Tim Brunson DCH

Welcome to The International Hypnosis Research Institute Web site. Our intention is to support and promote the further worldwide integration of comprehensive evidence-based research and clinical hypnotherapy with mainstream mental health, medicine, and coaching. We do so by disseminating, supporting, and conducting research, providing professional level education, advocating increased level of practitioner competency, and supporting the viability and success of clinical practitioners. Although currently over 80% of our membership is comprised of mental health practitioners, we fully recognize the role, support, involvement, and needs of those in the medical and coaching fields. This site is not intended as a source of medical or psychological advice. Tim Brunson, PhD

Mindfulness Meditation for Symptom Reduction in Fibromyalgia: Psychophysiological Correlates.



Fibromyalgia, a chronic pain syndrome, is often accompanied by psychological distress and increased basal sympathetic tone. In a previous report it was shown that mindfulness-based stress-reduction (MBSR) reduced depressive symptoms in patients with fibromyalgia with gains maintained at two months follow-up (Sephton et al., Arthr Rheum 57:77-85, 2007). This second study explores the effects of MBSR on basal sympathetic (SNS) activation among women with fibromyalgia. Methods Participants (n = 24) responded to a television news appearance, newspaper, and radio advertisements. Effects on anxiety, depressive symptoms, and SNS activation measures were tested before and after MBSR using a within-subjects design. Results The MBSR treatment significantly reduced basal electrodermal (skin conductance level; SCL) activity (t = 3.298, p = .005) and SCL activity during meditation (t = 4.389, p = .001), consistent with reduced SNS activation. Conclusions In this small sample, basal SNS activity was reduced following MBSR treatment. Future studies should assess how MBSR may help reduce negative psychological symptoms and attenuate SNS activation in fibromyalgia. Further clarification of psychological and physiological responses associated with fibromyalgia may lead to more beneficial treatment.

J Clin Psychol Med Settings. 2009 Mar 10. Lush E, Salmon P, Floyd A, Studts JL, Weissbecker I, Sephton SE. Department of Psychological and Brain Sciences, University of Louisville, 2301 South Third Street, Life Sciences Building, Suite 317, Louisville, KY, 40202, USA.

Long-term meditation is associated with increased gray matter density in the brain stem.



Extensive practice involving sustained attention can lead to changes in brain structure. Here, we report evidence of structural differences in the lower brainstem of participants engaged in the long-term practice of meditation. Using magnetic resonance imaging, we observed higher gray matter density in lower brain stem regions of experienced meditators compared with age-matched nonmeditators. Our findings show that long-term practitioners of meditation have structural differences in brainstem regions concerned with cardiorespiratory control. This could account for some of the cardiorespiratory parasympathetic effects and traits, as well as the cognitive, emotional, and immunoreactive impact reported in several studies of different meditation practices.

Neuroreport. 2009 Jan 28;20(2):170-4. Vestergaard-Poulsen P, van Beek M, Skewes J, Bjarkam CR, Stubberup M, Bertelsen J, Roepstorff A. Center for Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark. peterv@pet.auh.dk

The effectiveness of hypnosis for reducing procedure-related pain in children and adolescents



A comprehensive, methodologically informed review of studies of the effectiveness of hypnosis for reducing procedure-related pain in children and adolescents is provided. To be included in the review, studies were required to use a between-subjects or mixed model design in which hypnosis was compared with a control condition or an alternative intervention in reducing the procedure-related pain of patients younger than age 19. An exhaustive search identified 13 studies satisfying these criteria. Hypnosis was consistently found to be more effective than control conditions in alleviating discomfort associated with bone marrow aspirations, lumbar punctures, voiding cystourethograms, the Nuss procedure, and post-surgical pain. Furthermore, hypnosis was as at least as effective as distraction. Three hypnotic interventions met criteria as a possibly efficacious empirically supported therapy for reducing post-surgical or lumbar puncture pain. Several other hypnotic interventions would have achieved the status of a possibly efficacious therapy had studies used a treatment manual.

J Behav Med. 2009 Mar 3. Accardi MC, Milling LS. Department of Psychology, University of Hartford, 200 Bloomfield Avenue, West Hartford, CT, 06117, USA.

Massage therapy reduces physical discomfort and improves mood disturbances in women w/ breast cancer



A randomized controlled trial was conducted to investigate the efficacy of classical massage treatment in reducing breast cancer-related symptoms and in improving mood disturbances.Methods. Women diagnosed with primary breast cancer were randomized into an intervention group and a control group. For a period of 5 weeks, the intervention group received bi-weekly 30-min classical massages in the back and head-neck areas. The control group received no additional treatment to their routine healthcare. To evaluate treatment efficacy, the following validated questionnaires were administrated at baseline (T1), at the end of the intervention (T2), and at a followup at 11 weeks (T3): the Short Form-8 Health Surveytrade mark, the European Organization of Research and Treatment of Cancer quality of life questionnaire breast module (EORTC QLQ-BR23), the Giessen Complaints Inventory (GBB), and the Berlin Mood Questionnaire (BSF).Results. Eighty-six eligible women (mean age: 59 years) were enrolled in the study. A significantly higher reduction of physical discomfort was found in the intervention group compared with the control group at T2 (p=0.001) and at T3 (p=0.038). A decrease in fatigue was also observed. Women in the intervention group reported significantly lower mood disturbances at T2 (p<0.01) but not at T3. The effect of treatment on mood disturbances was significantly higher if a patient was treated continuously by the same masseur.Conclusion. Classical massage seems to be an effective adjuvant treatment for reducing physical discomfort and fatigue, and improving mood disturbances in women with early stage breast cancer. Copyright (c) 2009 John Wiley & Sons, Ltd.

