and via conscious intent (distally), and that individual differences in biofield awareness are related to self-awareness and sensitivity to others.

J Altern Complement Med. 2005 Feb;11(1) Nelson LA, Schwartz GE. Department of Psychology, University of Arizona, Tucson, AZ 85721-0068, USA.

ABSTRACT Background: Complementary and alternative medicine (CAM) use is high in people with multiple sclerosis (MS), yet there are limited reports on safety and effectiveness of CAM in MS. Naturopathic medicine encompasses a broad range of CAM modalities and may improve quality of life in patients with MS. Objective: To assess quality of life in MS subjects who received interventions designed to "model" the "whole practice" of naturopathy. Design: A pilot, randomized, controlled study with a 6-month intervention period. Participants: Participants who met criteria for clinically definite MS. Interventions: The 3 intervention arms were usual care, naturopathic medicine plus usual care, and MS education plus usual care. Outcome measures: The primary outcome measure was quality of life (36-item short form health survey [SF-36]). Secondary outcome measures included fatigue (Modified Fatigue Impact Scale); depression (Beck Depression Inventory); cognition battery (Stroop test and Paced Auditory Serial Addition Test 3), and neurologic impairment (Expanded Disability Status Scale [EDSS] and Multiple Sclerosis Functional Composite). Adverse event reporting and laboratory measures were used to assess safety. Results: Forty-five (45) participants (15 per group) were randomized and all completed the 6-month intervention. There were no significant differences between groups on any outcome measure. There was a trend in favoring the naturopathic group in the General Health subscale of the SF-36 (p = 0.11), Timed Walk (p = 0.11), and neurologic impairment (EDSS) (p = 0.07). There was a trend favoring the Education group in the Stroop attention test (p = 0.07). There was no difference between groups in adverse events or laboratory changes. Conclusions: Naturopathic medicine combined with usual care for MS showed a trend in improvement in the General Health subscale of the SF-36, Timed Walk, and neurologic impairment. Evaluation of naturopathic medicine, as a multimodality regimen, warrants further investigation.

J Altern Complement Med. 2008 Jun;14(5):489-96. Shinto L, Calabrese C, Morris C, Yadav V, Griffith D, Frank R, Oken BS, Baldauf-Wagner S, Bourdette D. Department of Neurology, Oregon Health & Science University, Portland, OR.

There is now good evidence that hypnotherapy benefits a substantial proportion of patients with irritable bowel syndrome and that improvement is maintained for many years. Most patients seen in secondary care with this condition also suffer from a wide range of noncolonic symptoms such as backache and lethargy, as well as a number of musculoskeletal, urological, and gynaecological problems. These features do not typically respond well to conventional medical treatment approaches, but fortunately, their intensity is often reduced by hypnosis. The mechanisms by which hypnosis mediates its benefit are not entirely clear, but there is evidence that, in addition to its psychological effects, it can modulate gastrointestinal physiology, alter the central processing of noxious stimuli, and even influence immune function.

J Psychosom Res. 2008 Jun;64(6):621-3. Epub 2008 Apr 28. Whorwell PJ. University of Manchester, Manchester, United Kingdom. peter.whorwell@manchseter.ac.uk

During her career as a teacher in further education Jayne William has delivered workshops and teaching sessions to all walks of life on the subject of personal development. Her topics include subjects such as business and personal planning skills, communication, time management, public speaking and positive outlook, as well as other essential subjects such as Maths, English, and Information Technology. An experienced practitioner in NLP Jayne advises her clieints on ways to enrich their lives and realize their aspirations.

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The use of complementary and alternative medicine (CAM) by cancer survivors is high, particularly among those with psychosocial distress, poor quality of life, culturally based health beliefs, and those who experience health disparities in the mainstream healthcare system. As the number of cancer survivors continues to increase, so does the diversity of the survivorship population, making it increasingly important to understand and address the CAM culture in different survivor groups. Given the known communication barriers between cancer patients and their physicians regarding CAM, it would be useful for oncology providers to have a platform from which to discuss CAM-related issues. It is proposed that mind-body therapies with some basis in evidence could provide such a platform and also serve as a possible means of connecting cancer survivors to psychosocial supportive services. This article reviews a few mind-body therapies that may have particular relevance to cancer survivors, such as hypnosis and meditation practices. A theoretical foundation by which such therapies provide benefit is presented, with particular emphasis on self-regulation.

