This is a complex case of post-traumatic stress disorder (PTSD) with comorbid panic disorder occurring in a woman in her mid-60s, with a family history of neurotic illness. PTSD arose in the context of treatment for terminal lung cancer. This patient who had been close to her father watched him die of cancer, when he was about her age. Her diagnosis and treatment prompted traumatic recollections of her father's illness and death that resulted in her voluntary withdrawal from cancer treatment. The goals of treatment were to promptly reduce anxiety, minimise use of sedating pharmacotherapy, promote lucidity and prolong anxiety-free state thereby allowing time for important family interactions. Prompt, sustained relief of severe anxiety was necessary to achieve comfort at the end of life. Skilled additions of psychological therapies (eye movement desensitisation reprocessing, clinical hypnosis and breathing exercises) with combined pharmacotherapy (mirtazepine and quetiapine) led to control of anxiety and reduction of post-traumatic stress.

BMJ Case Rep. 2012 Oct 9;2012. pii: bcr2012006800. doi: 10.1136/bcr-2012-006800. Udo I, Gash A. Liaison Psychiatry, Roseberry Park Hospital, Tees, Esk, Wear Valleys NHS Foundation Middlesbrough Trust, UK. dr_itoro@yahoo.com

Full title: Argentine tango dance compared to mindfulness meditation and a waiting-list control: a randomised trial for treating depression.

OBJECTIVES: To determine whether tango dancing is as effective as mindfulness meditation in reducing symptoms of psychological stress, anxiety and depression, and in promoting well-being.

DESIGN: This study employed analysis of covariance (ANCOVA) and multiple regression analysis.

PARTICIPANTS: Ninety-seven people with self-declared depression were randomised into tango dance or mindfulness meditation classes, or to control/waiting-list.

SETTING: classes were conducted in a venue suitable for both activities in the metropolitan area of Sydney, Australia.

INTERVENTIONS: Participants completed six-week programmes (1½h/week of tango or meditation). The outcome measures were assessed at pre-test and post-test.

MAIN OUTCOME MEASURES: Depression, Anxiety and Stress Scale; The Self Esteem Scale; Satisfaction with Life Scale, and Mindful Attention Awareness Scale.

RESULTS: Sixty-six participants completed the program and were included in the statistical analysis. Depression levels were significantly reduced in the tango (effect size d=0.50, p=.010), and meditation groups (effect size d=0.54, p=.025), relative to waiting-list controls. Stress levels were significantly reduced only in the tango group (effect size d=0.45, p=.022). Attending tango classes was a significant predictor for the increased levels of mindfulness R(2)=.10, adjusted R(2)=.07, F (2,59)=3.42, p=.039.

CONCLUSION: Mindfulness-meditation and tango dance could be effective complementary adjuncts for the treatment of depression and/or inclusion in stress management programmes. Subsequent trials are called to explore the therapeutic mechanisms involved.

Complement Ther Med. 2012 Dec;20(6):377-84. doi: 10.1016/j.ctim.2012.07.003. Epub 2012 Aug 3. Pinniger R, Brown RF, Thorsteinsson EB, McKinley P. University of New England, Australia. rpinnige@une.edu.au

Mary Hammond-Newman is a therapist, trainer, consultant, writer, from Oregon, treating depression daily for twenty-five years; ten years with Energy Psychology. She develops work combining her extensive background in human development, addictions, play therapy, EMDR II, and many models of Energy Psychology. Mary and Howard Brockman published Dynamic Energetic Healing: Soul Work at the Origins in Energy Psychology in Psychotherapy by Fred Gallo Ph.D. She is currently continuing her work with depression, and also with peri-menopausal and menopausal reactions in women. She has written articles and a training manual and is currently writing Healing the Mind Body and Soul. She enjoys her roles as Membership Director of ACEP, and as an ACEP Certification Consultant. She also parents two generations of children.

For more information, please visit http://www.onedynamicenergetichealing.org/

Full title: The management of dental anxiety and impact of psychosomatic factors on dentistry. - Is recent scientific research translated into German dental practices?

This study investigated the dentists' knowledge about psychosomatic medicine. Anxiolytic techniques, considerations about psychosomatic medicine, and referrals to psychotherapists were examined by a questionnaire. Overall, 65 percent felt negatively affected by patients with dental fear. Few dentists used relaxation techniques and hypnosis. The relationship between psychosomatic factors and pain perception was well known, but not their impact on wound healing. The frequency of continuing education courses correlated with a broader range of treatment techniques and less difficulties in treatment. Research evidence about the impact of psychological factors on dental treatment has not been translated into dental practice.

