The three Ds of disease, disability, and discomfort negatively affect hospice patient's energy, intelligence, and organization. Music therapy is a studied, learned, credentialed behavioral intervention. It is specific, prescribed, and delivered therapeutically. At a time when trust and belief are compromised by the three Ds, the utilization of the complementary alternative medical intervention of music therapy, with its positive effect on social relationships, may enhance weakened trust and belief abilities. The research to date regarding music therapy presents positive results from studies and surveys of nurses, music therapists, families, and patients. Recommendations for using music therapy and music therapists will establish the use of this intervention, giving increased numbers to sample sizes for further study.

Nurs Econ. 2009 Jan-Feb;27(1):26-33, 60. Gifford EJ. Pathways Hospice, Oakland, CA, USA.

by Jeff Belyea, PhD

Research at Harvard Business School has concluded "meditation and intuition are the two most valuable executive tools for the 21st century".

Imagine a senior management team or a board of directors who are gathered together to make several important decisions. On the table are crucial matters that could change the course of corporate life, or even make the different between success and failure of the company.

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Sharon Esonis has spent three decades helping individuals thrive through her work as a licensed psychologist, life coach and author. An expert in human behavior and motivation, Dr. Esonis specializes in the field of Positive Psychology, the scientific study of optimal human functioning and the core strengths that can lead to the achievement of one's personally-defined goals. Her latest book is It's Your Little Red Wagon... Six Core Strengths For Navigating Your Path to the Good Life.

For more information visit www.PositivePathLifeCoaching.com.

by Coach Cary Bayer

Recently, while preparing for a road trip, I was packing jars of vitamins and happened to examine the minimum daily requirement labels on each one. It dawned on me that human beings also have minimum daily requirements for what I call "inner vitamins."

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To examine the influence of hypnotic suggestibility testing as a source of individual differences in hypnotic responsiveness, we compared behavioral and subjective responses on three scales of hypnotic suggestibility: The Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS: A; Shor, R. E., Orne, E. C. (1962). Harvard Group Scale of Hypnotic Susceptibility. Berlin: Consulting Psychologists Press); the Carleton University Responsiveness to Suggestion Scale (CURSS; Spanos, N. P., Radtke, H. L., Hodgins, D. C., Stam, H. J., Bertrand, L. D. (1983b). The Carleton University Responsiveness to Suggestion Scale: Normative data and psychometric properties. Psychological Reports, 53, 523-535); and the Group Scale of Hypnotic Ability (GSHA; Hawkins, R., Wenzel, L. (1999). The Group Scale of Hypnotic Ability and response booklet. Australian Journal of Clinical and Experimental Hypnosis, 27, 20-31). Behavioral and subjective responses to the CURSS were significantly different than those on the HGSHS: A and GSHA. More participants were classified as "low suggestible" on the CURSS and they reported subjective experiences more similar to everyday mentation. Attitudes and expectancies of participants who received the GSHA were less predictive of responding, but rates of responding and subjective experiences were similar on the GSHA and the HGSHS: A. Discussion focuses on implications for the use of group hypnotic suggestibility scales.

Conscious Cogn. 2009 Mar;18(1):255-65. Epub 2008 Sep 7. Barnes SM, Lynn SJ, Pekala RJ. Psychology Department, Binghamton University, SUNY Binghamton, Binghamton, NY 13905, USA. sbarnes1@binghamton.edu

OBJECTIVE: The objective of this review is to evaluate the evidence on the effects of Spinal Manipulative Therapy (SMT) on back pain and other related symptoms during pregnancy. DATA SOURCES: A literature search was conducted using Pubmed, Manual, Alternative and Natural Therapy Index System, Cumulated Index to Nursing and Allied Health, Index to Chiropractic Literature, the Cochrane Library, and Google Scholar. In addition hand searches and reference tracking were also performed, and the citation list was assessed for comprehensiveness by content experts. METHODS OF STUDY SELECTION: This review was limited to peer-reviewed manuscripts published in English from 1966 until September 2008. The initial search strategy yielded 140 citations of which 12 studies were reviewed for quality. TABULATION, INTEGRATION, AND RESULTS: The methodological quality of the included studies was assessed independently using quality checklists of the Scottish Intercollegiate Guidelines Network and Council on Chiropractic Guidelines and Practice Parameters. The review indicates that the use of SMT during pregnancy to reduce back pain and other related symptoms is supported by limited evidence. CONCLUSION: Overall, this body of evidence is best described as emergent. However, since effective treatments for pregnancy-related back pain are limited, clinicians may want to consider SMT as a treatment option, if no contraindications are present. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians LEARNING OBJECTIVES: After completion of this article, the reader should be able to describe the concepts of spinal manipulative therapy and types of symptoms for which it might be considered in pregnancy, explain the quality of available research on the use of spinal manipulative therapy, and plan to discuss this therapy with interested pregnant patients.