Cancer. 2008 Jun 1;112(11 Suppl):2607-16. Monti DA, Sufian M, Peterson C. Myrna Brind Center of Integrative Medicine, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania 19107, USA. daniel.monti@jefferson.edu

The purpose of this study was to investigate the effects of two music therapy approaches, improvisation-assisted desensitization, and music-assisted progressive muscle relaxation and imagery on ameliorating the symptoms of music performance anxiety (MPA) among student pianists. Thirty female college pianists (N = 30) were randomly assigned to one of two conditions: (a) improvised music-assisted desensitization group (n = 15), or (b) music-assisted progressive muscle relaxation (PMR) and imagery group (n = 15). All participants received 6 weekly music therapy sessions according to their assigned group. Two lab performances were provided; one before and one after the 6 music therapy sessions, as the performance stimuli for MPA. All participants completed pretest and posttest measures that included four types of visual analogue scales (MPA, stress, tension, and comfort), the state portion of Spielberger's State-Trait Anxiety Inventory (STAI), and the Music Performance Anxiety Questionnaire (MPAQ) developed by Lehrer, Goldman, and Strommen (1990). Participants' finger temperatures were also measured. When results of the music-assisted PMR and imagery condition were compared from pretest to posttest, statistically significant differences occurred in 6 out of the 7 measures-MPA, tension, comfort, STAI, MPAQ, and finger temperature, indicating that the music-assisted PMR and imagery treatment was very successful in reducing MPA. For the improvisation-assisted desensitization condition, the statistically significant decreases in tension and STAI, with increases in finger temperature indicated that this approach was effective in managing MPA to some extent. When the difference scores for the two approaches were compared, there was no statistically significant difference between the two approaches for any of the seven measures. Therefore, no one treatment condition appeared more effective than the other. Although statistically significant differences were not found between the two groups, a visual analysis of mean difference scores revealed that the music-assisted PMR and imagery condition resulted in greater mean differences from pretest to posttest than the improvisation-assisted desensitization condition across all seven measures. This result may be due to the fact that all participants in the music-assisted PMR and imagery condition followed the procedure easily, while two of the 15 participants in the improvisation-assisted desensitization group had difficulty improvising.

J Music Ther. 2008 Summer;45(2) Kim Y.

This randomized pilot study investigated the effects of meditation with yoga (and psychoeducation) versus group therapy with hypnosis (and psychoeducation) versus psychoeducation alone on diagnostic status and symptom levels among 46 individuals with long-term depressive disorders. Results indicate that significantly more meditation group participants experienced a remission than did controls at 9-month follow-up. Eight hypnosis group participants also experienced a remission, but the difference from controls was not statistically significant. Three control participants, but no meditation or hypnosis participants, developed a new depressive episode during the study, though this difference did not reach statistical significance in any case. Although all groups reported some reduction in symptom levels, they did not differ significantly in that outcome. Overall, these results suggest that these two interventions show promise for treating low- to moderate-level depression. (c) 2008 Wiley Periodicals, Inc. J Clin Psychol 64(7): 1-15, 2008.

J Clin Psychol. 2008 Jul;64(7):806-20. Butler LD, Waelde LC, Hastings TA, Chen XH, Symons B, Marshall J, Kaufman A, Nagy TF, Blasey CM, Seibert EO, Spiegel D. Stanford University School of Medicine.

BACKGROUND: The frequent use of chiropractic, naturopathic, and physical and occupational therapy by patients with fibromyalgia has been emphasized repeatedly, but little is known about the attitudes of these therapists towards this challenging condition. METHODS: We administered a cross-sectional survey to 385 senior Canadian chiropractic, naturopathic, physical and occupational therapy students in their final year of studies, that inquired about attitudes towards the diagnosis and management of fibromyalgia. RESULTS: 336 students completed the survey (response rate 87%). While they disagreed about the etiology (primarily psychological 28%, physiological 23%, psychological and physiological 15%, unsure 34%), the majority (58%) reported that fibromyalgia was difficult to manage. Respondants were also conflicted in whether treatment should prioritize symptom relief (65%) or functional gains (85%), with the majority (58%) wanting to do both. The majority of respondents (57%) agreed that there was effective treatment for fibromyalgia and that they possessed the required clinical skills to manage patients (55%).Chiropractic students were most skeptical in regards to fibromyalgia as a useful diagnostic entity, and most likely to endorse a psychological etiology. In our regression model, only training in naturopathic medicine (unstandardized regression coefficient = 0.33; 95% confidence interval = 0.11 to 0.56) and the belief that effective therapies existed (unstandardized regression coefficient = 0.42; 95% confidence interval = 0.30 to 0.54) were associated with greater confidence in managing patients with fibromyalgia. CONCLUSION: The majority of senior Canadian chiropractic, naturopathic, physical and occupational therapy students, and in particular those with naturopathic training, believe that effective treatment for fibromyalgia exists and that they possess the clinical skillset to effectively manage this disorder. The majority place high priority on both symptom relief and functional gains when treating fibromyalgia.