J Health Psychol. 2012 Dec 6. Diercke K, Bürger GD, Bermejo JL, Lux CJ, Brunner M. University of Heidelberg, Germany.

by Tim Brunson PhD

Hypnosis is considered by most as an altered state of mind. Essentially, this is a misnomer. The brain goes through four main brain wave states multiple times per day. These are Beta (full awareness), Alpha (light relaxation), Theta (deep relaxation), and Delta (sleep). To day that there is a "altered state of mind" would assume that there is a normal state from which the mind deviates. (And, the lambda and gamma states are rarely discussed.)

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Abstract Objectives: The objective of this pilot study was to determine the effectiveness of a mixture of essential oils (peppermint, basil, and helichrysum) on mental exhaustion, or moderate burnout (ME/MB) using a personal inhaler. Design: This was a randomized, controlled, double-blind pilot study. Data were collected 3 times a day for 3 weeks (Monday-Friday). The first week was baseline for both groups, the second week was intervention (aromatherapy or placebo), and the third week was washout. Settings/location: Participants used a personal inhaler at home or at work. Subjects: The subjects comprised a convenience sample of 13 women and 1 man who each had self-assessed ME/MB. Interventions: Participants were randomized to receive a personal inhaler containing either a mixture of essential oils or rose water (as used in Indian cooking). Outcome measures: The outcome measures were a 0-10 scale with 10=worst feeling of burnout, 0=no feeling of burnout. There was a qualitative questionnaire rating aroma and a questionnaire listing perceived stressors. Results: While both groups had a reduction in perception of ME/MB, the aromatherapy group had a much greater reduction. Conclusions: The results suggest that inhaling essential oils may reduce the perceived level of mental fatigue/burnout. Further research is warranted.

J Altern Complement Med. 2012 Nov 9. Varney E, Buckle J. 1 Private Practice , Andover, MA.

Full title: Self-regulation of brain oscillations as a treatment for aberrant brain connections in children with autism.

Autism is a highly varied developmental disorder typically characterized by deficits in reciprocal social interaction, difficulties with verbal and nonverbal communication, and restricted interests and repetitive behaviors. Although a wide range of behavioral, pharmacological, and alternative medicine strategies have been reported to ameliorate specific symptoms for some individuals, there is at present no cure for the condition. Nonetheless, among the many incompatible observations about aspects of the development, anatomy, and functionality of the autistic brain, it is widely agreed that it is characterized by widespread aberrant connectivity. Such disordered connectivity, be it increased, decreased, or otherwise compromised, may complicate healthy synchronization and communication among and within different neural circuits, thereby producing abnormal processing of sensory inputs necessary for normal social life. It is widely accepted that the innate properties of brain electrical activity produce pacemaker elements and linked networks that oscillate synchronously or asynchronously, likely reflecting a type of functional connectivity. Using phase coherence in multiple frequency EEG bands as a measure of functional connectivity, studies have shown evidence for both global hypoconnectivity and local hyperconnectivity in individuals with ASD. However, the nature of the brain's experience-dependent structural plasticity suggests that these abnormal patterns may be reversed with the proper type of treatment. Indeed, neurofeedback (NF) training, an intervention based on operant conditioning that results in self-regulation of brain electrical oscillations, has shown promise in addressing marked abnormalities in functional and structural connectivity. It is hypothesized that neurofeedback produces positive behavioral changes in ASD children by normalizing the aberrant connections within and between neural circuits. NF exploits the brain's plasticity to normalize aberrant connectivity patterns apparent in the autistic brain. By grounding this training in known anatomical (e.g., mirror neuron system) and functional markers (e.g., mu rhythms) of autism, NF training holds promise to support current treatments for this complex disorder. The proposed hypothesis specifically states that neurofeedback-induced alpha mu (8-12Hz) rhythm suppression or desynchronization, a marker of cortical activation, should induce neuroplastic changes and lead to normalization in relevant mirroring networks that have been associated with higher-order social cognition.

Med Hypotheses. 2012 Dec;79(6):790-8. doi: 10.1016/j.mehy.2012.08.031. Epub 2012 Sep 20. Pineda JA, Juavinett A, Datko M. Department of Cognitive Science and Group in Neurosciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0515, United States. Electronic address: pineda@cogsci.ucsd.edu.

Three to four percent of full-term singleton pregnancies present themselves as breech deliveries. External cephalic version (ECV) is a procedure to try to turn a breech fetus to cephalic by externally maneuvering the fetus through the maternal abdomen. This trial examines a clinical hypnosis intervention against standard medical care of women before ECV. A total of 78 women, who received a hypnosis intervention prior to ECV, had a 41.6% (n = 32) successful ECV, whereas the control group of 122, who had similar baseline characteristics, had a 27.3% (n = 33) successful ECV procedure (p < 0.05). This trial found that a relaxation technique with the help of clinical hypnosis was successful at increasing the likelihood of a successful ECV procedure.