Obstet Gynecol Surv. 2009 Jun;64(6):416-27. Khorsan R, Hawk C, Lisi AJ, Kizhakkeveettil A. Military Medical Research and Integrative Medicine, Samueli Institute, Corona del Mar, California 92625, USA. rkhorsan@siib.org

A recent published model described the phenomenon of a global panic reaction (GPR) on the stock markets based on two remarkable stock market crashes in the months of January and March [Sperling W, Bleich S, Reulbach U, Black Monday on stock markets throughout the world - a new phenomenon of collective panic disorder? A psychiatric approach. Med Hypotheses; 2008]. This model was completed by a therapeutic approach following typical elements of cognitive behavioural therapy (CBT) [Sperling W, Biermann T, Maler JM, Global panic reaction - a therapeutic approach to a world-wide economic crisis. Med Hypotheses; 2009]. The phenomenon of a global panic reaction due to economic crises seems to have even larger implications on human health as well. It is well known that acute and chronic distress is competent to suppress the immune system by various mechanisms that are discussed in detail. This global panic reaction - that has also been observed in former times - might therefore be responsible for the new variation of recent influenza pandemic coming from Mexico.

Med Hypotheses. 2009 Jun 8. Sperling W, Biermann T. Department of Psychiatry and Psychotherapy, University Hospital of Erlangen, Schwabachanlage 6, D-91054 Erlangen, Germany.

by Robert DeMaria DC, DABCO, FASBE, NHD

We live in a day and age where everything from food preparation to treatment of health conditions is expected to be fast, extremely fast. The consumer is subliminally manipulated by the pharmaceutical and food manufacturers with a mind set that sickness is common, and you deserve to reward yourself with food.

The food designed today has been formulated to compliment the current research on health conditions that are destroying us; ironically the food being produced is actually the cause of most health ailments. The most blatant example of this is hydrogenated fat; or Trans fat was suppose to be good for heart function.

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BACKGROUND: Individual counselling, pharmacotherapy, and group therapy are evidence-based interventions that help patients stop smoking. Acupuncture, hypnosis, and relaxation have no demonstrated efficacy on smoking cessation, whereas self-help material may only have a small benefit. The purpose of this study is to assess physicians' current clinical practice regarding smokers motivated to stop smoking. METHODS: The survey included 3385 Swiss primary care physicians. Self-reported use of nine smoking cessation interventions was scored. One point was given for each positive answer about practicing interventions with demonstrated efficacy, i.e. nicotine replacement therapy, bupropion, counselling, group therapy, and smoking cessation specialist. No points were given for the recommendation of acupuncture, hypnosis, relaxation, and self-help material. Multivariable logistic analysis was performed to identify factors associated with a good practice score, defined as >or= 2. RESULTS: The response rate was 55%. Respondents were predominately over the age of 40 years (88%), male (79%), and resided in urban areas (74%). Seventeen percent reported being smokers. Most of the physicians prescribed nicotine replacement therapy (84%), bupropion (65%), or provided counselling (70%). A minority of physicians recommended acupuncture (26%), hypnosis (8%), relaxation (7%), or self-help material (24%). A good practice score was obtained by 85% of respondents. Having attended a smoking cessation-training program was the only significant predictor of a good practice score (odds ratio: 6.24, 95% CI 1.95-20.04). CONCLUSION: The majority of respondents practice recommended smoking cessation interventions. However, there is room for improvement and implementing an evidence-based smoking cessation-training program could provide additional benefit.

BMC Fam Pract. 2009 Mar 25;10:22. Jacot Sadowski I, Ruffieux C, Cornuz J. Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland. Isabelle.Jacot-Sadowski@chuv.ch

by Gary de Rodriquez

Greetings

I've been sitting here at my computer thinking about what I can write that will be meaningful for people at this intense time in our history. I have received so many calls and e-mails about the chaos that is currently surrounding many of our lives. It is as if life has accelerated at an alarming rate, leaving us confused and exhausted.

I know that in my own personal life there have been many people very close to me that have experienced unpredictable catastrophes, resulting in their lives being completely changed overnight. Is it possible that the current chaos that we are experiencing is a result of not accepting the gifts that life chooses to give us?