Psychooncology. 2009 Feb 2. Listing M, Reißhauer A, Krohn M, Voigt B, Tjahono G, Becker J, Klapp BF, Rauchfuß M. Department of Psychosomatics and Psychotherapy, Charité Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Michael Smith, PhD



Dr. Michael Smith is a Clinical Psychologist and Hypnotherapist who retired after a 27-year career working with cancer patients. He now works as a hypnotherapist at Qua Baths & Spa at Caesars Palace in Las Vegas, Nevada. He is the first jypnotherapist to practice in a major spa where he offers an extensive menu of services. In addition to his duties in the spa, Dr. Smith presents self-help seminars for Caesars Palace employees and is available as a speaker through Caesars Convention Sales.

Long-term meditation is associated with increased gray matter density in the brain stem.



Extensive practice involving sustained attention can lead to changes in brain structure. Here, we report evidence of structural differences in the lower brainstem of participants engaged in the long-term practice of meditation. Using magnetic resonance imaging, we observed higher gray matter density in lower brain stem regions of experienced meditators compared with age-matched nonmeditators. Our findings show that long-term practitioners of meditation have structural differences in brainstem regions concerned with cardiorespiratory control. This could account for some of the cardiorespiratory parasympathetic effects and traits, as well as the cognitive, emotional, and immunoreactive impact reported in several studies of different meditation practices.

Neuroreport. 2009 Jan 28;20(2):170-4. Vestergaard-Poulsen P, van Beek M, Skewes J, Bjarkam CR, Stubberup M, Bertelsen J, Roepstorff A. Center for Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark. peterv@pet.auh.dk

Treatment of chronic recurrent abdominal pain: laparoscopy or hypnosis?



OBJECTIVE: Functional chronic recurrent abdominal pain (FCRAP) is long lasting, intermittent, or constant pain affecting 15-30% of children ages 4-18 and presents a diagnostic and treatment challenge to the physician. The predictive value of diagnostic tests is questionable, and studies of the treatment of chronic abdominal pain show inconclusive evidence regarding diet regimens as well as medical and surgical treatments. However, there is evidence that cognitive-behavioral therapy may be useful in improving pain and disability outcome. Increasing the understanding of the neural-pain pathways and research in cognitive modulation of pain led to the application of behavioral strategies in children with FCRAP with variable success. However, the use of hypnotherapy in children with recurrent abdominal pain is not common. During the last 3 years, we have implemented hypnosis as the preferred treatment for patients with FCRAP. In the current study, we aimed to summarize our experience with hypnosis for the treatment of FCRAP in children. PATIENTS AND METHODS: Twenty patients who met the criteria for FCRAP were candidates for hypnosis. Hypnosis or imagery was offered to the families, of whom 3 refused. Seventeen patients underwent just one single session of hypnosis. RESULTS: A possible nonorganic etiology for the abdominal pain was revealed in all cases. In 14 adolescents, all clinical symptoms resolved. Hypnosis was not effective in 3 cases, in whom secondary gain was probably responsible for their symptoms. No side effects have been noted during and after the study. Follow-up was available for a period of 4-24 months. CONCLUSIONS: Although effective in the management of acute pain and distress in pediatric cancer patients, the use of hypnotherapy in children with FCRAP is not a common practice. The current study highly supports the use of hypnosis as a part of the biobehavioral approach for this dilemma.

J Laparoendosc Adv Surg Tech A. 2009 Feb;19(1):93-6. Galili O, Shaoul R, Mogilner J. Department of General Surgery, Bnei-Zion Medical Center, Haifa, Israel.

Salivary cortisol output before and after cognitive behavioural therapy for chronic fatigue syndrome



There is evidence that patients with chronic fatigue syndrome (CFS) have mild hypocortisolism. One theory about the aetiology of this hypocortisolism is that it occurs late in the course of CFS via factors such as inactivity, sleep disturbance, chronic stress and deconditioning. We aimed to determine whether therapy aimed at reversing these factors--cognitive behavioural therapy for CFS--could increase cortisol output in CFS. METHODS: We measured diurnal salivary cortisol output between 0800 and 2000 h before and after 15 sessions (or 6 months) of CBT in 41 patients with CDC-defined CFS attending a specialist, tertiary outpatient clinic. RESULTS: There was a significant clinical response to CBT, and a significant rise in salivary cortisol output after CBT. LIMITATIONS: We were unable to control for the passage of time using a non-treated CFS group. CONCLUSIONS: Hypocortisolism in CFS is potentially reversible by CBT. Given previous suggestions that lowered cortisol may be a maintaining factor in CFS, CBT offers a potential way to address this.

J Affect Disord. 2009 May;115(1-2):280-6. Roberts AD, Papadopoulos AS, Wessely S, Chalder T, Cleare AJ. King's College London, Institute of Psychiatry, Department of Psychological Medicine, De Crespigny Park, London SE5 8AF, UK.

Cognitive strategy use to enhance motor skill acquisition post-stroke: a critical review.



