OBJECTIVES: We aimed to determine the feasibility of conducting a randomised controlled trial (RCT) on the use of aromatherapy during labour as a care option that could improve maternal and neonatal outcomes. DESIGN: RCT comparing aromatherapy with standard care during labour. SETTING: District general maternity unit in Italy. SAMPLE: Two hundred and fifty-one women randomised to aromatherapy and 262 controls. METHODS: Participants randomly assigned to administration of selected essential oils during labour by midwives specifically trained in their use and modes of application. MAIN OUTCOME MEASURES: Intrapartum outcomes were the following: operative delivery, spontaneous delivery, first- and second-stage augmentation, pharmacological pain relief, artificial rupture of membranes, vaginal examinations, episiotomy, labour length, neonatal wellbeing (Apgar scores) and transfer to neonatal intensive care unit (NICU). RESULTS: There were no significant differences for the following outcomes: caesarean section (relative risk [RR] 0.99, 95% CI: 0.70-1.41), ventouse (RR 1.5, 95% CI: 0.31-7.62), Kristeller manoeuvre (RR 0.97, 95% CI: 0.64-1.48), spontaneous vaginal delivery (RR 0.99, 95% CI: 0.75-1.3), first-stage augmentation (RR 1.01, 95% CI: 0.83-1.4) and second-stage augmentation (RR 1.18, 95% CI: 0.82-1.7). Significantly more babies born to control participants were transferred to NICU, 0 versus 6 (2%), P = 0.017. Pain perception was reduced in aromatherapy group for nulliparae. The study, however, was underpowered. CONCLUSION: This study demonstrated that it is possible to undertake an RCT using aromatherapy as an intervention to examine a range of intrapartum outcomes, and it provides useful information for future sample size calculations.

BJOG. 2007 Jul;114(7):838-44. Epub 2007 May 16. Burns E, Zobbi V, Panzeri D, Oskrochi R, Regalia A. School of Health and Social Care, Oxford Brookes University, Oxford, UK. eburns@brookes.ac.uk

Leslie Bouché is a Certified Hypnotherapist and a Master of Therapeutic Imagery. She received her Diploma from the Hypnosis Motivation Institute in Tarzana, California, after a one-year intensive program, including a six-month internship. HMI was founded by Dr. John Kappas, a leader and legendary innovator in the field of hypnotherapy. It is the nation's leading accredited college of hypnotherapy.

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Full Title: Changes in resistance of the umbilical artery, foetal movements and short time variation through clinical hypnosis--preliminary results

BACKGROUND: The aim of this study was to determine whether there are any changes in short time variation (STV), foetal movements, and blood flow in the umbilical artery in the trance state. METHODS: Six pregnant patients who had already attended two hypnoreflexogenous birth preparation course units had a standardised hypnosis intervention under cardiotocography (CTG). Using the CTG-Player ((R)) STVs and foetal movements were calculated from the electronically saved CTG traces and evaluated against control CTGs recorded before and after hypnosis. Before and after the induction of hypnosis, blood flow in the umbilical artery was measured. RESULTS: Using the Wilcoxon test there is a significant lowering of blood flow resistance in the umbilical artery after hypnosis (p=0.042). There was a trend that the foetal movements increas at the beginning of the trance (Wilcoxon test, p=0.075). There was no significant difference in the STVs before, during and after trance. CONCLUSIONS: Preliminary results showed that blood flow of the umbilical artery can be improved by hypnosis. Further clinical studies are required to verify this hypothesis. The subjective impression of participants that foetal movements increase at the beginning of the trance seems to be correct.

Z Geburtshilfe Neonatol. 2009 Feb;213(1):23-6. Epub 2009 Mar 3. Reinhard J, Hüsken-Janssen H, Hatzmann H, Schiermeier S. Universität Witten/Herdecke, Frauenheilkunde, Marien Hospital Witten. J.Reinhard@Marien-Hospital-Witten.de

BACKGROUND: Music therapy in end-of-life care aims to improve a person's quality of life by helping relieve symptoms, addressing psychological needs, offering support, facilitating communication, and meeting spiritual needs. In addition, music therapists assist family and caregivers with coping, communication, and grief/bereavement. OBJECTIVES: To examine effects of music therapy with standard care versus standard care alone or standard care combined with other therapies on psychological, physiological, and social responses in end-of-life care. SEARCH STRATEGY: We searched CENTRAL, MEDLINE, CINAHL, EMBASE, PSYCINFO, LILACS, CancerLit, Science Citation Index, www.musictherapyworld.de, CAIRSS for Music, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, and the National Research Register to September 2009. We handsearched music therapy journals and reference lists, and contacted experts to identify unpublished manuscripts. There was no language restriction. SELECTION CRITERIA: We included all randomized and quasi-randomized controlled trials that compared music interventions and standard care with standard care alone or combined with other therapies in any care setting with a diagnosis of advanced life-limiting illness being treated with palliative intent and with a life expectancy of less than two years. DATA COLLECTION AND ANALYSIS: Data were extracted, and methodological quality was assessed, independently by review authors. Additional information was sought from study authors when necessary. Results are presented using weighted mean differences for outcomes measured by the same scale and standardized mean differences for outcomes measured by different scales. Posttest scores were used. In cases of statistically significant baseline difference, we used change scores. MAIN RESULTS: Five studies (175 participants) were included. There is insufficient evidence of high quality to support the effect of music therapy on quality of life of people in end-of-life care. Given the limited number of studies and small sample sizes, more research is needed.No strong evidence was found for the effect of music therapy on pain or anxiety.These results were based on two small studies. There were insufficient data to examine the effect of music therapy on other physical, psychological, or social outcomes. AUTHORS' CONCLUSIONS: A limited number of studies suggest there may be a benefit of music therapy on the quality of life of people in end-of-life care. However, the results stem from studies with a high risk of bias. More research is needed.

Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007169. Bradt J, Dileo C. The Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, Presser Hall, 2001 North 13 Street, Philadelphia, USA.