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INTRODUCTION: Interfacility ground critical care transport (CCT) of patients by ambulance may be stressful. This study evaluated whether playing music during CCT reduces patient anxiety and whether objective evidence is manifested by a change in vital signs. SETTING: Urban teaching hospital. METHODS: In this prospective cohort study, music was played for eligible adult patients during CCT while recording vital signs. A questionnaire was subsequently mailed to patients to rate whether the ambulance transport was stressful, the impact music had on transport, whether music changed their anxiety, whether music made them comfortable and relaxed, and whether they would prefer music to be played on future transports. Vital signs were compared between respondents who perceived transport as stressful and those who did not. RESULTS: One hundred two patients were enrolled; 23 respondents (22.5%) constituted the study group. Four patients (17.4%) reported CCT as stressful (average response, 4.75). Nineteen (82.6%) rated CCT as not stressful (average response, 1.63). Subjectively, patients reported a positive impact of music on transport, with improved comfort and relaxation but only a minimal decrease in anxiety. No statistically significant change in vital signs was observed between cohorts; too few patients were enrolled to generate power to detect any difference. CONCLUSIONS: Music therapy is a simple adjunct for use during CCT that may increase patient comfort and alleviate anxiety. The small number of patients in this preliminary report limits the strength of any conclusions. Larger studies are needed

Air Med J. 2009 Mar-Apr;28(2):88-91. Stuhlmiller DF, Lamba S, Rooney M, Chait S, Dolan B. New York Medical College, Valhalla, NY 10595, USA. stuhlmillerd@emamd.com

Background: Mindfulness-Based Cognitive Therapy (MBCT) is a promising approach to help people who suffer recurrent depression prevent depressive relapse. However, little is known about how MBCT works. Moreover, participants' subjective experiences of MBCT as a relapse prevention treatment remain largely unstudied. Aim: This study examines participants' representations of their experience of MBCT and its value as a relapse-prevention program for recurrent depression. Method: Twenty people who had participated in MBCT classes for recurrent depression within a primary care setting were interviewed 12 months after treatment. The focus of the interview was on participants' reflections on what they found helpful, meaningful and difficult about MBCT as a relapse prevention program. Thematic analysis was used to identify the key patterns and elements in participants' accounts. Results and conclusions: Four overarching themes were extracted: control, acceptance, relationships and struggle. The theoretical, clinical and research implications are discussed.

Behav Cogn Psychother. 2009 Jun 10:1-18. Allen M, Bromley A, Kuyken W, Sonnenberg SJ. University of Exeter, UK.

Lilia has been a Critical Care RN for more than 20 years working primarily in Coronary Care Unit in one of New York's busiest city hospitals. As an RN working in New York for many years, she worked in both city and private hospitals.

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by Robert Puff, PhD

What does peace of mind mean to you? Perhaps you feel that if you could land a high-power job; earn your college degree; find the perfect mate; get married and have children; retire with plenty of money in the bank; or...well, you fill in the blank. Then you could enjoy self-satisfaction and, ultimately, peace of mind.

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Venepuncture for blood sampling can be a distressing experience for a considerable number of children. A prospective controlled trial was conducted to compare the efficacy of a local anaesthetic (EMLA) with a combination of EMLA with self-hypnosis in the relief of venepuncture-induced pain and anxiety in 45 paediatric cancer outpatients (age 6-16years). A secondary aim of the trial was to test whether the intervention will have a beneficial effect on parents' anxiety levels during their child's procedure. Patients were randomized to one of three groups: local anaesthetic, local anaesthetic plus hypnosis, and local anaesthetic plus attention. Results confirmed that patients in the local anaesthetic plus hypnosis group reported less anticipatory anxiety, and less procedure-related pain and anxiety, and were rated as demonstrating less behavioural distress during the procedure than patients in the other two groups. Parents whose children were randomized to the local anaesthetic plus hypnosis condition experienced less anxiety during their child's procedure than parents whose children had been randomized to the other two conditions. The therapeutic benefit of the brief hypnotic intervention was maintained in the follow-up. The present findings are particularly important in that this study was a randomized, controlled trial conducted in a naturalistic medical setting. In this context, convergence of subjective and objective outcomes was reached with large effect sizes that were consistently supportive of the beneficial effects of self-hypnosis, an intervention that can be easily taught to children, is noninvasive and poses minimal risk to young patients and their parents.