The objective of this critical review was to examine the literature regarding the use of cognitive strategies to acquire motor skills in people who have had a stroke, to determine which strategies are in use and to compile evidence of their effectiveness. SEARCH TERMS: A computerized search of a range of databases was conducted using the following search terms: stroke, cerebrovascular accident; combined with strategy training, learning strateg*, cognitive strateg*, metacognitive strateg*, goal setting, goal planning, goal attainment, goal direct*, goal orient*, self talk, imagery, mental practice, self evaluat*, ready*, attentional focus*, problem solv*, goal management; combined with motor, mobility, activit*, skill, task, function, ADL. RESULTS: Twenty-six articles were reviewed. Seven studies investigated general cognitive strategies and 19 investigated task-specific strategies. The most commonly studied task-specific strategy was motor imagery. Findings suggest that general strategy training improves performance in both trained and untrained activities compared to traditional therapy; and that a specific motor imagery protocol can improve mobility and recovery in the affected upper extremity in people living with the chronic effects of stroke. CONCLUSION: This foundational evidence supports the further development of novel cognitive strategy-based interventions with the intention of improving long-term stroke outcomes.

Brain Inj. 2009 Apr;23(4):263-77. McEwen SE, Huijbregts MP, Ryan JD, Polatajko HJ. Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada. sara.mcewen@utoronto.ca

Nadine Romain, PhD



Dr. Nadine Romain has a PhD in Biomedical Experimental Sciences. She certified in HypnoBirthing® in 2001, and has now developed her own hypnotic assisted birthing program, Quantum Birthing taking childbirth back to the blissful experience it was meant to be. Dr. Romain presented Hypnotic Assisted Birthing to Medical Professionals at Painweek 2008. She has assisted more than 100 women during childbirth. She has been teaching Prenatal Yoga for 25 years.

Eyewitness identification evidence and innocence risk.



It is well known that the frailties of human memory and vulnerability to suggestion lead to eyewitness identification errors. However, variations in different aspects of the eyewitnessing conditions produce different kinds of errors that are related to wrongful convictions in very different ways. We present a review of the eyewitness identification literature, organized around underlying cognitive mechanisms, memory, similarity, and decision processes, assessing the effects on both correct and mistaken identification. In addition, we calculate a conditional probability we call innocence risk, which is the probability that the suspect is innocent, given that the suspect was identified. Assessment of innocence risk is critical to the theoretical development of eyewitness identification research, as well as to legal decision making and policy evaluation. Our review shows a complex relationship between misidentification and innocence risk, sheds light on some areas of controversy, and suggests that some issues thought to be resolved are in need of additional research.

Psychon Bull Rev. 2009 Feb;16(1):22-42. Clark SE, Godfrey RD. Psychology Department, University of California, Riverside, California 92521, USA. clark@ucr.edu

Guidelines on the management of fibromyalgia syndrome - A systematic review.



We compared the methodology and the recommendations of evidence-based guidelines for the management of fibromyalgia syndrome (FMS) to give an orientation within the continuously growing number of reviews on the therapy of FMS. Systematic searches up to April 2008 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, the Association of the Scientific Medical Societies in Germany (AWMF) and Medline were conducted. Three evidence-based guidelines for the management of FMS published by professional organizations were identified: The American Pain Society (APS) (2005), the European League Against Rheumatism (EULAR) (2007), and the AWMF (2008). The steering committees and panels of APS and AWMF were comprised of multiple disciplines engaged in the management of FMS and included patients, whereas the task force of EULAR only consisted of physicians, predominantly rheumatologists. APS and AWMF ascribed the highest level of evidence to systematic reviews and meta-analyses, whereas EULAR credited the highest level of evidence to randomised controlled studies. Both APS and AWMF assigned the highest level of recommendation to aerobic exercise, cognitive-behavioral therapy, amitriptyline, and multicomponent treatment. In contrast, EULAR assigned the highest level of recommendation to a set of to pharmacological treatment. Although there was some consistency in the recommendations regarding pharmacological treatments among the three guidelines, the APS and AWMF guidelines assigned higher ratings to CBT and multicomponent treatments. The inconsistencies across guidelines are likely attributable to the criteria used for study inclusion, weighting systems, and composition of the panels.

Eur J Pain. 2009 Mar 3. Häuser W, Thieme K, Turk DC. Department of Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, D-66119 Saarbrücken, Germany.

A mind-body treatment for hypothyroid dysfunction: A report of two cases.



For many years hypothyroid dysfunction has been treated with standard medical approaches yet some seek newer experimental conservative approaches. This paper describes the management of a new conservative approach to management in two individuals who sought treatment from a practitioner specialising in a new integrative mind-body based treatment. The purpose of this study is to present two case studies of the management of hypothyroid dysfunction using the mind-body neuro-emotional technique (NET). METHOD: The study was set in a private practice setting in Sydney, Australia. Two cases had been diagnosed with primary hypothyroidism by independent medical and laboratory based assessment, of which conservative management had not resolved the symptoms. Both cases underwent a schedule of NET as a modality to treat their hypothyroidism. RESULTS: Objective measures such as thyroid stimulating hormone and T(4) levels were reported, along with more subjective measures such as feelings of tiredness and general well being. In both cases, there were improvements in TSH and T(4) levels, both returning to normal levels. CONCLUSIONS: Thyroid dysfunction has been effectively treated by conventional medicine for many years. Changes in thyroid dysfunction after a course of NET have been described. As the standard medical model is associated with some adverse effects such as long-term medication use and potential side effects, all natural, non-invasive approaches to management should be reviewed. Further research into this mind-body therapy is recommended to evaluate its potential effectiveness for this common condition.

Complement Ther Clin Pract. 2009 May;15(2):67-71. Bablis P, Pollard H. Private practice; Macquarie Injury Management Group, Department of Health and Chiropractic, Macquarie University, Sydney 2109, Australia.

Light pressure massage for patients with severe anxiety.