Full Title: Post WISC-R and TOVA improvement with QEEG guided neurofeedback training in mentally retarded: a clinical case series of behavioral problems

According to the DSM-IV, Mental Retardation is significantly sub-average general intellectual functioning accompanied by significant limitations in adaptive functioning in at least two of the following skill areas: communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health and safety. In pilot work, we have seen positive clinical effects of Neurofeedback (NF) applied to children with Trisomy 21 (Down Syndrome) and other forms of mental retardation. Given that many clinicians use NF in Attention Deficit Hyperactivity Disorder and Generalized Learning Disability cases, we studied the outcomes of a clinical case series using Quantitative EEG (QEEG) guided NF in the treatment of mental retardation. All 23 subjects received NF training. The QEEG data for most subjects had increased theta, alpha, and coherence abnormalities. A few showed increased delta over the cortex. Some of the subjects were very poor in reading and some had illegible handwriting, and most subjects had academic failures, impulsive behavior, and very poor attention, concentration, memory problems, and social skills. This case series shows the impact of QEEG-guided NF training on these clients' clinical outcomes. Fourteen out of 23 subjects formerly took medications without any improvement. Twenty-three subjects ranging from 7-16 years old attending private learning centers were previously diagnosed with mental retardation (severity of degree: from moderate to mild) at various university hospitals. Evaluation measures included QEEG analysis, WISC-R (Wechsler Intelligence Scale for Children-Revised) IQ test, TOVA (Test of Variables of Attention) test, and DPC-P (Developmental Behaviour Checklist) were filled out by the parents. NF trainings were performed by Lexicor Biolex software. NX-Link was the commercial software reference database used to target the treatment protocols, along with the clinical judgment of the first author. QEEG signals were sampled at 128 samples per second per channel and electrodes were placed according to the International 10-20 system. Between 80 and 160 NF training sessions were completed, depending on the case. None of the subjects received any special education during NF treatment. Two subjects with the etiology of epilepsy were taking medication, and the other 21 subjects were medication-free at the baseline. Twenty-two out of 23 patients who received NF training showed clinical improvement according to the DPC-P with QEEG reports. Nineteen out of 23 patients showed significant improvement on the WISC-R, and the TOVA. For the WISC-R test, 2 showed decline on total IQ due to the decline on some of the subtests, 2 showed no improvement on total IQ although improvement was seen on some of the subtests, however even these cases showed improvement on QEEG and DPC-P. This study provides the first evidence for positive effects of NF treatment in mental retardation. The results of this study encourage further research.

Clin EEG Neurosci. 2010 Jan;41(1):32-41. Surmeli T, Ertem A. Living Mental Healthy Center for Research and Education, Istanbul, Turkey. neuropsychiatry@yahoo.com

by Bernie Siegel, MD

Unfortunately doctors and health professionals, in general, do not study success. We are far more likely to consider an unexpected recovery to be due to the treatment or a spontaneous remission. However, I have learned from my experience with patients and by asking them, "Why didn't you die when you were supposed to?" that they always had a story to tell. I can recall, as an intern, realizing that the seniors, with hip fractures, who were noisy and demanding didn't develop pneumonia and die while the submissive, quiet seniors who never raised their voice or caused a problem had a much higher mortality rate.

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Full Title:A randomized controlled trial of the safety and promise of cognitive-behavioral therapy using imaginal exposure in patients with posttraumatic stress disorder resulting from cardiovascular illness

OBJECTIVE: We investigated the physical safety of cognitive-behavioral therapy (CBT) utilizing imaginal exposure in patients who suffered from posttraumatic stress disorder (PTSD) following a life-threatening cardiovascular event. METHOD: In this phase I, prospective, single-blind trial conducted from April 2006 through April 2008, we randomly assigned 60 patients to receive either 3 to 5 sessions of imaginal exposure therapy (experimental group) or 1 to 3 educational sessions only (control group). Criteria for PTSD and other mental health disorders were evaluated according to DSM-IV using the full Structured Clinical Interview for DSM-IV (SCID). Safety assessments included patients' blood pressure and pulse before and after each study session and the occurrence of deaths, hospitalizations, repeat myocardial infarctions, or invasive procedures. We also investigated the effects of the treatment on PTSD symptoms (Impact of Event Scale and Posttraumatic Stress Disorder Scale), depression (Beck Depression Inventory-II), and the Clinical Global Impressions-Severity of Illness (CGI-S) scale. RESULTS: There were no significant differences between the experimental and control groups and between exposure and nonexposure sessions in any of the safety measures. In addition, confidence intervals were such that the nonsignificant effects of exposure therapy were not of clinical concern. For example, the mean difference in systolic pressure between control and exposure sessions was 0.5 mm Hg (95% CI, -6.1 to 7.1 mm Hg). Nonsignificant improvements were found on all psychiatric measures in the experimental group, with a significant improvement in CGI-S in the entire cohort (mean score difference, -0.6; 95% CI, -1.1 to -0.1; P = .02) and a significant improvement in PTSD symptoms in a subgroup of patients with acute unscheduled cardiovascular events and high baseline PTSD symptoms (mean score difference, -1.2; 95% CI, -2.0 to -0.3; P = .01). CONCLUSIONS: Cognitive-behavioral therapy that includes imaginal exposure is safe and promising for the treatment of posttraumatic stress in patients with cardiovascular illnesses who are traumatized by their illness. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00364910. © Copyright 2010 Physicians Postgraduate Press, Inc.

Shemesh E, Annunziato RA, Weatherley BD, Cotter G, Feaganes JR, Santra M, Yehuda R, Rubinstein D. Division of Developmental and Behavioral Health, Department of Pediatrics, Box 1198, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA. eyal.shemesh@mssm.edu. J Clin Psychiatry. 2010 Apr 6.

To stop smoking with hypnosis, a process of regression therapy is the best way to address the core reason why the individual is smoking, which is the first step in ceasing the habit. Discover the power of hypnosis, which can help people stop smoking or even lose weight, with information from a certified hypnotist trainer in this free video on hypnotism.