Am J Clin Hypn. 2012 Oct;55(2):184-92. Reinhard J, Heinrich TM, Reitter A, Herrmann E, Smart W, Louwen F. Department of Obstetrics and Gynaecology, Faculty of Medicine, Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt am Main, Germany. Joscha.Reinhard@kgu.de

Full title: Effects of music therapy and guided visual imagery on chemotherapy-induced anxiety and nausea-vomiting.

AIMS AND OBJECTIVES: To reveal the effects of music therapy and visual imagery on chemotherapy-induced anxiety and nausea-vomiting.

BACKGROUND: Behavioural techniques such as music therapy and visual imagery are becoming increasingly important in dealing with chemotherapy-induced anxiety, nausea and vomiting.

DESIGN: The study is an experimental and cross-sectional one and performed on a single sample group with the pre-post-test design consisting of 40 individuals. The individuals in the sample group comprised both the control and the case group of the study.

METHODS: To obtain the study data, the following forms were used: the Personal Information Form, Spielberger State-Trait Anxiety Inventory, The Visual Analogue Scale and Individual Evaluation Form for Nausea and Vomiting adapted from The Morrow Assessment of Nausea and Vomiting.

RESULTS: In the study, the participants' state and trait anxiety levels decreased significantly (p < 0·05). Music therapy and visual imagery reduced the severity and duration of chemotherapy-induced nausea and vomiting significantly (p < 0·05). In our research, 40% of the patients did not have anticipatory nausea and 55% of the patients did not have anticipatory vomiting during the third chemotherapy cycle during which music therapy and guided visual imagery were implemented.

CONCLUSIONS: It was determined that complementary approaches comprising music therapy and visual imagery had positive effects on chemotherapy-induced anxiety, nausea and vomiting, which are suffered too often and affect the patients' whole lives adversely. RELEVANCE TO CLINICAL PRACTICE:

This study is worthy of interest as it has revealed that music therapy and visual imagery which have been proven to be effective in many health problems in different areas are also important, and practical complementary approaches that are effective in getting chemotherapy-induced anxiety, nausea and vomiting under control.

J Clin Nurs. 2013 Jan;22(1-2):39-50. doi: 10.1111/jocn.12030. Epub 2012 Nov 8. Karagozoglu S, Tekyasar F, Yilmaz FA. Department of Fundamentals of Nursing, Division of Nursing, Cumhuriyet University Faculty of Health Science, Sivas.

Full title: Effects of music therapy and guided visual imagery on chemotherapy-induced anxiety and nausea-vomiting.

AIMS AND OBJECTIVES: To reveal the effects of music therapy and visual imagery on chemotherapy-induced anxiety and nausea-vomiting.

BACKGROUND: Behavioural techniques such as music therapy and visual imagery are becoming increasingly important in dealing with chemotherapy-induced anxiety, nausea and vomiting.

DESIGN: The study is an experimental and cross-sectional one and performed on a single sample group with the pre-post-test design consisting of 40 individuals. The individuals in the sample group comprised both the control and the case group of the study.

METHODS: To obtain the study data, the following forms were used: the Personal Information Form, Spielberger State-Trait Anxiety Inventory, The Visual Analogue Scale and Individual Evaluation Form for Nausea and Vomiting adapted from The Morrow Assessment of Nausea and Vomiting.

RESULTS: In the study, the participants' state and trait anxiety levels decreased significantly (p < 0·05). Music therapy and visual imagery reduced the severity and duration of chemotherapy-induced nausea and vomiting significantly (p < 0·05). In our research, 40% of the patients did not have anticipatory nausea and 55% of the patients did not have anticipatory vomiting during the third chemotherapy cycle during which music therapy and guided visual imagery were implemented.

CONCLUSIONS: It was determined that complementary approaches comprising music therapy and visual imagery had positive effects on chemotherapy-induced anxiety, nausea and vomiting, which are suffered too often and affect the patients' whole lives adversely. RELEVANCE TO CLINICAL PRACTICE:

This study is worthy of interest as it has revealed that music therapy and visual imagery which have been proven to be effective in many health problems in different areas are also important, and practical complementary approaches that are effective in getting chemotherapy-induced anxiety, nausea and vomiting under control.

J Clin Nurs. 2013 Jan;22(1-2):39-50. doi: 10.1111/jocn.12030. Epub 2012 Nov 8. Karagozoglu S, Tekyasar F, Yilmaz FA. Department of Fundamentals of Nursing, Division of Nursing, Cumhuriyet University Faculty of Health Science, Sivas.