Generalised anxiety disorder (GAD) is common in the western world with a lifetime prevalence of 4.3 to 5.9% and is twice as common in women as in men. GAD can have a decisive impact on a patient's everyday life as it is surrounded by unfocused worries and the severe anxiety may interfere with normal social functions. The treatments include cognitive behavioural therapy and/or psychopharmacological drugs. In previous studies the positive effects of massage on anxiety have been shown. The present study described the experience of receiving massage for eight patients with GAD. Findings revealed that the patients were able to rediscover their own capacity during the massage period. This was illuminated by the experience of being relaxed in body and mind, the experience of unconditional attention, the experience of decreased anxiety and the experience of increased self-confidence. The paper ends with a discussion of clinical implications.

Complement Ther Clin Pract. 2009 May;15(2):96-101. Billhult A, Määttä S. FoU-enheten i Södra Alvsborg, Sven Eriksonsplatsen 4, S- 503 38 Borås, Sweden.

Complementary and alternative medicine for treatment of irritable bowel syndrome.



To review the evidence supporting selected complementary and alternative medicine approaches used in the treatment of irritable bowel syndrome (IBS). QUALITY OF EVIDENCE: MEDLINE (from January 1966), EMBASE (from January 1980), and the Cochrane Database of Systematic Reviews were searched until March 2008, combining the terms irritable bowel syndrome or irritable colon with complementary therapies, alternative medicine, acupuncture, fiber, peppermint oil, herbal, traditional, yoga, massage, meditation, mind, relaxation, probiotic, hypnotherapy, psychotherapy, cognitive therapy, or behavior therapy. Results were screened to include only clinical trials, systematic reviews, and meta-analyses. Level I evidence was available for most interventions. MAIN MESSAGE: Soluble fibre improves constipation and global IBS symptoms. Peppermint oil alleviates IBS symptoms, including abdominal pain. Probiotic trials show overall benefit for IBS but there is little evidence supporting the use of any specific strain. Hypnotherapy and cognitive-behavioural therapy are also effective therapeutic options for appropriate patients. Certain herbal formulas are supported by limited evidence, but safety is a potential concern. All interventions are supported by systematic reviews or meta-analyses. CONCLUSION: Several complementary and alternative therapies can be recommended as part of an evidence-based approach to the treatment of IBS; these might provide patients with satisfactory relief and improve the therapeutic alliance.

Can Fam Physician. 2009 Feb;55(2):143-8. Comment in: Can Fam Physician. 2009 Feb;55(2):126-7, 128-9. Shen YH, Nahas R. Department of Family and Community Medicine at University of Ottawa in Ontario.

Padman Pillai



Padman Pillai of Edmonton, Canada is a board certified clinical hypnotherapist, former pharmaceutical marketing executive and research scientist. Padman earned a Master of Science degree in analytical chemistry at the University of London and was elected to the associate membership of the Royal Institute of Chemistry, U.K.

Hypnosis for Postradiation Xerostomia in Head and Neck Cancer Patients: A Pilot Study.



Xerostomia, the sensation of dry mouth, affects almost all patients who undergo radiotherapy for cancer in the head and neck area. Current therapies for xerostomia are inadequate, and the condition negatively impacts the quality of life. This prospective observational pilot aimed to evaluate whether hypnosis could improve salivation and decrease xerostomia. Twelve patients with xerostomia after radiotherapy for head and neck cancer were assessed for severity of xerostomia symptoms and sialometry. They then received a single hypnosis session with specific suggestions to increase salivation. The session was recorded on a compact disk (CD), and the participants were instructed to listen to it twice a day for one month. Sialometry was repeated immediately after hypnosis. Validated xerostomia questionnaires were completed at one, four, and 12 weeks after hypnosis. A substantial overall improvement was reported by eight patients at 12 weeks (66%). The saliva flow rate increased on sialometry in nine patients following hypnosis (75%). There was no correlation between the magnitude of changes in the measured saliva flow rate and changes in subjective measures (Spearman's correlation coefficient r=0.134). Symptomatic improvement significantly correlated with the number of times the patients listened to the hypnosis CD (r=0.714, P=0.009). No adverse events were reported. The data from this small observational trial suggest that hypnosis may be an effective treatment for xerostomia. Confirmation in a larger randomized and controlled investigation is warranted.

J Pain Symptom Manage. 2009 Jan 29. Schiff E, Mogilner JG, Sella E, Doweck I, Hershko O, Ben-Arye E, Yarom N. Department of Internal Medicine (E.S.), Bnai-Zion Hospital, Haifa; Department for Complementary/Integrative Medicine, Law and Ethics (E.S.), and The International Center for Health, Law and Ethics (E.S.), Haifa University, Haifa; Department of Pediatric Surgery (J.G.M.), The Ruth & Bruce Rappaport Faculty of Medicine, and the Complementary and Traditional Medicine Unit (E.B.-A.), Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa; Department of Otolaryngology-Head and Neck Surgery (E.S., I.D.), Carmel Medical Center, Haifa, Israel; Faculty of Medicine (O.H.), Semmelweis University, Budapest, Hungary; Clalit Health Services (E.B.-A.), Haifa and Western Galilee District; and Oral Medicine Clinic (N.Y.), Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Israel.

Theories and Management of Aging: Modern and Ayurveda Perspectives.



Aging is a complex phenomenon, a sum total of changes that occur in a living organism with the passage of time and lead to decreasing ability to survive stress, increasing functional impairment and growing probability of death. There are many theories of aging and skin remains the largest organ of the study. Skin aging is described as a consequence of intrinsic and extrinsic factors. The most common amongst visible signs of skin aging are wrinkles and there are various therapies including antiaging cosmeceuticals, sunscreens, chemical peeling, injectable agents, such as botox, fibrel, autologous fat grafting as also few surgical procedures have been used. Ayurveda, the Indian traditional medicine, describes aging with great details. This review provides modern and Ayurvedic perspectives on theories and management of aging.