BACKGROUND:: With continual improvements in screening uptake and adjuvant cancer treatments, the number of Canadian women surviving breast cancer continues to grow. Preliminary findings suggest yoga can improve quality of life (QoL) in breast cancer survivors, but few studies have focused on Iyengar yoga (IY). OBJECTIVE:: The purpose of this pilot study was to evaluate the impact of IY on QoL and psychosocial functioning in a select sample of breast cancer survivors. METHODS:: Breast cancer survivors (N = 24) participating in IY classes completed a questionnaire measuring generic and disease-specific QoL and psychosocial functioning, before and after the 12-week classes. RESULTS:: Postprogram questionnaires were completed by 17 participants (71%) who attended an average of 78.9% of the IY sessions. Several indicators of generic QoL improved significantly, including mental health (mean change, +4.2; P = .045), vitality (mean change, +4.9; P = .033), role-emotional (mean change, +6.4; P = .010), and bodily pain (mean change, +4.4; P = .024). Other improvements in QoL and psychosocial functioning were meaningful but were not statistically significant. Findings were further substantiated by participant's evaluation of the program's benefits and motivational value. CONCLUSION:: In this pilot study of breast cancer survivors participating in IY, we found improvements in QoL and psychosocial functioning. Moreover, positive program evaluation and motivational profile provide support for the acceptability of IY with breast cancer survivors. Randomized controlled trials comparing IY to usual care and other forms of yoga in breast cancer survivors are warranted. IMPLICATIONS FOR PRACTICE:: Nurses may consider IY as a possible intervention strategy to help breast cancer survivors improve their QoL and psychosocial functioning.

Cancer Nurs. 2010 May 12.Speed-Andrews AE, Stevinson C, Belanger LJ, Mirus JJ, Courneya KS. Author Affiliations: Faculty of Physical Education and Recreation, University of Alberta (Dr Speed-Andrews, Ms Belanger, and Dr Courneya), Edmonton, Canada; School of Sport, Exercise and Health Sciences, University of Loughborough, United Kingdom (Dr Stevinson); and Iyengar Yoga Association of Canada (Ms Mirus), Edmonton AB, Canada.

Yvonne Dolan M.A. conducts training in Solution-Focused and Ericksonian therapy throughout the U.S, Canada, Europe, South America and the Pacific Rim. In addition to Resolving Sexual Abuse: Solution-focused Therapy and Ericksonian Hypnosis for Survivors (W.W Norton), A Path With A Heart: Ericksonian Utilization with Resistant and Chronic Clients, One Small Step: Moving Beyond Trauma and Therapy To a Life of Joy, and numerous journal articles, she has recently co-authored Tales Of Solutions: A Collection Of Hope Inspiring Stories (with Insoo Kim Berg) and Miracles Happen: An Agency's Journey To Becoming Solution-focused, (with Terri Pichot). After a quarter of a century in the field she loves her work and it shines through in the following conversation. This conversation took place at the 2002 Brief Therapy Network Conference following Yvonne's first day presenting.

by Tim Brunson, PhD

In response to one of my recent articles, an esteemed colleague asked if I had previously read one of his articles. As I had not, upon doing so I discovered a phrase in which he stated that suggestions are what cause beliefs. Although the topic of suggestion was not the focus of his article and thus he refrained from expounding further, his statement led me to ponder the depth of meaning associated with the term "suggestion" and led to a realization that I had been using it purposefully but without much clarification. This needs to be rectified.

Clinicians frequently either use this word or skirt around it by referring to "expectancy bias", "placebo", or saying that some pathology is "all in the mind" of a client or patient. Yet, when use of any word by anyone with a self-perception as being educated is done so with imprecision and vulgarity, it most certainly becomes robbed of its utility and potential. As like imagination, suggestion is at the core of the hypnotherapeutic field, it is incumbent that among clinicians we must take the lead in clarifying the concept. Otherwise, we would be like a skilled surgeon who attempts to use a blunt screwdriver as a replacement for a scalpel.

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OBJECTIVE: To evaluate the clinical studies of acupuncture for treatment of depressive neurosis, collect the high quality evidence relative to clinical acupuncture practice for clinical decision-making reference. METHODS: Around crucial common questions of acupuncture clinical practice, the documents of clinical study were comprehensively retrieved. According to 5-grade criterion of evidence-based medicine, the evidence from high to low level were selected to answer corresponding clincal questions and RevMan 5.0.20 was used to analyze the final indicator. RESULTS: Nineteen documents of clinical study accord with the inclusive criterion were retrieved. Level-A evidence showed effectiveness of acupuncture. Acupuncture might be superior or equal to fluoxetine, with little adverse effect and high safety. Level-C evidence showed acupuncture might be superior or equal to Amitriptyline, with little adverse effect and high safety. And no relative clinicial evidence compared effect of acupuncture with that of psychotherapy or behavior therapy. Only one level-C evidence showed there was no effect difference between acupuncture combined with bloodletting therapy and bloodletting alone. Two level-C evidence showed the effect of acupuncture combined with western medicine was superior to that of medicine alone, eg. catgut embedding therapy combined with Fluoxetine, electroacupuncture combined with Seroxat. CONCLUSION: Acupuncture for depressive nerosis has a positive effect. Acupuncture has an equal effect compared with western medicine, while strictly designed equivalent and non-inferior studies are demanded. The effect of acupuncture combined with medicine has some advantage, but need high quality studies to verify.

Zhongguo Zhen Jiu. 2010 Mar;30(3):235-40. Xiong J, Du YH, Liu JL, Lin XM, Sun P, Xiao L, Gao X, Chen YW. Graduate School, Tianjin University of TCM, Tianjin 300193, China.

by Lorraine Pirihi

What are you focussing on achieving in your business in the next 90 days?

Do you have any idea? If you don't then you better come up with a goal or outcome otherwise you may find that another 3 months has passed you by and you're no further ahead than where you are right now.