Dr. Bulbrook is a Certified Specialist and Instructor in Energy Medicine, Certified Healing Touch Practitioner, psychotherapist, medical/spiritual intuitive, energy healer and teacher with thirty years experience doing workshops in Peru, Chile, South Africa, Austrailia, New Zealand, Canada, and throughout the USA. Her grounded theory approach to research in partnership with her traditional healer form South Africa, Austrailia, New Zealand, and Peru has enriched out understanding of the healing process. Gifted with intuitive insight, Mary Jo has been able to communicate across time dimensions. Her experience with dying and death process in her hospice work started in 1976. She helped launch hospice of Salt Lake and served as the first Director of Training. Mary Jo's abilities of Higher Sense Perception development as she went about the world teaching, practicing and researching ways to help grow and change.

For more information, please visit http://www.energymedicinepartnerships.com.

OBJECTIVE: To estimate the use of epidural analgesia and experienced pain during childbirth after a short antenatal training course in self-hypnosis to ease childbirth.

DESIGN: Randomised, controlled, single-blinded trial using a three-arm design.

SETTING: Aarhus University Hospital Skejby in Denmark during the period July 2009 until August 2011.

POPULATION: A total of 1222 healthy nulliparous women.

METHOD: Use of epidural analgesia and self-reported pain during delivery was compared in three groups: a hypnosis group receiving three 1-hour lessons in self-hypnosis with additional audiorecordings to ease childbirth, a relaxation group receiving three 1-hour lessons in various relaxation methods and mindfulness with audiorecordings for additional training, and a usual care group receiving ordinary antenatal care only.

MAIN OUTCOME MEASURES: Primary outcome: Use of epidural analgesia. Secondary outcomes included self-reported pain.

RESULTS: There were no between-group differences in use of epidural analgesia-31.2% (95% confidence interval [95% CI] 27.1-35.3) in the hypnosis group, 29.8% (95% CI 25.7-33.8) in the relaxation group and 30.0% (95% CI 24.0-36.0) in the control group. No statistically significant differences between the three groups were observed for any of the self-reported pain measures.

CONCLUSION: In this large randomised controlled trial of a brief course in self-hypnosis to ease childbirth, no differences in use of epidural analgesia or pain experience were found across study groups. Before turning down self-hypnosis as a method for pain relief, further studies are warranted with focus on specific subgroups.

BJOG. 2012 Nov 27. doi: 10.1111/1471-0528.12087. Werner A, Uldbjerg N, Zachariae R, Rosen G, Nohr E. Department of Gynaecology and Obstetrics, Aarhus University Hospital Skejby, Aarhus, Denmark.

by Tim Brunson PhD

For a very long time I have been fascinated by the relationship between the mind and body. In fact, despite resistance from much of the medical community, the field of integrative medicine is rapidly gaining a foothold. (The Joint Commission, which accredits hospitals in the U.S. has mandated that all hospitals adopt integrative medicine programs by 2007.) This trend is being documented almost daily by the United States National Institutes of Health. Professionally I spend a considerable amount of time documenting such research for The International Hypnosis Research Institute. This is especially true when integrative research involves hypnosis.

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Full title: Auricular acupuncture for chemically dependent pregnant women: a randomized controlled trial of the NADA protocol.

BACKGROUND: The prevalence of maternal drug use during pregnancy in North America has been estimated to be as high as 6-10%. The consequences for the newborn include increased risk for perinatal mortality and ongoing physical, neurobehavioral, and psychosocial problems. Methadone is frequently used to wean women off street drugs but is implicated as a cause of adverse fetal/neonatal outcomes itself. The purpose of our study was to test the ability of maternal acupuncture treatment among mothers who use illicit drugs to reduce the frequency and severity of withdrawal symptoms among their newborns.

METHODS: We randomly assigned chemically dependent pregnant women at BC Women's Hospital in Vancouver, British Columbia to daily acupuncture treatments versus usual care. By necessity, neither our participants nor acupuncturists were blinded as to treatment allocation. Our primary outcome was days of neonatal morphine treatment for symptoms of neonatal withdrawal. Secondary neonatal outcomes included admission to a neonatal ICU and transfer to foster care.

RESULTS: We randomized 50 women to acupuncture and 39 to standard care. When analyzed by randomized groups, we did not find benefit of acupuncture; the average length of treatment with morphine for newborns in the acupuncture group was 2.7 (6.3) compared to 2.8 (7.0) in the control group. Among newborns of women who were compliant with the acupuncture regime, we observed a reduction of 2.1 and 1.5 days in length of treatment for neonatal abstinence syndrome compared to the non-compliant and control groups, respectively. These differences were not statistically significant.