Evid Based Complement Alternat Med. 2009 Feb 20. Datta HS, Mitra SK, Paramesh R, Patwardhan B. Chief Academics, Manipal Education, Manipal Towers, Bangalore 560 008, India. bhushan.patwardhan@manipalu.com.

Psychosocial treatments for childhood and adolescent bipolar disorder.



Adjunctive psychosocial interventions are increasingly recognized as an important aspect of comprehensive treatment for bipolar disorder (BPD) in childhood and adolescence. Research in this area is relatively new, but psychosocial interventions being developed and tested include: multi-family psychoeducation groups for school-aged children with either BPD or depressive disorders; family-focused treatment, dialectical behavior therapy, and interpersonal and social rhythm therapy for adolescents with BPD; and child and family-focused cognitive-behavioral therapy for school-aged children with BPD. Preliminary evidence, where available, indicates that these interventions are feasible, well-received by families, and associated with positive outcomes. The continued study of adjunctive psychosocial interventions will help identify critical treatment ingredients that target specific areas of functioning and enhance overall treatment effectiveness for children and adolescents with BPD and their families.

Child Adolesc Psychiatr Clin N Am. 2009 Apr;18(2):471-82, x-xi. West AE, Pavuluri MN. University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, USA. awest@psych.uic.edu

Diane Pope, RN



Diane Pope, a master's prepared nurse, has been using for over 40 years in health care. Her background includes instructor at School of Nursing, and Program Director of Substance Abuse Prevention Program at University of Texas Health Science Center San Antonio. Since 1999, Diane has specialized in hypnosis. Diane has had many articles published in news papers, magazines, newsletters and on the Web.

Childhood habit cough treated with consultation by telephone: a case report.



Childhood habit cough has been treated successfully by making suggestions that it can be stopped, desensitization techniques, use of distractors, provision of rewards, and self-hypnosis. All of these techniques have involved personal contact between a health care provider and a patient. CASE PRESENTATION: A 5-year-old with cystic fibrosis was diagnosed with habit cough following evaluation by a pediatric pulmonologist and otolaryngologist. An expert in the treatment of habit cough provided instruction by telephone to the patient's mother regarding use of hypnotic techniques in this setting, which was associated with resolution of the cough within a week. CONCLUSION: As this report describes a single patient, it is possible that his improvement was unrelated to the given advice. Therefore, it remains to be seen whether therapy by telephone for habit cough is applicable widely.

Cough. 2009 Jan 21;5:2. Anbar RD. Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, NY, USA. anbarr@upstate.edu.

Brief cognitive behavioural therapy for extreme shape concern: an evaluation.



This study was designed to evaluate a new brief cognitive-behavioural intervention to reduce concerns about body shape. DESIGN: Women with high levels of shape concern (N=50) were randomly assigned to cognitive behaviour therapy or applied relaxation (AR). Baseline assessments were made and then women received their treatment immediately after this assessment, ('immediate' treatment) or 5 weeks after this assessment, during which time no treatment was given ('delayed' treatment, DT). METHODS: Shape concern and related cognitions and emotions were assessed at baseline, post-treatment and at 4 and 12 week follow-up (FU). RESULTS: Immediate treatment was superior to DT in reducing shape concerns, and this difference was maintained at 4 week FU. The cognitive behavioural intervention was more effective than AR in changing shape concern and this difference was largely maintained for 3 months. CONCLUSIONS: These initial findings support the further investigation of this brief intervention.

Br J Clin Psychol. 2009 Mar;48(Pt 1):79-92. Shafran R, Farrell C, Lee M, Fairburn CG. Department of Psychology, University of Reading, Reading, UK. r.shafran@reading.ac.uk

Identification with mainstream culture and preference for alternative alcohol treatment approaches.



Although various treatment approaches are available for alcohol problems, less than 25% of individuals with alcohol use disorders obtain treatment. The purpose of this study is to evaluate interest in attending alternative alcohol treatments, such as meditation and acupuncture, compared to Alcoholics Anonymous (AA). A community sample of 156 adult participants concerned about their drinking were recruited through flyers and newspaper advertisements to complete a Web-based survey assessing identification with mainstream culture, sexual identity, and likelihood to attend alternative alcohol treatments. Participants reported higher likelihood of attending alternative treatments as compared to AA, and lesbian, gay, and bisexual participants (28.2% of the sample) were more likely to attend alternative treatments than heterosexual participants. A series of regression analyses were conducted to test whether the relationship between sexual identity and likelihood to attend alternative treatments was mediated by identification with mainstream culture. Participants who were less strongly identified with mainstream culture, regardless of sexual identity, reported higher likelihood of attending alternative treatments. These findings highlight that, for certain subgroups of the population, alternative treatments for alcohol misuse are appealing and suggest the need for future research testing the efficacy of alternative treatments for alcohol problems.

Behav Ther. 2009 Mar;40(1):72-81. Dillworth TM, Kaysen D, Montoya HD, Larimer ME. University of Washington, Box 354944, Seattle, WA 98195-0650, USA. tiara@u.washington.edu

Cardiorespiratory phase synchronization during normal rest and inward-attention meditation.