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This meta-analysis evaluates the effect of hypnosis in reducing emotional distress associated with medical procedures. PsycINFO and PubMed were searched from their inception through February 2008. Randomized controlled trials of hypnosis interventions, administered in the context of clinical medical procedures, with a distress outcome, were included in the meta-analysis (26 of 61 papers initially reviewed). Information on sample size, study methodology, participant age and outcomes were abstracted independently by 2 authors using a standardized form. Disagreements were resolved by consensus. Effects from the 26 trials were based on 2342 participants. Results indicated an overall large effect size (ES) of 0.88 (95% CI = 0.57-1.19) in favour of hypnosis. Effect sizes differed significantly (p < 0.01) according to age (children benefitted to a greater extent than adults) and method of hypnosis delivery, but did not differ based on the control condition used (standard care vs. attention control).

Contemp Hypn. 2008 Aug 21;25(3-4):114-128. Schnur JB, Kafer I, Marcus C, Montgomery GH. Mount Sinai School of Medicine, New York, USA.

BACKGROUND: Chiropractors commonly use a combination of interventions to treat people with low-back pain (LBP). OBJECTIVES: To determine the effects of combined chiropractic interventions (that is, a combination of therapies, other than spinal manipulation alone) on pain, disability, back-related function, overall improvement, and patient satisfaction in adults with LBP, aged 18 and older. SEARCH STRATEGY: We searched: The Cochrane Back Review Group Trials Register (May 2009), CENTRAL (The Cochrane Library 2009, Issue 2), and MEDLINE (from January 1966), EMBASE (from January 1980), CINAHL (from January 1982), MANTIS (from Inception) and the Index to Chiropractic Literature (from Inception) to May 2009. We also screened references of identified articles and contacted chiropractic researchers. SELECTION CRITERIA: All randomised trials comparing the use of combined chiropractic interventions (rather than spinal manipulation alone) with no treatment or other therapies. DATA COLLECTION AND ANALYSIS: At least two review authors selected studies, assessed the risk of bias, and extracted the data using standardised forms. Both descriptive synthesis and meta-analyses were performed. MAIN RESULTS: We included 12 studies involving 2887 participants with LBP. Three studies had low risk of bias. Included studies evaluated a range of chiropractic procedures in a variety of sub-populations of people with LBP.No trials were located of combined chiropractic interventions compared to no treatment. For acute and subacute LBP, chiropractic interventions improved short- and medium-term pain (SMD -0.25 (95% CI -0.46 to -0.04) and MD -0.89 (95%CI -1.60 to -0.18)) compared to other treatments, but there was no significant difference in long-term pain (MD -0.46 (95% CI -1.18 to 0.26)). Short-term improvement in disability was greater in the chiropractic group compared to other therapies (SMD -0.36 (95% CI -0.70 to -0.02)). However, the effect was small and all studies contributing to these results had high risk of bias. There was no difference in medium- and long-term disability. No difference was demonstrated for combined chiropractic interventions for chronic LBP and for studies that had a mixed population of LBP. AUTHORS' CONCLUSIONS: Combined chiropractic interventions slightly improved pain and disability in the short-term and pain in the medium-term for acute and subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions. Future research is very likely to change the estimate of effect and our confidence in the results.

Cochrane Database Syst Rev. 2010 Apr 14;4:CD005427. Walker BF, French SD, Grant W, Green S. School of Chiropractic and Sports Science, Murdoch University, Faculty of Health Sciences, Murdoch, Australia, 6150.

OBJECTIVE: Behavioural and psychological symptoms in dementia (BPSD) are common and distressing to both patients and carers. The use of antipsychotics to treat BPSD is associated with a high burden of side-effects and alternative strategies are required. Aromatherapy is an option that has been recommended for use in dementia. We aimed to review the evidence supporting the use of aromatherapy in BPSD. METHODS: We searched Medline, Cochrane and EMBASE for randomised controlled trials of aromatherapy in patients with dementia. RESULTS: Eleven prospective randomised studies of aromatherapy in BPSD were identified. The aromatherapy oils tested, method of administration and outcome measures used varied widely across the studies. Most of the studies included very small numbers of patients and were designed in such a way that made interpretation of the findings difficult. CONCLUSION: Data supporting the efficacy of aromatherapy are scarce; available studies reported positive and negative consequences for both people with dementia and their carers. The side-effect profile of commonly used oils is virtually unexplored. Although a potentially useful treatment for BPSD, the expectations of clinicians and patients with respect to the efficacy and tolerability of conventional medicines should equally apply to aromatherapy.

Int J Geriatr Psychiatry. 2008 Apr;23(4):337-46. Nguyen QA, Paton C. Oxleas NHS Foundation Trust, Dartford, Kent, UK. Quynh-Anh.Nguyen@oxleas.nhs.uk

Colin was trained at one of the most prestigious schools in the UK and received further expert training through Kevin Hogan of the Minnesota Institute of Hypnosis and Hypnotherapy.

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The real mystery about hypnosis is the simplicity of induction and the ease with which a willing participant will accept and work within the trance state. Something so natural must involve neural systems that make trance a normal phenomenon. Presented is the language for emotion developed by Silvan Tomkins between 1960 and his death in 1991, brought into contemporary science by the author. Tomkins focused on the facial displays of affect, programmed reactions to specific patterns of stimulation. Each of these 9 innate mechanisms initiates a reaction pattern people experience as an emotion that brings its trigger into conscious awareness. How people think about or understand anything is controlled by the affect with which it has become linked. Cognitions locked to unpleasant emotions can become disturbingly resistant to change until trance work alters the affective environment of the participant.