CONCLUSIONS: Acupuncture may be a safe and feasible treatment to assist mothers to reduce their dosage of methadone. Our results should encourage ongoing studies to test the ability of acupuncture to mitigate the severity of neonatal abstinence syndrome among their newborns.

Subst Abuse Treat Prev Policy. 2012 Dec 23;7(1):48. Janssen P, Demorest LC, Kelly A, Thiessen P, Abrahams R.

Full title: Mind over chatter: Plastic up-regulation of the fMRI salience network directly after EEG neurofeedback.

Neurofeedback (NFB) involves a brain-computer interface that allows users to learn to voluntarily control their cortical oscillations, reflected in the electroencephalogram (EEG). Although NFB is being pioneered as a noninvasive tool for treating brain disorders, there is insufficient evidence on the mechanism of its impact on brain function. Furthermore, the dominant rhythm of the human brain is the alpha oscillation (8-12Hz), yet its behavioral significance remains multifaceted and largely correlative. In this study with 34 healthy participants, we examined whether during the performance of an attentional task, the functional connectivity of distinct fMRI networks would be plastically altered after a 30-min session of voluntary reduction of alpha rhythm (n=17) versus a sham-feedback condition (n=17). We reveal that compared to sham-feedback, NFB induced an increase of connectivity within regions of the salience network involved in intrinsic alertness (dorsal anterior cingulate), which was detectable 30min after termination of training. The increase in salience network (default-mode network) connectivity was negatively (positively) correlated with changes in 'on task' mind-wandering as well as resting state alpha rhythm. Crucially, we observed a causal dependence between alpha rhythm synchronization during NFB and its subsequent change at resting state, not exhibited by the SHAM group. Our findings provide neurobehavioral evidence for the brain's exquisite functional plasticity, and for a temporally direct impact of NFB on a key cognitive control network, suggesting a promising basis for its use to treat cognitive disorders under physiological conditions.

Neuroimage. 2013 Jan 15;65:324-35. doi: 10.1016/j.neuroimage.2012.09.046. Epub 2012 Sep 26. Ros T, Théberge J, Frewen PA, Kluetsch R, Densmore M, Calhoun VD, Lanius RA. Department of Psychiatry, University of Western Ontario, London, Ontario, Canada; Laboratory for Neurology and Imaging of Cognition, Department of Neurosciences, University of Geneva, Switzerland. Electronic address: dr.t.ros@gmail.com.

Tourette syndrome (TS) is a disorder characterised by multiple motor and vocal tics and is frequently associated with behavioural problems. Tics are known to be affected by internal factors such as inner tension and external factors such as the surrounding environment. A number of behavioural treatments have been suggested to treat the symptoms of TS, in addition to pharmacotherapy and surgery for the most severe cases. This review compiled all the studies investigating behavioural therapies for TS, briefly describing each technique and assessing the evidence in order to determine which of these appear to be effective. Different behavioural therapies that were used included habit reversal training (HRT), massed negative practice, supportive psychotherapy, exposure with response prevention, self-monitoring, cognitive-behavioural therapy, relaxation therapy, assertiveness training, contingency management, ahan controls). Statistically significant differences in RMU time between groups were seen post intervention (-7% at T1 and +15% at T2 for the intervention group). Fifty-five percent of the intervention group was willing to continue using the mouse. It appears feasible to perform an RCT for this type of intervention in a workplace setting. Further study including more participants is suggested. Practitioner Summary: The study findings support the feasibility of conducting randomised control trials in office settings to evaluate ergonomics interventions. The intervention resulted in reduced pain and discomfort in the shoulder. The intervention could be a relevant tool in the reduction of upper extremity musculoskeletal disorder. Further research will better explain the study's preliminary findings.

Behav Neurol. 2012 Nov 27. Frank M, Cavanna AE. The Michael Trimble Neuropsychiatry Research Group, Department of Neuropsychiatry, University of Birmingham and BSMHFT, Birmingham, UK College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

Numerous creative methods have been developed to incorporate computer technology into cognitive behavior therapy for anxiety disorders. In contrast, little has been written about the role that computer technology might play in therapy with hypnosis. This article is an exploration of some basic ways that clinicians can use images from computer search engines and YouTube to enhance exposure therapy for phobias. These adaptations may be particularly useful for the subgroup of patients who have difficulty re-creating and experiencing vivid and compelling aversive imagery in hypnosis, and consequently are reluctant to pursue in vivo exposure. Three cases are presented that illustrate ways in which computer images of fear inducing stimuli can be used with traditional permissive hypnosis to amplify exposure therapy.