The cardiac and respiratory systems can be viewed as two self-sustained oscillators with various interactions between them. In this study, the cardiorespiratory phase synchronization (CRPS) quantified by synchrogram was investigated to explore the phase synchronization between these two systems. The synchrogram scheme was applied to electrocardiogram (ECG) and respiration signals. Particular focus was the distinct cardiac-respiratory regulation phenomena intervened by inward-attention meditation and normal relaxation. Four synchronization parameters were measured: frequency ratio, lasting length, number of epochs, and total length. The results showed that normal rest resulted in much weaker CRPS. Statistical analysis reveals that the number of synchronous epochs and the total synchronization length significantly increase (p=0.024 and 0.034 respectively) during meditation. Furthermore, a predominance of 4:1 and 5:1 rhythm-ratio synchronizations was observed during meditation. Consequently, this study concludes that CRPS can be enhanced during meditation, compared with normal relaxation, and reveals a predominance of specific frequency ratios.

Int J Cardiol. 2009 Jan 13. Wu SD, Lo PC. Department of Electrical and Control Engineering, National Chiao Tung University, Taiwan, ROC.

The psychosocial genomics of therapeutic hypnosis, psychotherapy, and rehabilitation.



This paean composed on the occasion of the inaugural Bernauer W. Newton Trust presentation celebrates the personal and professional culture of 50 years of mentorship, teaching, and research by the American Society for Clinical Hypnosis (ASCH). This review of current neuroscience concepts of therapeutic hypnosis and psychotherapy is made possible by the cooperation and dedication of all members of our society. Emerging pathways of psychosocial genomic research, which will lead to new directions for our society, are highlighted for their impact on our professional practice in the present and future.

Am J Clin Hypn. 2009 Jan;51(3):281-98. Rossi EL. Ernest@ErnestRossi.com

Procedural pain heart rate responses in massaged preterm infants.



Heart rate (HR) responses to the removal of a monitoring lead were assessed in 56 preterm infants who received moderate pressure, light pressure or no massage therapy. The infants who received moderate pressure massage therapy exhibited lower increases in HR suggesting an attenuated pain response. The heart rate of infants who received moderate pressure massage also returned to baseline faster than the heart rate of the other two groups, suggesting a faster recovery rate.

Infant Behav Dev. 2009 Apr;32(2):226-9. Epub 2009 Jan 30. Diego MA, Field T, Hernandez-Reif M. Touch Research Institute, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33101, USA. mdiego@med.miami.edu

Use of complementary and alternative medicine by Korean patients with Parkinson's disease.



Many patients with Parkinson's disease (PD) often utilize complementary and alternative medicine (CAM). We aimed to survey the prevalence, spectrum of use, and factors related to utilization of CAM in patients with PD in Korea. PATIENTS AND METHODS: Between 15 December 2005 and 30 April 2006, we studied 123 patients with PD who volunteered to be interviewed using semi-structured questionnaires. RESULTS: Ninety-four (76%) patients had used CAM. The mean cost of CAM paid by patients (out-of-pocket costs) was 102.3 US Dollars (USD) per month, while medical costs of treatment for PD paid by patients (out-of-pocket costs) averaged 72.8 USD per month. Patients using CAM sought to improve motor symptoms (57.6%), fatigue (19.6%), pain (4.3%), constipation (5.4%) or specified no single reason (13.0%). The spectrum of CAM use included oriental medicines (76.6%), traditional food (44.7%), non-prescribed drugs (31.9%), traditional therapies (7.4%), massage (7.4%) and behavioral therapy (7.4%). Factors related to current use of CAM were disease duration, degree of education, and daily levodopa equivalent dose. In a logistic regression analysis, the duration of PD was a significant factor for CAM use. CONCLUSIONS: These results suggest that a high proportion of Korean PD patients employed CAM, associated with high costs and serious side effects in some patients.

Clin Neurol Neurosurg. 2009 Feb;111(2):156-60. Kim SR, Lee TY, Kim MS, Lee MC, Chung SJ. Center for Parkinsonism and Other Movement Disorders, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Kweethai Neill, PhD



Dr. Kweethai Neill is a nationally known health educator and health consultant with more than 25 years of experience. She is an exceptionally skilled clinical hypnotherapist helping many clients change their minds so they can change their life situations at home and at work. Dr. Kweethai is a popular speaker, loved for her passion, enthusiasm, and humor. She facilitates conflict resolutions in Collaborative Law and helps businesses succeed through positive communication. Dr. Kweethai is the author of Hypnotherapy, An Alternative Path to Health and Happiness. She is founder of the iHealth Center for Integrative Wellness and iHealth Hypnotherapy School in Roanoke, Texas. Dr. Kweethai also offers training in skills of "The Positive Humant subject of her next book.

Hypnotic analgesia for combat-related spinal cord injury pain: a case study.



A U.S. Army soldier stationed in Iraq developed myriad pain problems after sustaining a high-level spinal cord injury (SCI) from a gunshot wound. These problems were negatively impacting his ability to participate fully in his physical rehabilitation and care. Ten sessions of self-hypnosis training were administered to the patient over a 5-week period to help him address these problems. Both the patient and his occupational therapist reported a substantial reduction in pain over the course of treatment, which allowed the patient to actively engage in his therapies. Six months post treatment, the patient reported continued use of the hypnosis strategies taught, which effectively reduced his experience of pain. This case study demonstrates the efficacy of hypnotic analgesia treatment for U.S. military veterans who are experiencing pain problems due to traumatic or combat-related SCIs.

Am J Clin Hypn. 2009 Jan;51(3):273-80. Stoelb BL, Jensen MP, Tackett MJ. University of Washington School of Medicine, Department of Rehabilitation Medicine, Seattle, WA 98195, USA. bstoelb@u.washington.edu

A demonstration of the efficacy of two of the components of cognitive therapy for social phobia.