Int J Clin Exp Hypn. 2009 Oct;57(4):319-42.Nathanson DL. Silvan S. Tomkins Institute and Jefferson Medical College, Philadelphia, Pennsylvania19103-6224, USA. nathanson@tomkins.org

OBJECTIVE: To observe clinical therapeutic effects of acupuncture combined with music therapy for treatment of cerebral palsy. METHODS: Sixty children with cerebral palsy were randomly divided into an acupuncture group (Group Acup.) and an acupuncture plus music group (Group Acup.+ M). Simple acupuncture was applied in Group Acup., and acupuncture at 5 groups of points plus music were applied in Group Acup. +M. The treatment was given once every two days with 3 treatments weekly, and 36 treatments constituted a therapeutic course. Therapeutic effects including movement improvement were observed for comparison after 3 courses of treatments. RESULTS: The comprehensive functions were elevated in both groups, and the total effective rate in Group Acup. + M was obviously better than that in Group Acup (P < 0.05). Movement functions were also improved in both groups, but the differences in improvement of creeping and kneeling, standing, and walking were significant between the two groups (P < 0.01), showing the effect in Group Acup. + M was better than that in Group Acup.. CONCLUSION: The therapy of acupuncture plus music gained better therapeutic effect on cerebral palsy than simple acupuncture, which provided new thoughts for treating the disease by comprehensive therapies.

J Tradit Chin Med. 2009 Dec;29(4):243-8. Yu HB, Liu YF, Wu LX. Department of Acupuncture, Shenzhen TCM Hospital of Guangdong Province, Shenzhen 518000, China.

by Nadine Aurel

The CognitiveOS Hypnosis, a mind therapy developed by Luca Bosurgi during 20 years of clinical experience, is a healing strategy based on working with the spirit to control and troubleshoot the mind. This may sound far from clinical to many, suggesting philosophy over science; a notion hardly accepted by most scientists and physicians.

Well, the question is simple, do you feel that your spirit it is just a philosophical notion or is it your real-self incarnated in your body and mind as your tools for living on earth? And, if you agree that your spirit is your real-self, doesn't it make sense that the driver takes control over its vehicle?

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Full Title: Effectiveness of respiratory-sinus-arrhythmia biofeedback on state-anxiety in patients undergoing coronary angiography

AIM: This study is a report of a study conducted to evaluate the value of psychological assistance including respiratory-sinus-arrhythmia biofeedback training in its ability to reduce the level of anxiety in patients undergoing coronary angiography. BACKGROUND: Coronary angiography has been reported to cause anxiety and emotional stress. METHODS: Between March 2004 and January 2005, 212 patients undergoing routine elective coronary angiography for the evaluation of stable coronary artery disease were randomized into two groups. In the psychological support group (n = 106) a structured psychological conversation and respiratory-sinus-arrhythmia biofeedback training were offered prior to coronary angiography. In the control group (n = 106) standard care and information was provided without psychological support. State-anxiety was measured (scale 20-80) 1 day prior to and after coronary angiography, along with blood pressure and heart rate. FINDINGS: Prior to coronary angiography, state-anxiety was 54.8 +/- 11.5 (mean +/- SD) in the control group and 54.8 +/- 12.6 in the psychological support group. After coronary angiography, state-anxiety was 47.9 +/- 18.5 in the control group but 28.3 +/- 12.5 in the psychological support group (Wilcoxon rank sum test W = 7272, P < 0.001). Blood pressure was statistically significantly lower in the psychological support group prior to the intervention and the day after coronary angiography. CONCLUSION: Psychological support including respiratory-sinus-arrhythmia biofeedback is an effective and simple tool that could be used by nurses to reduce state-anxiety and emotional stress in patients undergoing coronary angiography.

J Adv Nurs. 2010 May;66(5):1101-10. Mikosch P, Hadrawa T, Laubreiter K, Brandl J, Pilz J, Stettner H, Grimm G. Department of Internal Medicine 2, General Hospital Klagenfurt, Austria. peter.mikosch@tele2.at

by Cheryl Janecky

Summer Solstice is the season Mother Nature is at the peak of abundance, and you too can join this natural cycle, align with the abundance, and accomplish miracles. If you are in the Southern hemisphere, then you are entering the season of Winter Solstice. The energy time of the season is the opposite of Summer. New Year planning will soon be underway. Plant the seeds now - of the future you want to harvest in the Fall.

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Full Title: Twelve-Step Facilitated Versus Mapping-Enhanced Cognitive-Behavioral Therapy for Pathological Gambling: A Controlled Study

This study examined the efficacy of two group treatments for pathological gambling, a node-link mapping-enhanced cognitive-behavioral group therapy (CBGT-mapping) and twelve-step facilitated (TSF) group treatment. Forty-nine participants meeting criteria for pathological gambling were recruited from local newspaper advertisements. These participants were randomly assigned to one of three conditions: TSF (n = 11), CBGT-mapping (n = 18), and Wait-List control (n = 9); 11 refused treatment prior to randomization. Outcome measures included number of DSM-IV criteria met, perception of control/self-efficacy, desire to gamble, and frequency of gambling episodes. Analyses revealed a significant treatment group x time interaction (eta(2)(partial) = .39). Specifically, the group treatments resulted in significant improvements in the dependent measures, while the Wait-List group remained relatively stable. Overall, CBGT-mapping and TSF had no significant differences on any outcome measure at follow-up assessments. Analysis of post-treatment and 6-month follow-up reveal a significant improvement in gambling outcomes (i.e., fewer DSM-IV criteria met, greater self-efficacy, and fewer gambling episodes (eta(2)(partial) = .35), with treatment gains maintained at 6 months. These results are consistent with previous research for group treatment for pathological gambling and provide support for the utility of TSF and a mapping-based CBT therapy as viable intervention for pathological gambling.

J Gambl Stud. 2010 May 19. Marceaux JC, Melville CL. McNeese State University, 4205 Ryan St., Lake Charles, LA, 70609, USA, janice23@uab.edu.