Am J Clin Hypn. 2012 Oct;55(2):174-83. Spiegel SB. shaspi@gmail.com

Full title: Virtual reality exposure therapy and hypnosis for flying phobia in a treatment-resistant patient: a case report. Flying phobia is a problem that affects a significant portion of the population. There are a number of therapeutic approaches but no one is universally accepted as the gold standard. One therapy is hypnosis. A recent addition to the armamentarium is virtual reality exposure (VRE) therapy. Both therapies are short-term and compare favorably to in vivo desensitization. Heretofore a combination of both approaches has not been reported. This article presents a case of a 50-year phobia to flying that was refractory to traditional methods including pharmacotherapy, systematic desensitization, and cognitive behavioral therapy but was successfully treated using VRE therapy and hypnosis as the primary modalities. This treatment was supplemented by other approaches. The rationale for this multimodal therapy and possible mechanisms involved are discussed.

Am J Clin Hypn. 2012 Oct;55(2):168-73. Hirsch JA. josephhirsch1@me.com

Full title: A systems biology approach to studying Tai Chi, physiological complexity and healthy aging: Design and rationale of a pragmatic randomized controlled trial.

INTRODUCTION: Aging is typically associated with progressive multi-system impairment that leads to decreased physical and cognitive function and reduced adaptability to stress. Due to its capacity to characterize complex dynamics within and between physiological systems, the emerging field of complex systems biology and its array of quantitative tools show great promise for improving our understanding of aging, monitoring senescence, and providing biomarkers for evaluating novel interventions, including promising mind-body exercises, that treat age-related disease and promote healthy aging.

MATERIAL AND METHODS: An ongoing, two-arm randomized clinical trial is evaluating the potential of Tai Chi mind-body exercise to attenuate age-related loss of complexity. A total of 60 Tai Chi-naïve healthy older adults (aged 50-79) are being randomized to either six months of Tai Chi training (n=30), or to a waitlist control receiving unaltered usual medical care (n=30). Our primary outcomes are complexity-based measures of heart rate, standing postural sway and gait stride interval dynamics assessed at 3 and 6months. Multiscale entropy and detrended fluctuation analysis are used as entropy- and fractal-based measures of complexity, respectively. Secondary outcomes include measures of physical and psychological function and tests of physiological adaptability also assessed at 3 and 6months.

DISCUSSION: Results of this study may lead to novel biomarkers that help us monitor and understand the physiological processes of aging and explore the potential benefits of Tai Chi and related mind-body exercises for healthy aging.

Contemp Clin Trials. 2013 Jan;34(1):21-34. doi: 10.1016/j.cct.2012.09.006. Epub 2012 Sep 29. Wayne PM, Manor B, Novak V, Costa MD, Hausdorff JM, Goldberger AL, Ahn AC, Yeh GY, Peng CK, Lough M, Davis RB, Quilty MT, Lipsitz LA. Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: pwayne@partners.org.

PURPOSE OF REVIEW: The fields of clinical genetics and pharmacogenetics are rapidly expanding. Genetic factors have numerous associations with injury and with treatment effects in the setting of neural plasticity and recovery.

RECENT FINDINGS: Evidence is reviewed that established genetic variants, as well as some more recently described variants, are related to outcome after neural injury and in some cases are useful for predicting clinical course. In many cases, the interaction of genetics with clinical factors such as experience and therapy may be important. As an extension of this, genetic factors have been associated with differential response to a number of forms of therapy, including pharmacological, brain stimulation, psychotherapy, and meditation. Genetic variation might also have a significant effect on plasticity and recovery through key covariates such as depression or stress. A key point is that genetic associations might be most accurately identified when studied in relation to distinct forms of a disorder rather than in relation to broad clinical syndromes.

SUMMARY: Understanding genetic variation gives clinicians a biological signal that could be used to predict who is most likely to recover from neural injury, to choose the optimal treatment for a patient, or to supplement rehabilitation therapy.

Curr Opin Neurol. 2012 Dec;25(6):682-8. doi: 10.1097/WCO.0b013e32835a360a. Pearson-Fuhrhop KM, Burke E, Cramer SC. Department of Anatomy and Neurobiology bDepartment of Neurology, University of California, Irvine, Orange, California, USA.

Full title: Cardiovascular effects of music by entraining cardiovascular autonomic rhythms music therapy update: tailored to each person, or does one size fit all?

Music goes back a very long way in human experience. Music therapy is now used in many disparate areas-from coronary care units to rehabilitation after a stroke. But its widespread adoption has a poor scientific evidence base, founded more on enthusiasm than on proper evaluation in any controlled way. This has led to a lack of clarity about whether any particular type of music is superior, or whether different types of music should be tailored to differing individuals. We therefore conducted a series of controlled studies in which we examined the effects of different styles of music-from raga to jazz-presented in random order to normal young subjects (both musically trained or not). We found that contrary to many beliefs the effect of a style of music was similar in all subjects, whatever their individual music taste. We also found that this effect appeared to operate at a sub-conscious level through the autonomic nervous system. Furthermore, musical or verbal phrases of a 10 s duration (which coincided with the normal circulatory 'Mayer' waves) induced bigger excursions in blood pressure and heart rate (reciprocal of pulse interval) and so triggered more vagal slowing and feelings of calm. These findings need to now be tested in the clinical setting since, if confirmed, this would greatly simplify the practical use of this promising tool.