Cognitive-behavioral treatments have demonstrated efficacy in the treatment of social phobia. However, such treatments comprise a complex set of procedures, and there has been little investigation of the effects of individual procedures. The current study investigates the effects of two single session procedures that form part of cognitive therapy for social phobia [Clark, D., Ehlers, A., McManus, F., Hackmann, A., Fennell, M., Campbell, H., et al. (2003). Cognitive therapy vs fluoxetine in the treatment of social phobia: A randomised placebo controlled trial. Journal of Consulting and Clinical Psychology, 71, 1058-1067; Clark, D., Ehlers, A., McManus, F., Fennell, M., Grey, N., Waddington, L., et al. (2006). Cognitive therapy versus exposure and applied relaxation in social phobia: A randomised controlled trial. Journal of Consulting and Clinical Psychology, 74, 568-578], namely the "self-focused attention and safety behaviors experiment" and the "video feedback experiment." Results suggest that both procedures are effective in achieving their aims, which are: (i) demonstrating to patients the role of self-focused attention, safety behaviors, and excessively negative self-impressions in maintaining social phobia and (ii) reducing the symptoms of social phobia.

J Anxiety Disord. 2009 May;23(4):496-503. McManus F, Clark DM, Grey N, Wild J, Hirsch C, Fennell M, Hackmann A, Waddington L, Liness S, Manley J. University of Oxford, Department of Psychiatry & Oxford Cognitive Therapy Centre, Warneford Hospital, Oxford OX3 7JX, UK. freda.mcmanus@psych.ox.ac.uk

Bonnie Miller, CHt



Bonnie Miller is a Certified Clinical Hypnotherapist holding the position of Director of Clinical Hypnotherapy with Methodist Health System Foundation, Inc., in Louisiana. In 2004, she was awarded Life Fellow with the International Medical and Dental Hypnotherapy Association. An active member of the Louisiana Hypnotherapy Organization and the International Association of Counselors and Therapists. She uses her hypnosis experience to spread the benefits of hypnosis and integrate those benefits to all areas of the community.

Hypnosis for complex trauma survivors: four case studies.



This report described a phased-oriented treatment of complex trauma in four Chinese women. Two women were survivors of childhood sexual abuse, one was a rape victim, and the other was a battered spouse. A phased-oriented treatment that tailored to the needs of the clients was used. The treatment framework consisted of three phases: stabilization, trauma processing, and integration. Hypnotic techniques had been used in these phases as means for grounding and stabilization, for accessing the traumatic memories, and for consolidating the gains. Data from self-reports, observation and objective measures indicates a significant reduction in the trauma symptoms after treatment.

Am J Clin Hypn. 2009 Jan;51(3):263-71. Poon MW. Clinical Psychological Unit 3, Social Welfare Department, 14/F Cornwall House, Taikoo Place, 979 King's Road, Quarry Bay, Hong Kong. maggie@cuhk.edu.hk

Fear of heights: cognitive performance and postural control.



Fear of heights, or acrophobia, is one of the most frequent subtypes of specific phobia frequently associated to depression and other anxiety disorders. Previous evidence suggests a correlation between acrophobia and abnormalities in balance control, particularly involving the use of visual information to keep postural stability. This study investigates the hypotheses that (1) abnormalities in balance control are more frequent in individuals with acrophobia even when not exposed to heights, that (2) acrophobic symptoms are associated to abnormalities in visual perception of movement; and that (3) individuals with acrophobia are more sensitive to balance-cognition interactions. METHOD: Thirty-one individuals with specific phobia of heights and thirty one non-phobic controls were compared using dynamic posturography and a manual tracking task. RESULTS: Acrophobics had poorer performance in both tasks, especially when carried out simultaneously. Previously described interference between posture control and cognitive activity seems to play a major role in these individuals. DISCUSSION: The presence of physiologic abnormalities is compatible with the hypothesis of a non-associative acquisition of fear of heights, i.e., not associated to previous traumatic events or other learning experiences. Clinically, this preliminary study corroborates the hypothesis that vestibular physical therapy can be particularly useful in treating individuals with fear of heights.

Eur Arch Psychiatry Clin Neurosci. 2009 Mar;259(2):114-9. Epub 2008 Sep 19. Boffino CC, de Sá CS, Gorenstein C, Brown RG, Basile LF, Ramos RT. Institute of Psychiatry and Division of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil.

How to select a chiropractor for the management of athletic conditions.



Chiropractors are an integral part of the management of musculoskeletal injuries. A considerable communication gap between the chiropractic and medical professions exists. Subsequently referring allopathic practitioners lack confidence in picking a chiropractic practitioner with appropriate management strategies to adequately resolve sporting injuries. Subsequently, the question is often raised: "how do you find a good chiropractor?". DISCUSSION: Best practice guidelines are increasingly suggesting that musculoskeletal injuries should be managed with multimodal active and passive care strategies. Broadly speaking chiropractors may be subdivided into "modern multimodal" or "classical" (unimodal) in nature. The modern multimodal practitioner is better suited to managing sporting injuries by incorporating passive and active care management strategies to address three important phases of care in the continuum of injury from the acute inflammation/pain phase to the chronic/rehabilitation phase to the injury prevention phase. In contrast, the unimodal, manipulation only and typically spine only approach of the classical practitioner seems less suited to the challenges of the injured athlete. Identifying what part of the philosophical management spectrum a chiropractor falls is important as it is clearly not easily evident in most published material such as Yellow Pages advertisements. SUMMARY: Identifying a chiropractic practitioner who uses multimodal treatment of adequate duration, who incorporates active and passive components of therapy including exercise prescription whilst using medical terminology and diagnosis without mandatory x-rays or predetermined treatment schedules or prepaid contracts of care will likely result in selection of a chiropractor with the approach and philosophy suited to appropriately managing athletic conditions. Sporting organizations and associations should consider using similar criteria as a minimum standard to allow participation in health care team selections.