BMC Complement Altern Med. 2008 May 31 Busse JW, Kulkarni AV, Badwall P, Guyatt GH; Medically Unexplained Syndromes Study Group. Collaborators (12) Badii M, Barsky A, Busse JW, Dufton J, Greidanus N, Guyatt GH, Krasnik C, Montori VM, Mills E, Qureshi R, Reid S, Wu P. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. j.busse@utoronto.ca

by Dennis K. Chong MD & Jennifer K. Smith Chong

Neuro-Semantic Programming, NSP, proposed that the form of the tuple depended on the manner of operation by the governances that we use to drive our thinking, speaking and our way of being in any given context. These governances are the semantic paradigms or blueprints that we use to understand ourselves, others, things, and situations. They include our Race, Family, Language, Religion, Culture, Politics Politic, Social System, Myths, Traditions and NSP designated any given context as a space/time intersection, e.g. s/t1 s/t2, s/t3, s/t4 . . . s/tn. As a result, you could have s/t1 . . . s/t1+N. Everything is language or more accurately the language structures (our red inking) of the language. Fritzof Capra: Web of Life, A New Scientific Understanding of Living Systems, Anchor Books, Doubleday, 1996, page 288.

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Heart rate and heart-rate variability (HRV) were studied through a set of different methods in high (highs) and low hypnotizable subjects (lows) not receiving any deliberate hypnotic induction in basal conditions (simple relaxation) and during nociceptive-pressor stimulation with and without suggestions of analgesia. ANOVA did not reveal any difference between highs and lows for heart rate and for the HRV indexes extracted from the series of the interbeat intervals (RR) of the ECG in the frequency (spectral analysis) and time domain (standard deviation, Poincare plot) in both basal and stimulation conditions. Factors possibly accounting for the results and likely responsible for an underestimation of group differences are discussed.

Int J Clin Exp Hypn. 2008 Jul;56(3):255-69. Santarcangelo EL, Carli G, Migliorini S, Fontani G, Varanini M, Balocchi R. University of Pisa, Italy.

Harry Cannon D.Hyp FNRAH MIMDHA MAPHP is an Advanced Hypnotherapist and Harley Street specialist, practicing in Carterton, West Oxfordshire and Harley Street, London, Initially studying hypnotherapy in 1988 Harry then went on to become certified through the UK's Hypnotherapy Control Board. He later became (by invitation only) a registered practicing member of the International Association of Hypno-Analysts. He was honoured by the association by being offered a seat on the council of management. This was in recognition of his dedication to the association and the help he constantly offers his fellow members.

www.HarryCannon.com

Alopecia areata (AA) is an autoimmune disease leading to loss of scalp hairs. The disease seems triggered by stress. Data on the possibility of using hypnotherapy in the treatment of AA are very limited. Twenty-eight patients with extensive AA, all refractory to previous conventional treatment, were treated with hypnosis at the Academic Hospital UZ Brussel, Brussels, Belgium. This paper describes in detail the authors' hypnotherapeutic approach combining symptom-oriented suggestions with suggestions to improve self-esteem. Twelve out of 21 patients, including 4 with total loss of scalp hair, presented a significant hair growth. All patients presented a significant decrease in scores for anxiety and depression. Although the exact mechanism of hypnotic interventions has not been elucidated, the authors' results demonstrate that hypnotic interventions may ameliorate the clinical outcome of patients with AA and may improve their psychological well-being.

Int J Clin Exp Hypn. 2008 Jul;56(3):318-33. Academic Hospital UZ Brussel, Brussels, Belgium. Willemsen R, Vanderlinden J.