CONTEXT: Rheumatoid arthritis (RA) is a chronic disease that often impacts patient's quality of life. For young people with RA, there is a need for rehabilitative approaches that have been shown to be safe and to lead to improved functioning. OBJECTIVES: This pilot study investigated the feasibility of a single-arm, group-administered, six-week, biweekly Iyengar yoga (IY) program for eight young adults with RA. METHODS: IY is known for its use of props, therapeutic sequences designed for patient populations, emphasis on alignment, and a rigorous teacher training. Treatment outcomes were evaluated using a mixed-methods approach that combined quantitative results from standardized questionnaires and qualitative interviews with participants. RESULTS: Initial attrition was 37% (n=3) after the first week because of scheduling conflicts and a prior non-RA related injury. However, the remaining participants (n=5) completed between 75% and 100% of treatment sessions (mean=95%). No adverse events were reported. The quantitative results indicated significant improvements in pain, pain disability, depression, mental health, vitality, and self-efficacy. Interviews demonstrated improvement in RA symptoms and functioning but uncertainty about whether the intervention affected pain. CONCLUSION: These preliminary findings indicate that IY is a feasible complementary approach for young people with RA, although larger clinical trials are needed to demonstrate safety and efficacy. Copyright 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

J Pain Symptom Manage. 2010 May;39(5):904-13.Evans S, Moieni M, Taub R, Subramanian SK, Tsao JC,

Sternlieb B, Zeltzer LK. Pediatric Pain Program, David Geffen School of Medicine, University of California, Los Angeles, California 90024, USA. suevans@mednet.ucla.edu

Charles M. Citrenbaum, Ph.D. is a psychologist in private practice with a national reputation for his work in brief and strategic therapeutic techniques, clinical hypnosis, stress management techniques and creative communication strategies.

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by Tim Brunson, PhD

When the Esalen Institute's Michael Murphy wrote his classic The Future of the Body: Explorations into the Further Evolutions of Human Nature, he boldly stated that mankind can easily move in either the direction of Enlightenment or rapidly devolve into the dark morass of ignorance and evil. This should not have surprised anyone who has even a layman's appreciation of world history. Indeed, every Dark Age is preceded by a Renaissance. The opposite is also true. This applies not only to society as a whole. The state of an individual's happiness and fulfillment can easily move toward a better life or despair. This article explores the question of choice and the role that hypnotherapy may play.

What immediately comes to mind is the hierarchy of needs model first proposed by Abraham Maslow in his 1943 paper A Theory of Human Motivation. In it he states that we concern ourselves with five basic levels: physiological needs, safety, love/belonging, esteem, and self-actualization. He believed that we are only motivated to seek achievement at higher levels once we are fully satisfied that our needs are met regarding the subordinate ones.

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Full Title: Acupuncture-ameliorated menopausal symptoms: single-blind, placebo-controlled, randomized trial

Objectives To evaluate the effects of acupuncture and sham-acupuncture on women with menopausal symptoms as reflected in the intensity of their hot flushes and the Kupperman Menopausal Index (KMI). Method This was a randomized, single-blind, placebo-controlled, cross-over trial with 81 patients assigned to two groups: Group 1 received 12 months of acupuncture, then 6 months of sham-acupuncture treatment (n = 56) and Group 2 received 6 months of sham-acupuncture, then 12 months of acupuncture treatment (n = 25). The needles were inserted in a harmonic craniocaudal manner at a depth of about 2 cm, and each session lasted approximately 40 min. The efficacy of acupuncture in ameliorating the climacteric symptoms of patients in postmenopause was determined through the KMI and the intensity of hot flushes. The analysis of variance method for two factors and repeated measures was applied. Results The baseline values of the women in both groups were similar for the KMI score and number of hot flushes. At the end of 6 months, the values for the KMI and hot flushes for the women in Group 1 were lower than those of the women in Group 2 (p < 0.05). After 12 months, the KMI and hot flush data were similar in both groups. After 18 months, the values of the KMI and hot flushes for the women in Group 2 for were lower than those of the women in Group 1 (p < 0.05). Conclusion Acupuncture treatment for relieving menopausal symptoms may be effective for decreasing hot flushes and the KMI score in postmenopausal women.

Climacteric. 2010 May 24. Castelo Branco de Luca A, Maggio da Fonseca A, Carvalho Lopes CM, Bagnoli VR, Soares JM, Baracat EC. Medical School of University of São Paulo, Obstetrics and Gynecology, São Paulo.

The efficacy of hypnosis in the treatment of depressive symptoms was subjected to a meta-analysis. Studies were identified using Google Scholar and 6 electronic databases: PubMed, Cochrane Library, PsiTri, PsychLit, Embase, and the Cochrane Depression, Anxiety and Neurosis Review Group (CCDAN). The keywords used were (a) hypnosis, (b) hypnotherapy, (c) mood disorder, (d) depression, and (e) dysthymia. Six studies qualified and were analyzed using the Comprehensive Meta-Analysis software package. The combined effect size of hypnosis for depressive symptoms was 0.57. Hypnosis appeared to significantly improve symptoms of depression (p < .001). Hypnosis appears to be a viable nonpharmacologic intervention for depression. Suggestions for future research are discussed.

Int J Clin Exp Hypn. 2009 Oct;57(4):431-42. Shih M, Yang YH, Koo M. Nanhua University, Chiayi, Taiwan.

ABSTRACT: BACKGROUND: When conservative therapies for low back pain (LBP) are not effective, elective surgery may be proposed to these patients. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a patient from pain and related disability, soreness and stiffness of the lumbopelvic region seem to be common aftermaths of the surgery. This prospective case series was undertaken to identify and describe potential adverse events of lumbar spinal manipulation, a common therapy for low back pain, in a group of patients with symptoms after disc prostheses. CASES PRESENTATION: Eight patients who underwent lumbar spine total disc replacement were referred by an orthopaedic surgeon for chiropractic treatments. These patients had 1 or 2 total lumbar disc replacements and were considered stable according to the surgical protocol but presented persistent, post-surgical, non-specific LBP or pelvic pain. They were treated with lumbar spine side posture manipulations only and received 8 to 10 chiropractic treatments based on the clinical evolution and the chiropractor's judgment. Outcome measures included benign, self-limiting, and serious adverse events after low back spinal manipulative therapy. The Oswestry Disability Index, a pain scale and the fear avoidance belief questionnaire were administered to respectively assess disability, pain and fear avoidance belief about work and physical activity. This prospective case series comprised 8 patients who all had at least 1 total disc replacement at the L4/L5 or L5/S1 level and described persistent post-surgical LBP interfering with their daily activities. Commonly-reported side-effects of a benign nature included increased pain and/or stiffness of short duration in nearly half of the chiropractic treatment period. No major or irreversible complication was noted. CONCLUSIONS: During the short treatment period, no major complication was encountered by the patients. Moreover, the benign side-effects reported after lumbar spine manipulation were similar in nature and duration to those frequently experienced by the general population.