Neth Heart J. 2012 Dec 6. Sleight P. Cardiovascular Medicine, University of Oxford, Oxford, UK, peter.sleight@attglobal.net.

Both hypnosis and acupuncture have gained credibility over the years in their effectiveness for treating various health conditions. Currently, each of these treatments is administered in distinct settings and separate times. That is, even if patients receive both treatments as part of a multidimensional therapeutic program, they would typically receive them separately rather than simultaneously at the same session. This separation however might be undesirable since, at least theoretically, hypnosis and acupuncture could potentially augment each other if administered concomitantly. In this article we outline the rationale for this hypothesis and discuss the potential ramifications of its implementation.

Bnai Zion Medical Center, Internal Medicine Division Haifa, Israel, University of Arizona, Program in Integrative Medicine Arizona, USA and The Recanati Center for Medicine and Research and the Section for Integrative Medicine, Rabin Medical Center (Beilinson Campus) and the Tel-Aviv University Sackler Faculty of Medicine Israel.

by Tim Brunson PhD

Recent findings in cognitive neurosciences challenge not only traditional medicine but also many of the tenets of the incipient integrative community as well. The fact that suggestions may by themselves have direct (and measurable) neurological and physical effects open up the possibilities that new methodologies may exist for the practice of medicine and mental health, as well as for counseling and coaching. As this happens, die-hard hypnotists who are enamored by their own talents will face the realization that the Freudian-era myth of the existence of the "subconscious mind" hampers their ability to fully realize the true potential of the art of suggestion. Indeed, hypnotists and hypnotherapists are challenged to open their minds as they discard worn out litanies and assumptions.

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Background: Aromatherapy is widely used around the world for stress relief. Whether exposure to essential oil increases the risk of cardiovascular events is still unknown. The purpose of this study was to investigate the effect of essential oil on heart rate and blood pressure among solus por aqua (spa) workers. Methods: We recruited 100 healthy workers from various spa centres in Taipei, Taiwan. Between July and August of 2010, three repeated measurements - resting heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) - were taken of each spa worker in our study room. Participants were exposed to essential oil vapour generated from an ultrasonic atomizer in the study room for two consecutive hours. The total volatile organic compound (VOC) level in the study room was measured during the study period. We used a linear mixed-effect model to determine the association between the total VOC level and the participants' HR, SBP, and DBP.Results: For the times from 15 to 60 min after start of exposure, we found that the VOC level was significantly associated with reduced 15-min mean BP and HR. After exposure for more than 1 hour, from 75 to 120 min after start of exposure, we found that the VOC levels were associated with increased 15-min mean BP and HR.Conclusions: Exposure to essential oil for 1 hour was found to be an effective method of relaxation, as indicated by decreases in the HR and BP. Prolonged exposure for longer than 1 hour to essential oils may be harmful to cardiovascular health among spa workers.

Eur J Prev Cardiol. 2012 Nov 29. Chuang KJ, Chen HW, Liu IJ, Chuang HC, Lin LY. Dept of Public Health, School of Med., College of Med./School of Public Hlth College of Public Health and Nutrition, Taipei Med. Uni., Taipei, Taiwan.

Perception depends on the interplay of ongoing spontaneous activity and stimulus-evoked activity in sensory cortices. This raises the possibility that training ongoing spontaneous activity alone might be sufficient for enhancing perceptual sensitivity. To test this, we trained human participants to control ongoing spontaneous activity in circumscribed regions of retinotopic visual cortex using real-time functional MRI-based neurofeedback. After training, we tested participants using a new and previously untrained visual detection task that was presented at the visual field location corresponding to the trained region of visual cortex. Perceptual sensitivity was significantly enhanced only when participants who had previously learned control over ongoing activity were now exercising control and only for that region of visual cortex. Our new approach allows us to non-invasively and non-pharmacologically manipulate regionally specific brain activity and thus provide "brain training" to deliver particular perceptual enhancements.

J Neurosci. 2012 Dec 5;32(49):17830-41. doi: 10.1523/JNEUROSCI.6334-11.2012. Scharnowski F, Hutton C, Josephs O, Weiskopf N, Rees G. Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, and UCL Institute of Cognitive Neuroscience, University College London, London WC1N 3AR, United Kingdom, Institute of Bioengineering, Swiss Institute of Technology (EPFL), CH-1015 Lausanne, Switzerland, and Department of Radiology and Medical Informatics, Center for Biomedical Imaging (CIBM), University of Geneva, CH-1211 Geneva 14, Switzerland.