OBJECTIVES: To explore the biofield aspect of cancer care; to identify the benefits of energetic approaches in cancer care; and to examine one approach through a case study. DATA SOURCES: Current research and national reports on biofield approaches in complementary therapies. CONCLUSION: Caring for the biofield is important in assisting the patient with cancer to enhance vitality, reduce pain, fatigue, and other side effects as a result of cancer treatments. IMPLICATIONS FOR NURSING PRACTICE: Cancer care must be holistic to provide maximal healing opportunities for patients. Consideration of the biofield is an important aspect of this care.

Semin Oncol Nurs. 2005 Aug;21(3) Hibdon SS. Student Health and Wellness Center, University of North Texas, Denton, TX, USA. Hibdon@dsa.admin.unt.edu

In many traditional schools of medicine it is claimed that a balanced modulation of several targets can provide a superior therapeutic effect and decrease in side effect profile compared to a single action from a single selective ligand, especially in the treatment of certain chronic and complex diseases, such as diabetes and obesity. Diabetes and obesity have a multi-factorial basis involving both genetic and environmental risk factors. A wide array of medicinal plants and their active constituents play a role in the prevention and treatment of diabetes. Salacia roots have been used in Ayurvedic medicine for diabetes and obesity since antiquity, and have been extensively consumed in Japan, the United States and other countries as a food supplement for the prevention of obesity and diabetes. Recent pharmacological studies have demonstrated that Salacia roots modulate multiple targets: peroxisome proliferator-activated receptor-alpha-mediated lipogenic gene transcription, angiotensin II/angiotensin II type 1 receptor, alpha-glucosidase, aldose reductase and pancreatic lipase. These multi-target actions may mainly contribute to Salacia root-induced improvement of type 2 diabetes and obesity-associated hyperglycemia, dyslipidemia and related cardiovascular complications seen in humans and rodents. The results of bioassay-guided identification indicate that mangiferin, salacinol, kotalanol and kotalagenin 16-acetate are at least in part responsible for these multi-target regulatory activities of Salacia roots. The evidence suggests that this unique traditional medicine fulfills a multiple-target strategy in the prevention and treatment of diabetes and obesity. Although toxicological studies have suggested minimal adverse effects of the herbal medicine in rodents, a clinical trial is crucial to further confirm the safety of Salacia roots. In addition, further mechanistic studies are necessary in order to allow a better understanding of how use of Salacia root may interact with other therapeutic interventions.

Life Sci. 2008 May 23;82(21-22):1045-9. Epub 2008 Mar 28. Li Y, Huang TH, Yamahara J. Faculty of Pharmacy, The University of Sydney, NSW 2006 Australia. yuhao@pharm.usyd.edu.au

For the past 20 years, the magnitude of the "placebo effect" in double-blind, medical experiments has strongly increased. This paper asks why and how. Starting with the human "psychophysiologic principle," two unconscious and one conscious biofeedback examples are given to demonstrate how malleable we humans are to our expectations and our intentions and how strong our psychoenergetic forces can be relative to conventional chemical forces. Ending with several experimental examples wherein a therapeutically processed device and an unprocessed device are critically compared, one finds strong evidence to propose that an information entanglement process is converting the unprocessed device to a functional replica of the processed device in that its therapeutic efficacy is comparable to that of the treatment device. Furthermore, arguments are provided to indicate that a practitioner's biofield is capable of expanding the range of diagnostic capability of commercial measurement instruments so that the practitioner/device hybrid system becomes a potent psychoenergetic instrument for diagnostic and treatment purposes. In between, a theoretical model is provided, based on the author's extensive experimental psychoenergetic research on long-range interconnectivity between objects, between humans and between humans and objects, to show how long-range, quantitative coupling can occur between our normal atom/molecule level of physical reality and a second, unique level of physical reality whose physics can be modulated by psychoenergetic forces. It is the material qualities of this duplex physical reality that convert a seemingly inert object/device (placebo) into a synergistically active element in double-blind placebo experiments.

J Altern Complement Med. 2006 Dec;12(10) Tiller WA. The William A. Tiller Foundation for New Science, Payson, AZ 85541-5731, USA. bill@tiller.org

Freud's early article, "Psychical (or mental) treatment," first appeared in a health textbook for educated lay people. It was included in his Gesammelte Werke with the publication date of 1905. Subsequently, this date was questioned because the text dealt mainly with hypnosis and suggestion, so James Strachey, among others, erroneously changed it to 1890. This error is corrected in the present paper. Until now, no one noticed that a second edition of the textbook, which appeared in 1918-19, contained an amended version of Freud's original article in which he added a summary of psychoanalytic theory and practice. The first edition was published in 1905-06. However, Freud's contribution must have been written at a much earlier date. Its presumed date of composition is discussed. Freud's addition to the original text is reprinted in an appendix for the first time.