Pain. 2009 Apr;142(3):255-63. Liossi C, White P, Hatira P. School of Psychology, University of Southampton, Highfield, Southampton S017 1BJ, UK. cliossi@soton.ac.uk

by Jeff Belyea, PhD

Golf is a mind game. Two or three good shots in a row and your mind starts entertaining a round in the low 80s or better. The pro tour, the senior tour, admiration from all your friends, golf buddies and family, and all the money in the world seem within your grasp. But then the next shot goes into the woods and your dreams go pop, pop, pop. You're back to reality.

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Acupuncture-induced sensations have historically been associated with clinical efficacy. These sensations are atypical, arising from sub-dermal receptors, and their neural encoding is not well known. In this fMRI study, subjects were stimulated at acupoint PC-6, while rating sensation with a custom-built, MR-compatible potentiometer. Separate runs included real (ACUP) and sham (SHAM) acupuncture, the latter characterized by non-insertive, cutaneous stimulation. FMRI data analysis was guided by the on-line rating timeseries, thereby localizing brain correlates of acupuncture sensation. Sensation ratings correlated with stimulation more (p<0.001) for SHAM (r=0.63) than for ACUP (r=0.32). ACUP induced stronger and more varied sensations with significant persistence into no-stimulation blocks, leading to more runtime spent rating low and moderate sensations compared to SHAM. ACUP sensation correlated with activation in regions associated with sensorimotor (SII, insula) and cognitive (dorsomedial prefrontal cortex (dmPFC)) processing, and deactivation in default-mode network (DMN) regions (posterior cingulate, precuneus). Compared to SHAM, ACUP yielded greater activity in both anterior and posterior dmPFC and dlPFC. In contrast, SHAM produced greater activation in sensorimotor (SI, SII, insula) and greater deactivation in DMN regions. Thus, brain encoding of ACUP sensation (more persistent and varied, leading to increased cognitive load) demonstrated greater activity in both cognitive/evaluative (posterior dmPFC) and emotional/interoceptive (anterior dmPFC) cortical regions. Increased cognitive load and dmPFC activity may be a salient component of acupuncture analgesia - sensations focus attention and accentuate bodily awareness, contributing to enhanced top-down modulation of any nociceptive afference and central pain networks. Hence, acupuncture may function as a somatosensory-guided mind-body therapy.

Neuroimage. 2009 Jun 2. Napadow V, Dhond RP, Kim J, Lacount L, Vangel M, Harris RE, Kettner N, Park K. MGH/HMS/MIT Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 Thirteenth St. #2301, Charlestown, Boston, MA 02129; Department of Radiology, Logan College of Chiropractic, Chesterfield, MO.

by Paul G. Durbin Retired Director of Clinical Hypnotherapy, Methodist Hospital, New Orleans, LA

Paradoxical Intension: It is commonly observed that anxiety often produces precisely what the patient fears. Frankl calls this "anticipatory anxiety". For instance, in cases of insomnia, the patient reports that she has trouble going to sleep. The fear of not going to sleep only adds to the difficulty of trying to go to sleep. Many sexual problems may be traced back to the forced intention of attaining the goal of sexual intercourse: as in the male seeking to prove his potency or the female her ability to experience orgasm. It seems that anticipatory anxiety causes precisely what the patient fears.

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The "false-hope syndrome" suggests that unrealistic expectations are responsible for the cycle of repeated failure and renewed efforts at self-change characterizing many self-changers. Our hypotheses were that: (1) committing to a particular self-change task would inflate initial expectations, (2) participants would be unsuccessful relative to their expectations, and (3) more elevated expectations would lead to more negative outcomes. Participants were randomly assigned to either increase their physical activity or reduce their stress through meditating or were assigned to a no-change control group. In accordance with Hypotheses 1 and 2, exercise participants had more positive expectations about their resolutions immediately after committing to them, and both exercise and meditation participants were unsuccessful relative to their expectations. With respect to Hypothesis 3, however, having more positive expectations about one's resolution did not predict a worse outcome.

Behav Ther. 2009 Jun;40(2):164-70. Trottier K, Polivy J, Herman CP. University Health Network, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. kathryn.trottier@uhn.on.ca

By Ralph McCutcheon ND DO BAc

As a young naturopath and osteopath in the early 1970's, I was pretty impressed with the results of these therapies compared with the medicine of the day. They had firm philosophical backgrounds and I felt that they provided a truly holistic approach to patients health. Thanks to my optimistic nature, and strong will, even my greenhorn skills seemed to work well, and patients got better. Looking back, it was because we reached the point where the patient made their own significant choice to choose to be healed, as much as anything I 'did'.