Chiropr Osteopat. 2009 Mar 10;17:3. Hoskins W, Pollard H, Garbutt P. Macquarie Injury Management Group, Department of Health & Chiropractic, Macquarie University, Sydney, NSW 2109, Australia. waynehoskins@iinet.com.au.

How to get rid of a *MIGRAINE* Headache using EFT Technique



Meditation, mindfulness and cognitive flexibility.



This study investigated the link between meditation, self-reported mindfulness and cognitive flexibility as well as other attentional functions. It compared a group of meditators experienced in mindfulness meditation with a meditation-naïve control group on measures of Stroop interference and the "d2-concentration and endurance test". Overall the results suggest that attentional performance and cognitive flexibility are positively related to meditation practice and levels of mindfulness. Meditators performed significantly better than non-meditators on all measures of attention. Furthermore, self-reported mindfulness was higher in meditators than non-meditators and correlations with all attention measures were of moderate to high strength. This pattern of results suggests that mindfulness is intimately linked to improvements of attentional functions and cognitive flexibility. The relevance of these findings for mental balance and well-being are discussed.

Conscious Cogn. 2009 Mar;18(1):176-86. Moore A, Malinowski P. Liverpool John Moores University, School of Psychology, Liverpool, United Kingdom.

The Effects of Therapeutic Touch on Pain.



To better understand how Therapeutic Touch can be used in today's health care arena, this integrative literature review will examine current research that will help answer the question, Does Therapeutic Touch reduce pain? Method: An extensive search was conducted of the online databases MEDLINE, CINAHL, Cochrane Library, EMBASE, PsychLIT, and PubMed to retrieve research articles published from 1997 to 2007. Findings: Seven studies that were conducted between 1997 and 2004 were found and only five of the seven were included as pertinent evidence to answer the question. All of the research that was reviewed to answer whether Therapeutic Touch could significantly reduce pain revealed a majority of statistically significant positive results for implementing this intervention. Conclusion: Because there are no identified risks to Therapeutic Touch as a pain relief measure, it is safe to recommend despite the limitations of current research. Implications: Therapeutic Touch should be considered among the many possible nursing interventions for the treatment of pain.

J Holist Nurs. 2009 Mar 19. Monroe CM.

Hypnotherapy as an adjuvant for the management of inflammatory bowel disease: a case report.



Idiopathic inflammatory bowel diseases (IBDs) significantly affect the quality of life of sufferers. Improved quality of life and patient symptom management may be achieved through integrating psychological/behavioral interventions with pharmacologic treatments. Here is our experience with hypnotherapy as an adjuvant management for an 18-year-old female with Crohn's Disease (CD) in remission (patient I) and a 24-year-old female with CD in active phase (patient II). The patients participated in 12 weekly one-hour sessions of hypnotherapy. Gut-directed, ego-strengthening, and post-hypnotic suggestions and immune-directed imaginations were used. After the hypnotherapy course, symptoms, psychological state, and quality of life improved in patient I, but not patient II (according to questionnaires). After a 6 month follow-up, symptoms and quality of life were the same as at the end of hypnotherapy sessions in both patients. The patients reported the greatest benefit of hypnotherapy was in helping them to cope better with their disease and also in improving their psychological state. Hypnotherapy may improve quality of life of IBD patients in remission and help them to cope better with their disease. Well-designed controlled clinical trials are needed in this field.

Am J Clin Hypn. 2009 Jan;51(3):255-62. Emami MH, Gholamrezaei A, Daneshgar H. Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran.

A Randomized Controlled Trial of Massage Therapy in Children with Sickle Cell Disease.



This randomized controlled trial investigated the short-term effects of massage therapy on youth with SCD and their parents. METHODS: Thirty-four children and adolescents, and their parents were assigned to a massage therapy or an attention control group. Parents were trained in massage in their homes once a week for 4 weeks, with instructions to provide nightly massages. Families in the control group were visited weekly by a research assistant. Participants completed measures of depression and anxiety, functional status, pain intensity, medication use, and service utilization. RESULTS: Parents in the massage therapy group reported higher levels of depression and anxiety following the intervention. Youth in this group showed higher levels of functional status, and lower levels of depression, anxiety, and pain. Health service utilization rates were unchanged from pre- to post-intervention. CONCLUSIONS: These results offer preliminary support for parent-delivered massage therapy as an intervention for SCD pain.

J Pediatr Psychol. 2009 Mar 12. Lemanek KL, Ranalli M, Lukens C. Ohio State University College of Medicine and Children's Hospital of Philadelphia.

Designing clinical trials of homeopathy for menopausal symptoms: a review of the literature.



Homeopathy is a system of therapeutics placed outside the boundaries of orthodox medicine and regarded as a complementary and alternative medicine. Homeopathy has been used to alleviate menopausal symptoms both in the climacteric and in breast cancer survivors. Individualized treatment by a homeopath, regarded as the gold standard of homeopathic care, is a complex intervention where the homeopathic medicine is matched to the individual using holistic principles. This review article describes and interprets the existing evidence from observational studies and clinical trials and makes recommendations for trial design in the future.

Menopause Int. 2009 Mar;15(1):31-4. Thompson EA, Relton C. Bristol Homeopathic Hospital, Cotham Hill, Bristol, UK. Elizabeth.Thompson@UHBristol.nhs.uk

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