Luzif Amor. 2007;20(40):122-41. Fichtner G.

Institut für Ethik und Geschichte der Medizin, Goethestr. 6, D-72076 Tübingen. gerhard.fichtner@uni-tuebingen.de

The central autonomic network (CAN) has been described in animal models but has been difficult to elucidate in humans. Potential confounds include physiological noise artifacts affecting brainstem neuroimaging data, and difficulty in deriving non-invasive continuous assessments of autonomic modulation. We have developed and implemented a new method which relates cardiac-gated fMRI timeseries with continuous-time heart rate variability (HRV) to estimate central autonomic processing. As many autonomic structures of interest are in brain regions strongly affected by cardiogenic pulsatility, we chose to cardiac-gate our fMRI acquisition to increase sensitivity. Cardiac-gating introduces T1-variability, which was corrected by transforming fMRI data to a fixed TR using a previously published method [Guimaraes, A.R., Melcher, J.R., et al., 1998. Imaging subcortical auditory activity in humans. Hum. Brain Mapp. 6(1), 33-41]. The electrocardiogram was analyzed with a novel point process adaptive-filter algorithm for computation of the high-frequency (HF) index, reflecting the time-varying dynamics of efferent cardiovagal modulation. Central command of cardiovagal outflow was inferred by using the resample HF timeseries as a regressor to the fMRI data. A grip task was used to perturb the autonomic nervous system. Our combined HRV-fMRI approach demonstrated HF correlation with fMRI activity in the hypothalamus, cerebellum, parabrachial nucleus/locus ceruleus, periaqueductal gray, amygdala, hippocampus, thalamus, and dorsomedial/dorsolateral prefrontal, posterior insular, and middle temporal cortices. While some regions consistent with central cardiovagal control in animal models gave corroborative evidence for our methodology, other mostly higher cortical or limbic-related brain regions may be unique to humans. Our approach should be optimized and applied to study the human brain correlates of autonomic modulation for various stimuli in both physiological and pathological states.

Neuroimage. 2008 Apr 30. Napadow V, Dhond R, Conti G, Makris N, Brown EN, Barbieri R. MGH/MIT/HMS Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Department of Radiology, Logan College of Chiropractic, Chesterfield, MO, USA.

Subjects with high (Highs) and low (Lows) susceptibility to hypnosis show differences in the sensory-motor integration for postural control and in the cardiovascular response to stress and experimental pain. Aim of the experiment was to assess whether the cardiac response to gravity-related stimulation depending on changes in the body position were different in the two groups. Thus, heart rate (HR) and heart rate variability (HRV) were evaluated in sitting and upright position in Highs and Lows. Position-related HRV changes were studied in the time (statistical indexes, Poincaré Plot) and frequency (spectral analysis) domain. Results indicated that upright stance was associated with similar changes in heart rate and different modulation of HRV in the two groups. The association of time and frequency domain analyses allowed hypothesizing different control mechanisms as responsible for the cardiac response to upright stance in Highs and Lows, likely due to a different role of the Very Low Frequency (VLF) spectral component of HRV in the two groups. The results are in line with previous findings indicating a natural protection of Highs against cardiovascular events and suggest that the Highs' cardiac function might be less impaired by microgravity than the Lows' one.

Brain Res Bull. 2008 Mar 28;75(5):692-7. Epub 2007 Dec 18.Related Articles, Links Santarcangelo EL, Balocchi R, Scattina E, Manzoni D, Bruschini L, Ghelarducci B, Varanini M.

Department of Human Physiology, University of Pisa, Via San Zeno 31, Pisa, Italy. enricals@dfb.unipi.it

by Edward J Longo – ABH CCH RBT

Words Can Inspire Transformation. Words portray thoughts, feelings, emotions, ideas and ever so much more. They bridge the gap between the conscious and the subconscious, and always provide infinite possibilities. Yet this Secret Weapon that is freely available to all is way too often underestimated, or misunderstood. Normally, people love to be engulfed, surrounded, and entertained by words used in stories, speaking, and tales expressed in books. That's why advertising and the media are such a booming industries. That's why people read newspapers... it's why people love reading about stories they've experienced themselves. And the more the person can become a confident story teller, the more people will become attracted to that voice, that personality, that therapist, or that entertainer.