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Background: Utero-vaginal agenesis, also called the Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH), is a congenital abnormality of the female genital tract, characterized by the non-formation of the vagina and the uterus. It is a common cause of primary amenorrhoea. Little is known about the psychological impact and management of this condition. Method: We describe a specific model of the core negative psychological impact of diagnosis and medical treatment of MRKH and a cognitive-behavioural therapy of MRKH based on the model (CBT-MRKH). The Medical Research Council's (2002) framework for the development and evaluation of complex health interventions was used for intervention development and evaluation. Results: Evidence from a recent cross-sectional study and a small randomized controlled trial (RCT) provides preliminary support for the model and treatment (Heller-Boersma, Schmidt and Edmonds, in press; Heller-Boersma, Schmidt and Edmonds, 2007), and this is further validated by extensive qualitative material gathered over the course of the RCT from participants. Conclusions: The model and treatment described may also be applicable to a number of other congenital or acquired gynaecological conditions such as premature ovarian failure, breast cancer, early onset endometrial cancer, female genital mutilation, Turner's Syndrome, ovarian dys/agenesis or, Complete Androgen Insensitivity Syndrome, all of which have a psychological impact not dissimilar to MRKH in terms of these women's sense of self and femininity.

Behav Cogn Psychother. 2009 Jun 10:1-19. Heller-Boersma JG, Edmonds DK, Schmidt UH. Queen Charlotte's and Chelsea Hospital and City University, London, UK.

GOALS OF WORK: Scant attention focuses on supporting parent-child communication during the parents' cancer hospitalizations. Parents may struggle to remain emotionally available. Caregiver absences may threaten secure attachment relationships with infants and elicit problems amongst older children. Music therapists help many parents with cancer to compose songs for their children. Their lyric analysis may provide insight into song writing's communicative and therapeutic potential. MATERIALS AND METHODS: Two song lyric groups were comparatively analyzed (based on grounded theory). One group included 19 songs written by 12 patients with the first author. Another included 16 songs written by 15 patients with three music therapists (including two authors), which were previously published or recorded for the public. Songs were composed by 20 mothers and seven fathers for at least 46 offspring. All parents had hematological or metastatic diseases. Qualitative inter-rater reliability was integrated. MAIN RESULTS: Comparable lyrical ideas in the two parent song groups included: love; memories; yearning for children; metaphysical presence (now and afterlife); loss and grief; the meaning and helpfulness of the children in their lives; hopes for and compliments about their children; encouragement; requests; personal reflections; existential beliefs; and suggestions about to whom the children can turn. CONCLUSIONS: Parents' song lyric messages may support their children during the parents' illnesses and through the children's developmental transitions and possible bereavement. Some parents use song writing for catharsis and to encourage their children's continuing attachment with them after death. Through promoting parent-child connectedness and emotional expression, therapeutic song writing can be a valuable oncologic supportive care modality.

Support Care Cancer. 2008 Dec 17. O'Callaghan C, O'Brien E, Magill L, Ballinger E. Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett Street, Melbourne, VIC, 8006, Australia, clare.ocallaghan@petermac.org.

by Val Gokenbach DM, RN, MBA

Introduction
When we hear the word rhythm, most of us think of a great song with a great beat that makes us feel good when we listen to it. Born to be Wild by Steppenwolf comes to mind for me, especially with the volume turned up! It is however, this simple example that highlights the effect a rhythm can have on the human body. Outcomes of various rhythmic patterns can have a profound effect on the mind, body and personal success far more profound than the beat of a song. This article will explore the notion of rhythm and the effects, both positive and negative on the body and personal success. Strategies to improve these rhythms will also be included.

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by Tim Brunson, PhD

There is a tremendous amount of scientific research within the published literature indicating that remarkable hidden potentials exist within the neuro-physiology of a typical human being. Noteworthy conclusions are easily derived by reviewing projects regarding mental pathologies – such as autism, the savant syndrome (i.e. idiot savant), and stroke recovery – the constant record-breaking athletic performance in competitions like the Olympics, and stories regarding ordinary people performing extraordinary feats under life-threatening stress. It is very obvious to even the most casual observer that there is much more to the human experience than we would like to admit. These potentials lie dormant within each and every human. Yet despite the propensity to resist change, social conditioning, and a tendency toward mediocrity, there is a yearning for greatness (or at least for a unique quality). Meanwhile, individuals and entire social systems insist on suppressing – and even frequently crucifying – those whom they feel deviate from the bland and normal. Nevertheless, in addition to the numerous clues found in mainstream research literature, there is a wealth of evidence of a desire for extra-ordinary human potential and desire for change in the pop culture as well.