Chiropr Osteopat. 2010 Apr 21;18:7. O'Shaughnessy J, Drolet M, Roy JF, Descarreaux M. Département de chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada. martin.descarreaux@uqtr.ca.

by Sam Slay

Surveys say organizations that regularly communicate with staff report employee engagement, lower turnover, and higher financial performance.

If you want employees to think of your business like their own you must communicate more often and more effectively. What is so secret that you can't share with your employees. I will grant you that their are some things you'd rather not report, but why try and keep everything a mystery. Employees will be more engaged if you engage them. Employees will remain in your employment if they know you care about them.

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Full Title: Expectancies, not aroma, explain impact of lavender aromatherapy on psychophysiological indices of relaxation in young healthy women

OBJECTIVES: In aromatherapy, lavender aroma is reputed to assist with relaxation. However, while there is much anecdotal evidence to that effect, the empirical literature is very inconsistent. Failure to employ adequate placebos, proper blinding, objective measures, or screening of prior beliefs about aromatherapy means that many previous findings could have been influenced by expectancy biases. The present study sought to establish whether lavender aroma and/or expectancies affect post-stress relaxation. DESIGN: A double-blind, 3 (aroma) x 3 (instruction) x 10 (time in minutes) mixed-factorial placebo-controlled trial. METHOD: In a laboratory, 96 healthy undergraduate women were exposed to lavender, placebo, or no aroma during physiologically assessed relaxation after an arousing cognitive task. Where an aroma was presented, an instructional priming procedure was used to manipulate participants' expectancies about the aroma's likely impact on their ability to relax. RESULTS: Results showed no effect of aroma on galvanic skin response during relaxation. However, the nature of instructional prime was associated with relaxation patterns: when expecting the aroma to inhibit them, participants relaxed more; when expecting facilitation, participants relaxed less. The effect was not seen with regard to self-reported relaxation (as represented by changes in state anxiety) and was independent of ratings of attitudes towards aromatherapy. CONCLUSIONS: The findings imply that the previous associations of lavender aroma with assisted relaxation may have been influenced by expectancy biases, and that the relevant expectancies are easily manipulable.

Br J Health Psychol. 2008 Nov;13(Pt 4):603-17. Epub 2007 Sep 7. Howard S, Hughes BM. National University of Ireland, Galway, Ireland.

Rosalba is an honors graduate from the Hypnosis Motivation Institute. In her bilingual practice, she successfully helps clients rediscover themselves and guides them to find their true path in life's journey. She has a deep understanding of others and a strong commitment to assist her clients in attaining their goals.

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Full Title: Clinical research on the utility of hypnosis in the prevention, diagnosis, and treatment of medical and psychiatric disorders

The authors summarize 4 articles of special interest to the hypnosis community in the general scientific and medical literatures. All are empirical studies testing the clinical utility of hypnosis, and together address the role of hypnosis in prevention, diagnosis, and treatment of medical and psychiatric disorders/conditions. The first is a randomized controlled study of smoking cessation treatments comparing a hypnosis-based protocol to an established behavioral counseling protocol. Hypnosis quit rates are superior to those of the accepted behavioral counseling protocol. A second study with pediatric patients finds hypnosis critically helpful in differentiating nonepileptic seizure-like behaviors (pseudoseizures) from epilepsy. The remaining 2 papers are randomized controlled trials testing whether hypnosis is effective in helping patients manage the emotional distress of medical procedures associated with cancer treatment. Among female survivors of breast cancer, hypnosis reduces perceived hot flashes and associated emotional and sleep disruptions. Among pediatric cancer patients, a brief hypnotic intervention helps control venepuncture-related pain.

Int J Clin Exp Hypn. 2009 Oct;57(4):443-50. Nash MR, Perez N, Tasso A, Levy JJ. Psychology Department, University of Tennessee, Knoxville, Tennessee 37996-0900, USA. mnash@utk.edu

Bone marrow biopsy and aspiration are commonly used for diagnosing, treating, and following up after treatment for blood disorders and solid tumors. For adults, the infiltration of local anesthesia at the biopsy site has been used as the principal form of analgesia for bone marrow biopsy and aspiration. Pain relief during these procedures is often incomplete, especially during aspiration of the bone marrow, and pain is likely to contribute to patient anxiety. Researchers at the Tabriz Hematology and Oncology Center in Iran conducted a study to quantify and evaluate the effectiveness of music therapy interventions on pain and anxiety control for 100 patients undergoing bone marrow biopsy and aspiration. Participants in the study were randomly assigned to one of two groups: one group listened to music during the procedure, and the other did not. Patients completed the Spielberger State-Trait Anxiety Inventory both before and after the procedure and reported pain severity by using a visual analog scale. Results showed that participants who listened to music had lower state anxiety and pain levels than those who did not listen to music. Copyright © 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

AORN J. 2010 Jun;91(6):746-751. Shabanloei R, Golchin M, Esfahani A, Dolatkhah R, Rasoulian M.

by Joyce-Anne Locking

"On the black dog" is an expression used by writers. It represents a period of time when a writer is unable to find inspiration and soon becomes unable to write. I once heard the term mentioned by famous Canadian writer,Pierre Berton, as a writing disorder that afflicts writers from time to time. When a writer is "on the black dog," black becomes the colour of everything: black mood, black thoughts. Even the blank page seems black as one is unable to shed light on its blankness. And black is the colour of our power to change this dreaded affliction, although writing about it definitely helps a little.