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Functional dyspepsia (FD) is common in children, with as many as 80% of those being evaluated for chronic abdominal pain reporting symptoms of epigastric discomfort, nausea, or fullness. It is known that patients with persistent complaints have increased comorbidities such as depression and anxiety. The interaction with psychopathologic variables has been found to mediate the association between upper abdominal pain and gastric hypersensitivity. These observations suggest that abnormal central nervous system processing of gastric stimuli may be a relevant pathophysiologic mechanism in FD. Despite increased understanding, no specific therapy has emerged; however, recent nonpharmacological-based options such as hypnosis may be effective. Novel approaches, including dietary manipulation and use of nutraceuticals such as ginger and Iberogast (Medical Futures Inc., Ontario, Canada), may also be considered.

Curr Gastroenterol Rep. 2007 Dec;9(6):447-55. Perez ME, Youssef NN.

Center for Pediatric Irritable Bowel and Motility Disorders, Goryeb Children's Hospital at Atlantic Health, 100 Madison Avenue, Internal Box 82, Morristown, NJ 07962, USA.

Yvonne Herrington completed her initial hypnotherapy training with the International Association of Hypnotherapists (IAH) in 1995 and has been in practice for 12 years. Throughout that time she have helped thousands of clients overcome their difficulties and emerge as the person they were destined to be. She is a cognitive behavioural therapist (CBT).

For more information visit: www.Changes.co.uk

OBJECTIVE: The purpose of this study was to determine whether hypnotic analgesia can reduce the need for intravenous sedation analgesia without increasing pain and anxiety levels during abortion. STUDY DESIGN: A cohort of 350 women who were scheduled for surgical abortion (<14 weeks' gestation) were assigned randomly to a standard care group or a group that received a standardized hypnotic analgesia intervention 20 minutes before and throughout the surgical procedure. Primary outcome was the difference between the 2 groups: (1) the proportion who received sedation (yes/no) during the surgical procedure and (2) self-assessments of pain and anxiety during suction evacuation of uterus content. RESULTS: Women who underwent hypnosis required less intravenous sedation analgesia (108/172 women; 63%) than the control group (149/175 women; 85%; P < .0001) and self-reported no difference in pain, but not in anxiety, levels during suction evacuation. CONCLUSION: Hypnotic interventions can be effective as an adjunct to pharmacologic management of acute pain during abortion.

Am J Obstet Gynecol. 2008 Mar 28. Marc I, Rainville P, Masse B, Verreault R, Vaillancourt L, Vallée E, Dodin S.

Research Center, Hôpital St-François d'Assise (CHUQ), Quebec City, Canada; Department of Pediatrics, Hôpital St-François d'Assise, Quebec City, Canada.

OBJECTIVE: To report the results of a systematic review of randomized controlled trials (RCTs) of psychological interventions for children and adolescents undergoing needle-related procedures. METHODS: A variety of cognitive-behavioral psychological interventions for managing procedural pain and distress in children and adolescents between 2 and 19 years of age were examined. Outcome measures included pain and distress as assessed by self-report, observer report, behavioral/observational measures, and physiological correlates. RESULTS: Twenty-eight trials met the criteria for inclusion in the review and provided the data necessary for pooling the results. Together, the trials included 1,039 participants in treatment conditions and 951 in control conditions. The largest effect sizes for treatment improvement over control conditions were found for distraction, combined cognitive-behavioral interventions, and hypnosis, with promising but limited evidence for several other psychological interventions. CONCLUSIONS: Recommendations for conducting future RCTs are provided, and particular attention to the quality of trial design and reporting is highlighted.

Pediatr Psychol. 2008 Apr 2. [Epub ahead of print]Related Articles Uman LS, Chambers CT, McGrath PJ, Kisely S.

Department of Psychology, Dalhousie University, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Department of Community Health & Epidemiology, Dalhousie University, and School of Medicine, Griffith University, Australia.

Peter Moule, Advanced trained & Accredited Hypnotherapist, Hypno-Analyst & Peak Performance Consultant, uses his skills in Hypnosis, as a practitioner, master practitioner and trainer of Neuro Linguistic Programming (NLP) and as a Stress Counsellor to help you overcome life's problems. His work on hypnosis, hypnotherapy and psychotherapy has featured in the media many times and he is frequently called in to BBC Essex as an expert in his field.