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Breast cancer radiotherapy can be an emotionally difficult experience. Despite this, few studies have examined the effectiveness of psychological interventions to reduce negative affect, and none to date have explicitly examined interventions to improve positive affect among breast cancer radiotherapy patients. The present study examined the effectiveness of a multimodal psychotherapeutic approach, combining cognitive-behavioral therapy and hypnosis (CBTH), to reduce negative affect and increase positive affect in 40 women undergoing breast cancer radiotherapy. Participants were randomly assigned to receive either CBTH or standard care. Participants completed weekly self-report measures of positive and negative affect. Repeated and univariate analyses of variance revealed that the CBTH approach reduced levels of negative affect [F(1, 38)=13.49; p=.0007, omega(2)=.56], and increased levels of positive affect [F(1, 38)=9.67; p=.0035, omega(2)=.48], during the course of radiotherapy. Additionally, relative to the control group, the CBTH group demonstrated significantly more intense positive affect [F(1, 38)=7.09; p=.0113, d=.71] and significantly less intense negative affect [F(1, 38)=10.30; p=.0027, d=.90] during radiotherapy. The CBTH group also had a significantly higher frequency of days where positive affect was greater than negative affect (85% of days assessed for the CBTH group versus 43% of the Control group) [F(1, 38)=18.16; p=.0001, d=1.16]. Therefore, the CBTH intervention has the potential to improve the affective experience of women undergoing breast cancer radiotherapy.

J Clin Psychol. 2009 Apr;65(4):443-55. Schnur JB, David D, Kangas M, Green S, Bovbjerg DH, Montgomery GH. Department of Oncological Sciences, Mount Sinai School of Medicine, New York, New York 10029-6574, USA. julie.schnur@mssm.edu

Complementary and alternative medicine (CAM) is a diverse group of health care practices and products that fall outside the realm of traditional Western medical theory and practice and that are used to complement or replace conventional medical therapies. The use of CAM has increased over the past two decades, and surveys have shown that up to 44% of patients with epilepsy are using some form of CAM treatment. This article reviews the CAM modalities of meditation, yoga, relaxation techniques, biofeedback, nutritional and herbal supplements, dietary measures, chiropractic care, acupuncture, Reiki, and homeopathy and what is known about their potential efficacy in patients with epilepsy.

Curr Neurol Neurosci Rep. 2009 Jul;9(4):313-8. McElroy-Cox C. Columbia Comprehensive Epilepsy Center, Columbia University, Neurologic Institute, New York, NY 10032, USA. cam18@columbia.edu

Clinical biofeedback procedures are highly effective ameliorating a variety of symptoms that range from urinary incontinence to hypertension as well as assess a person's somatic awareness by making the invisible visible. The paper reviews the biofeedback process and some psychosomatic applications. Psychosomatic patients often demand more skills than just attaching them to the equipment. Successful treatment includes a) assessing physiology as a diagnostic strategy, b) explaining the illness processes and healing strategies that are congruent with patients' perspective, c) reframing the patients' illness beliefs, and d) psychophysiological training with homework practices to generalize the skills. This process is illustrated through the description of a single session with a patient who experienced severe gastrointestinal distress and insomnia.

Peper, E., Harvey, R., & Takebayashi, N. (2009). Biofeedback an evidence based approach in clinical practice. Japanese Journal of Biofeedback Research, 36(1), 3-10.

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by Joe Rubino, PhD

In our daily lives as well as in our businesses, we typically operate from the perspective of doing the best we know how to do in dealing with life's

challenges and opportunities. If we knew what it would take to be more effective in our relationships, more productive in our activities or more successful in reaching our goals, we would surely alter our behavior to correspond with these insights. The only access we ordinarily have to impact our lives comes from the areas of "what we know" and "what we don't know."

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OBJECTIVE: Cognitive changes are highly prevalent in multiple sclerosis (MS) however evidence-based research on cognitive rehabilitation programs for this population is only beginning to emerge. This article presents results from a process evaluation of a group-based, self-management cognitive intervention program developed specifically for people with MS. METHODS: Quantitative and qualitative data were collected using focus group interviews, facilitator reflection notes, and program evaluations. The data were used to identify the strengths and limitations of the program and to document recommendations for future development. Forty-one individuals met eligibility criteria and were enrolled in the program. RESULTS: Overall, participants reported that the program had a positive impact on their ability to manage cognitive symptoms. Program components that contributed to successful application of cognitive management strategies included increasing participant's knowledge of cognitive changes, problem-solving through cognitive challenges, practicing strategies through homework assignments, and conducting the program in a group format. Participants recommended that caregivers be included in future programs. CONCLUSION: Both content and structural components of the program facilitated participants' ability to manage cognitive changes and contributed to behavior changes made by the participants. PRACTICE IMPLICATIONS: This study points to the benefits of incorporating self-management programs into the cognitive rehabilitation process in MS.