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Full Title: Correcting abnormal flexion-relaxation in chronic lumbar pain: responsiveness to a new biofeedback training protocol

OBJECTIVES: Lumbar flexion-relaxation is a well-known phenomenon that can reliably be seen in normal participants, but not in most chronic low back pain (CLBP) participants. No earlier studies have investigated any specific clinical intervention designed to correct abnormal flexion-relaxation. The objective of this study was to evaluate the contribution of a surface EMG-assisted stretching (SEMGAS) biofeedback training protocol, within a functional restoration treatment program, on flexion range of motion (ROM) and erector spinae surface EMG (SEMG) during maximum voluntary flexion (MVF). METHODS: Lumbar flexion ROM and MVF SEMG were assessed in 2 groups of CLBP patients at the beginning and end of rehabilitation. One group participated in functional restoration only, whereas the other group participated in functional restoration plus SEMGAS biofeedback training. Both treatment groups were compared with a separate control group of normal, pain-free participants. RESULTS: Pretreatment ROM and MVF SEMG measures were similar in both treatment groups, but were very different than the control group. At posttreatment, the functional restoration only group remained statistically different than the control group on MVF SEMG and some ROM measures, but the SEMGAS group was statistically equivalent to the control participants on all posttreatment measures, including the ability to show flexion-relaxation. DISCUSSION: Interdisciplinary functional restoration rehabilitation of CLBP participants is effective for increasing ROM and other functional measures, but the addition of a SEMGAS biofeedback training protocol can result in normalization of the flexion-relaxation phenomenon, so that these participants are comparable with a pain-free control group.

Clin J Pain. 2010 Jun;26(5):403-9. Neblett R, Mayer TG, Brede E, Gatchel RJ. PRIDE Research Foundation, Dallas, TX, USA.

by Katherine Zimmerman, PhD, CHT

In my private practice I have found several starting points with clients that are very effective. One of my standard approaches with a new client is to reframe their issue. It might be stress, panic, negative emotions or even physical pain. A reframe is simply looking at the problem from a different perspective. It's natural to reframe experiences for our friends and family. For example, here's one that I found recently: "Laziness is nothing more than the habit of resting before you get tired."

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Full Title: Cognitive-Behavioral Therapy for Threshold and Subthreshold Anorexia Nervosa: A Three-Year Follow-Up Study

Background: Few long-term follow-up studies have evaluated the response to psychotherapeutical interventions in anorexia nervosa (AN). The effectiveness of individual cognitive-behavioral therapy (CBT) and the possible predictors of outcome in outpatients suffering from threshold and subthreshold AN (s-AN) were evaluated. Methods: At the beginning (T0) and at the end of treatment (T1), and 3 years after the end of treatment (T2), 53 subjects with AN and 50 with s-AN (all DSM-IV criteria except amenorrhea or underweight) were assessed by a face-to-face clinical interview and by self-reported questionnaires for eating attitudes and behavior (Eating Disorder Examination Questionnaire), body uneasiness (Body Uneasiness Test) and general psychopathology (Symptom Checklist, Beck Depression Inventory, State-Trait Anxiety Inventory). Results: No deaths occurred during the treatment and the follow-up period. At the end of the follow-up 34 subjects (33%) initially enrolled in the study obtained a full recovery. AN and s-AN patients did not show significant differences on most of the clinical measures at baseline and in terms of treatment response (T1, T2). The reduction in weight and shape concerns was associated with weight gain at T1 and T2, and the shape concern level at baseline represented the main risk factor for recovery and treatment resistance. According to survival analysis, patients with high shape concern had a lower probability of remission across time. Conclusions: The distinction between threshold and subthreshold AN does not seem to be of clinical relevance in terms of response to CBT. Shape concern rather than demographic or general psychopathological features represents the best predictor of outcome for CBT. Copyright © 2010 S. Karger AG, Basel.

Psychother Psychosom. 2010 May 25;79(4):238-248. Ricca V, Castellini G, Lo Sauro C, Mannucci E, Ravaldi C, Rotella F, Faravelli C. Psychiatric Unit, Department of Neuropsychiatric Sciences, Florence University, Florence, Italy.

This tutorial teaches you who will be the best subjects for hypnosis. You can learn more about hypnosis at www.vancouverhypnotherapy.org.

Full Title: Yoga as a complementary treatment for smoking cessation: rationale, study design and participant characteristics of the Quitting-in-Balance study

BACKGROUND: Tobacco smoking remains the leading preventable cause of death among American women. Exercise has shown promise as an aid to smoking cessation because it reduces weight gain and weight concerns, improves affect, and reduces nicotine withdrawal symptoms and cigarette craving. Studies have shown that the practice of yoga improves weight control, and reduces perceived stress and negative affect. Yoga practice also includes regulation of breathing and focused attention, both of which may enhance stress reduction and improve mood and well-being and may improve cessation outcomes. METHODS/DESIGN: This pilot efficacy study is designed to examine the rates of cessation among women randomized to either a novel, 8-week Yoga plus Cognitive Behavioral Therapy (CBT) smoking cessation intervention versus a Wellness program plus the same CBT smoking cessation intervention. Outcome measures include 7-day point prevalence abstinence at end of treatment, 3 and 6 months follow up and potential mediating variables (e.g., confidence in quitting smoking, self-efficacy). Other assessments include measures of mindfulness, spirituality, depressive symptoms, anxiety and perceived health (SF-36). DISCUSSION: Innovative treatments are needed that address barriers to successful smoking cessation among men and women. The design chosen for this study will allow us to explore potential mediators of intervention efficacy so that we may better understand the mechanism(s) by which yoga may act as an effective complementary treatment for smoking cessation. If shown to be effective, yoga can offer an alternative to traditional exercise for reducing negative symptoms that often accompany smoking cessation and predict relapse to smoking among recent quitters. TRIAL REGISTRATION: ClinicalTrials NCT00492310.

BMC Complement Altern Med. 2010 Apr 29;10:14. Bock BC, Morrow KM, Becker BM, Williams DM, Tremont G, Gaskins RB, Jennings E, Fava J, Marcus BH. Centers for Behavioral and Preventive Medicine, Alpert School of Medicine at Brown University, The Miriam Hospital, Providence, RI 02903, USA. Bbock@lifespan.org