For more information visit: www.Petermoule.com

There is increasing clinical evidence that reflex therapies such as massage, Gua Sha, cupping, wet packs, acupuncture etc. are helpful in reducing symptoms of chronic pain. However, the neurobiological basis of these effects has rarely been investigated even though the increasing knowledge of the pathophysiology of chronic pain syndromes allows for specific hypotheses. Reflex therapies are likely able to influence chronic pain at the level of the nociceptor and the spinal cord. Moreover, it can be speculated that these therapies have a strong impact on relaxation and maybe understood as a social, comforting interaction. Since it is well accepted that the positive effect of grooming has a neurobiological basis in non-human primates, its biosocial impact on wellbeing and pain processing in humans may be underestimated. A synopsis of the neurobiological foundations of pain perception, from the nociceptor up the spinal cord to brain mechanisms provides the basis for the investigation of the 'way of action' of reflex therapies. Specific hypotheses on their neurobiological bases and methods suitable for their investigation are outlined. Further clarification of the mechanisms of action of reflex therapies will support their clinical evidence and add to our understanding of the neurobiology of complementary medicine. Copyright 2008 S. Karger AG, Basel.

Forsch Komplement Med (2006). 2008 Apr;15(2):97-103. Epub 2008 Apr 7. Musial F, Michalsen A, Dobos G. Alfried Krupp von Bohlen und Halbach Foundation, University of Duisburg-Essen, Germany. f.musial@kliniken-essen-mitte.de

Trace and major elements were determined in medicinal herbs (Cynara scolymus, Matricaria chamomilla, Artemisia absinthium L., Achillea millefolium, and Inula britannica) as well as in rhizosphere soil samples. Based on the results obtained after microwave-acid-assisted digestion (nitric acid + hydrogen peroxide) and single-step extraction (ammonium acetate), the real and potential acidity and redox potential of the soils, uptake, mobility, and bioavailability of potassium, calcium, magnesium, iron, manganese, copper, zinc, nickel, chromium, lead, and cadmium are discussed. By calculating the bioconcentration factors and their deviation from the recommended values, elevated concentrations, were explained in terms of contamination and pollution. The concentrations measured in both plants and soil samples were below maximum allowable concentration ranges considered for the European Union.

Nat Med (Tokyo). 2008 Jul;62(3) Razic S, Dogo S, Slavkovic L. Institute of Analytical Chemistry, Faculty of Pharmacy, University of Belgrade, P.O. Box 146, 11221, Belgrade, Serbia. snsn@sezampro.yu

BACKGROUND: Ayurvedic medicines are known to contain arsenic and concentrations up to toxic levels have been reported in certain formulations. However, clinical disease due to arsenic containing ayurvedic medicines has rarely been reported. We seek to highlight the existence of toxic levels of arsenic in certain ayurvedic preparations that can produce serious systemic manifestations. METHODS: An 11-year-old girl developed manifestations of arsenical keratosis (punctuate palmoplantar keratoderma and leucomelanoderma) and non-cirrhotic portal hypertension, 6 months and 18 months respectively after intake of ayurvedic medications, prescribed for epilepsy. The eight ayurvedic preparations consumed by the patient and her serum levels were analyzed for arsenic content. RESULTS: Arsenic content of ayurvedic medicines ranged from 5 mg/L to 248 mg/L. The serum arsenic level was 202.20 microg/L (normal < 60 microg/L). Skin manifestations improved after the discontinuation of ayurvedic medications. CONCLUSIONS: Ayurvedic medications should be consumed under strict guidance and supervision of qualified practitioners to prevent such catastrophies.

Int J Dermatol. 2008 Jun;47(6):618-21. Khandpur S, Malhotra AK, Bhatia V, Gupta S, Sharma VK, Mishra R, Arora NK. Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