Patient Educ Couns. 2009 Jul;76(1):77-83. Shevil E, Finlayson M. Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Ramat Aviv, Tel Aviv 69978, Israel.

by Sharon S. Esonis, PhD

It's hard to emphasize strongly enough the importance of breathing in your quest to manage the stress response and take control of your life. You have a choice: deep abdominal breathing or shallow chest breathing. The diaphragm, which is under the lungs and just above the abdomen, is the most efficient breathing muscle and is connected to the relaxed nervous system, also known as the parasympathetic nervous system (PNS). Deep, slow abdominal breathing promotes mental concentration, decreases body tension and anxiety, and provides a greater supply of oxygen to the brain. This article provides a practical, useful routine for learning diaphragmatic breathing that can be provided to patients and clients. At the end of the article is a link to an online audio exercise that I've used with many of my clients.

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James Braid's last manuscript on hypnotism, summarizing his mature views and lost since his death, existed only in French and German translations. The author discusses the history and importance of this document, "On Hypnotism" (1860), as well as his new English version, translated back from the French and German editions. Braid's manuscript constitutes an important, missing jigsaw piece in the early history of psychological therapy and helps to explain the origin of hypnotherapy and correct certain historical misconceptions that have developed concerning the meaning of the term hypnotism. The rediscovery of this text provides additional evidence that hypnotism originated as an explicitly empirical and "common sense" reaction against the pseudo-scientific excesses of mesmerism. Although drawing heavily on excerpts from his previous writings, some of Braid's observations and techniques may renew interest among contemporary researchers and clinicians.

Int J Clin Exp Hypn. 2009 Apr;57(2):127-32. Robertson D. HypnoSynthesisUK@aol.com

by Blanc Greenberg, ND

The molecules in the body are constantly recreating. We can clearly comprehend this when we analyze the organ of the skin and how the layers of cells are constantly in motion of reproduction and rejuvenation. Intellectually, though, we do not always apply this fundamental truth to the rest of the structure --specifically when it deals with illness and/or disharmony in the body or the mind.

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by Christy Witman

Do you believe that everything happens for a reason? Most people do, but struggle to find out the meaning behind it all. We observe what is happening and have a hard time understanding the big picture. Haven't you had the experience where you are going through something and you know that it is happening for a reason, but you can't figure out what the reason is? You let go, and then months later all the puzzle pieces fall into place and you then feel grateful that it all happened the way it did?

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Recently there has been a growth of interest in mindfulness-based psychotherapeutic approaches across a range of medical problems. Cardiac rehabilitation patients often suffer from stress, worry, anxiety and depression, all of which can lead to poor prognosis and worsening of cardiac symptoms. Using interpretive phenomenological analysis (IPA) of participant experiences, this study reports on the first known Mindfulness-based Cognitive Therapy group adapted for cardiac rehabilitation. Analysis identified the development of awareness, commitment, within group experiences, relating to the material and acceptance as central experiential themes. The use of the approach was supported for this population.

J Health Psychol. 2009 Jul;14(5):675-81. Griffiths K, Camic PM, Hutton JM. Oxleas NHS Foundation Trust, UK.

by Robert Puff, PhD

What Meditation Is
Simply put, meditation is sitting still and quieting your mind. It is the act of being totally present with "what is," without making mental commentary. When you meditate, you are in the most pristine, natural state of being. In other words, your mind is quiet and you are "just being." Think of meditating as the freedom to "just be." There's no pressure. There are no deadlines. And while there are a lot of different styles of meditation, there's really no right or wrong way to do it. You are simply in a calming, peaceful "state of being." I believe that when you are in this quiet state of mind, you are a human being, instead of a human doing...

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Dr. Robert DeMaria has been providing and championing alternative health solutions to thousands of patients globally for over thirty years. Realizing that the world needs a drugless "hero," Dr. Bob has answered the call by writing six books in the "Dr. Bob's Guide to Health" series. These books delve into Dr. Bob's expertise in the areas of ADHD, Female Hormones, and Sex and Relationships. Dr. Bob's keen intellect and "go-get'em" attitude has resulted in many TV and radio appearances, including regular segments on Cleveland Fox 8's "That's Life with Robin Swoboda", WFAN in New York City, and his own "Half-Hour to Health" television program which airs each Saturday in the Northern Ohio market. Dr. Bob's drugless approach emphasizes education, empowerment, and prevention, which are three qualities that our world needs most. Dr. Bob's mission is to provide answers to topics for which we all have questions.

For more information visit www.DruglessDoctor.com.

The authors developed a technique, which they call hypnotherapeutic olfactory conditioning (HOC), for exploiting the ability of scents to arouse potent emotional reactions. During hypnosis, the patient learns to associate pleasant scents with a sense of security and self-control. The patient can subsequently use this newfound association to overcome phobias and prevent panic attacks. This may be especially effective for posttraumatic stress disorder (PTSD) with episodes of anxiety, flashbacks, and dissociation triggered by smells. The authors present 3 cases, patients with needle phobia, panic disorder, and combat-induced PTSD who were successfully treated with the HOC technique.

Int J Clin Exp Hypn. 2009 Apr;57(2):184-97. Abramowitz EG, Lichtenberg P. Mental Health Division, Israel Defense Forces, Israel.

Full title: Intentions of Chiropractic Interns Regarding use of Health Promotion in Practice: Applying Theory of Reasoned Action to Identify Attitudes, Beliefs, and Influencing Factors.

PURPOSE: The theory of reasoned action is a health behavioral theory that has been used to predict personal health behaviors and intentions as well as those of providers delivering health care. The purpose of this study was to determine interns' future practices regarding the use of health promotion using this model to develop survey questions and to determine attitudes and perceived influences on their prospective behaviors in general, toward the use of health promotion once in practice. METHODS: Across the course of one year, all graduating interns at a chiropractic college were queried with a 20 question survey designed using the theory of reasoned action. Frequencies and inferential statistics were performed including prediction modeling using logistic regression. RESULTS: A majority (>85%) of interns indicated they would use health promotion in practice. Differences were noted based on perceived skill levels, perception of educational emphasis, various normative beliefs, and gender. CONCLUSION: Most interns will use some form of health promotion in practice. Normative influences including those seen as key influencers are as powerful a predictor as perceived education or skill levels on future practice of health promotion.

J Chiropr Educ. 2009 Spring;23(1):17-27. Evans MW, Ndetan H, Williams RD. Cleveland Chiropractic College.

by Paul G. Durbin Retired Director of Clinical Hypnotherapy, Methodist Hospital, New Orleans, LA

Viktor Frankl was one time Professor of Psychiatry at the University of Vienna Medical School and later taught at a number of schools in the United States. Frankl's first book in English was Man's Search for Meaning, which he wrote while in a Nazi prison during World War II. He spent three years in various Nazi prison camps and experienced incredible suffering and degradation, but through those experiences further developed his theory of Logotherapy. Dr. Frankl's "Logotherapy" has had a profound influence on my life and therapy.

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Five days of integrative body-mind training (IBMT) improves attention and self-regulation in comparison with the same amount of relaxation training. This paper explores the underlying mechanisms of this finding. We measured the physiological and brain changes at rest before, during, and after 5 days of IBMT and relaxation training. During and after training, the IBMT group showed significantly better physiological reactions in heart rate, respiratory amplitude and rate, and skin conductance response (SCR) than the relaxation control. Differences in heart rate variability (HRV) and EEG power suggested greater involvement of the autonomic nervous system (ANS) in the IBMT group during and after training. Imaging data demonstrated stronger subgenual and adjacent ventral anterior cingulate cortex (ACC) activity in the IBMT group. Frontal midline ACC theta was correlated with high-frequency HRV, suggesting control by the ACC over parasympathetic activity. These results indicate that after 5 days of training, the IBMT group shows better regulation of the ANS by a ventral midfrontal brain system than does the relaxation group. This changed state probably reflects training in the coordination of body and mind given in the IBMT but not in the control group. These results could be useful in the design of further specific interventions.

Proc Natl Acad Sci U S A. 2009 Jun 2;106(22):8865-70. Tang YY, Ma Y, Fan Y, Feng H, Wang J, Feng S, Lu Q, Hu B, Lin Y, Li J, Zhang Y, Wang Y, Zhou L, Fan M. Institute of Neuroinformatics and Laboratory for Body and Mind, Dalian University of Technology, Dalian 116024, China. yiyuan@uoregon.edu