BACKGROUND: With regard to the management of dental anxiety in general dental practice, it has been considered that general dental practitioners (GDPs) are well placed to treat adults with mild forms of dental anxiety. However, little is known about the specific anxiety management techniques being used by GDPs in the UK.Aim To determine the views and experiences of dental practitioners in their current use of anxiety management techniques, their undergraduate and post-graduation training in these techniques and future training needs. METHODS: A postal questionnaire was sent to a sample of GDPs working in the Midlands region (n = 750) in the UK. Dentists were randomly selected using lists provided by the primary care trusts for each locality. RESULTS: The response rate was 73% (n = 550). Of these, 90 were not included in the final analysis due to exclusion criteria set prior to questionnaire release. This left 460 questionnaires for analysis. Eighty-five percent of respondents agreed that dentists had a responsibility to help dentally anxious patients (n = 391). Dentists were asked their reasons for not using anxiety management techniques in practice. Psychological techniques, sedation (oral, inhalation, or intravenous) and hypnosis were reported as not having been used due to the paucity of time available in practice, a shortage of confidence in using these techniques and the lack of fees available under the NHS regulations. Also, 91% reported feeling stressed when treating anxious patients. When asked about the quality of teaching they had received (undergraduate and postgraduate), 65% considered that the teaching was less than adequate in the use of psychological methods, whereas 44% indicated that they would be interested in further training in psychological methods if financial support was available. CONCLUSION: The need for further training in managing the dentally anxious patient is supported by dentists' lack of confidence and inadequate training in treating such patients, as determined from the results of a postal questionnaire to UK GDPs.

Br Dent J. 2008 Apr 26;204(8):E13; discussion 442-3. Hill KB, Hainsworth JM, Burke FJ, Fairbrother KJ. University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham, B4 6NN. K.B.Hill@bham.ac.uk

CONTEXT: Stimulant medication can effectively treat 60% to 70% of youth with attention-deficit/hyperactivity disorder (ADHD). Yet many parents seek alternative therapies, and Hypericum perforatum (St John's wort) is 1 of the top 3 botanicals used. OBJECTIVE: To determine the efficacy and safety of H. perforatum for the treatment of ADHD in children. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled trial conducted between March 2005 and August 2006 at Bastyr University, Kenmore, Washington, among a volunteer sample of 54 children aged 6 to 17 years who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for ADHD by structured interview. INTERVENTION: After a placebo run-in phase of 1 week, participants were randomly assigned to receive 300 mg of H. perforatum standardized to 0.3% hypericin (n = 27) or a matched placebo (n = 27) 3 times daily for 8 weeks. Other medications for ADHD were not allowed during the trial. MAIN OUTCOME MEASURES: Performance on the ADHD Rating Scale-IV (range, 0-54) and Clinical Global Impression Improvement Scale (range, 0-7), and adverse events. RESULTS: One patient in the placebo group withdrew because of an adverse event. No significant difference was found in the change in ADHD Rating Scale-IV scores from baseline to week 8 between the treatment and placebo groups: inattentiveness improved 2.6 points (95% confidence interval [CI], -4.6 to -0.6 points) with H. perforatum vs 3.2 points (95% CI, -5.7 to -0.8 points) with placebo (P = .68) and hyperactivity improved 1.8 points (95% CI, -3.7 to 0.1 points) with H. perforatum vs 2.0 points (95% CI, -4.1 to 0.1 points) with placebo (P = .89). There was also no significant difference between the 2 groups in the percentage of participants who met criteria for improvement (score < or = 2) on the Clinical Global Impression Improvement Scale (H. perforatum, 44.4%; 95% CI, 25.5%-64.7% vs placebo, 51.9%; 95% CI, 31.9%-71.3%; P = .59). No difference between groups was found in the number of participants who experienced adverse effects during the study period (H. perforatum, 40.7%; 95% CI, 22.4%-61.2% vs placebo, 44.4%; 95% CI, 25.5%-64.7%; P = .78). CONCLUSION: In this study, use of H. perforatum for treatment of ADHD over the course of 8 weeks did not improve symptoms. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00100295.

JAMA. 2008 Jun 11;299(22):2633-41. Weber W, Vander Stoep A, McCarty RL, Weiss NS, Biederman J, McClellan J.

School of Naturopathic Medicine, Bastyr University, Kenmore, Washington, USA. wendyw@bastyr.edu

There is now good evidence that hypnotherapy benefits a substantial proportion of patients with irritable bowel syndrome and that improvement is maintained for many years. Most patients seen in secondary care with this condition also suffer from a wide range of noncolonic symptoms such as backache and lethargy, as well as a number of musculoskeletal, urological, and gynaecological problems. These features do not typically respond well to conventional medical treatment approaches, but fortunately, their intensity is often reduced by hypnosis. The mechanisms by which hypnosis mediates its benefit are not entirely clear, but there is evidence that, in addition to its psychological effects, it can modulate gastrointestinal physiology, alter the central processing of noxious stimuli, and even influence immune function.

J Psychosom Res. 2008 Jun;64(6):621-3. Epub 2008 Apr 28. Whorwell PJ. University of Manchester, Manchester, United Kingdom.