Recent studies have demonstrated the importance of identifying and addressing failures of realerting or dehypnosis. In parallel with the exploration of the adverse consequences of hypnosis in workshop settings, a number of techniques for effecting realerting subjects from hypnosis were collected. Some of these techniques are well-known, some were developed by applying techniques developed for other purposes to the task of realerting, and some were developed by the author when other known techniques proved unsuccessful or were rejected by subjects requiring dehypnosis. This article reports 15 techniques, three of which are foundational and designed to orient the subject to becoming realerted, and 12 more specific approaches to achieving dehypnosis. When appropriate, the particular opportunities of and the potential difficulties and relative contraindications for each technique are discussed.

Am J Clin Hypn. 2012 Oct;55(2):140-59. Kluft RP. Temple University School of Medicine, Philadelphia, Pennsylvania, USA. rpkluft@aol.com

Objective: To investigate whether listening to pleasant music improves visual attention to and awareness of contralesional stimuli in patients with unilateral neglect after stroke. Methods: A within-subject design was used with 19 participants with unilateral neglect following a right hemisphere stroke. Participants were tested in three conditions (pleasant music, unpleasant music and white noise) within 1 week. All musical pieces were chosen by the participants. In each condition, participants were asked to complete three sub-tests of the Behavioural Inattention Test (the Star Cancellation Test, the Line Bisection Test and the Picture Scanning test) and a visual exploration task with everyday scenes. Eye movements in the visual exploration task were recorded simultaneously. Mood and arousal induced by different auditory stimuli were assessed using visual analogue scales, heart rate and galvanic skin response. Results: Compared with unpleasant music and white noise, participants rated their moods as more positive and arousal as higher with pleasant music, but also showed significant improvement on all tasks and eye movement data, except the Line Bisection Test. Conclusion: The findings suggest that pleasant music can improve visual attention in patients with unilateral neglect after stroke. Additional research using randomized controlled trials is required to validate these findings.

Brain Inj. 2013;27(1):75-82. doi: 10.3109/02699052.2012.722255. Chen MC, Tsai PL, Huang YT, Lin KC. Department of Occupational Therapy, National Cheng Kung University , Tainan , Taiwan.

Nan Lu is the founding director of the Traditional Chinese Medicine World Foundation and its sister organization, the American Taoist Healing Center. Classically and university trained. Dr. Lu is a New York State-licensed acupuncturist, a master herbalist, an internationally recognized Taiji expert and Qigong master, and the best-selling author of three TCM Books.

Answer questions and earn CME/CNE Hypnosis has been used to provide psychological and physical comfort to individuals diagnosed with cancer for nearly 200 years. The goals of this review are: 1) to describe hypnosis and its components and to dispel misconceptions; 2) to provide an overview of hypnosis as a cancer prevention and control technique (covering its use in weight management, smoking cessation, as an adjunct to diagnostic and treatment procedures, survivorship, and metastatic disease); and 3) to discuss future research directions. Overall, the literature supports the benefits of hypnosis for improving quality of life during the course of cancer and its treatment. However, a great deal more work needs to be done to explore the use of hypnosis in survivorship, to understand the mediators and moderators of hypnosis interventions, and to develop effective dissemination strategies. CA Cancer J Clin 2012. © 2012 American Cancer Society.

CA Cancer J Clin. 2012 Nov 20. doi: 10.3322/caac.21165. Montgomery GH, Schnur JB, Kravits K. Director, Integrative Behavioral Medicine Program, Associate Professor, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY. guy.montgomery@mssm.edu.

by Tim Brunson PhD

The placebo effect and suggestion are indeed similar. They provide positive expectations. And, when coupled with the reverent authority of the operator or administrator of the drug, both present great value. However, since the standards (used by the FDA) attribute only a 0.3 correlation to the placebo effect, this does not explain why the use of hypnosis can produce much greater results. For instance, in forensic hypnosis approximately 80% of the cases were either solved leading to conviction or valuable information was obtained (according to Dr. Diamond, the head psychologist for the LAPD). Also, my experience with IBS and Fibromyalgia is that about 90% of the refractory, long-term cases benefit with major symptom relief through the use of hypnosis protocols. This is backed up by several research studies conducted by medical hospitals and documented on PUBMED.

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OBJECTIVE: Dissociation is a mental process with psychological and somatoform manifestations, which is closely related to hypnotic suggestibility and essentially shows the ability to obtain distance from reality. An increased tendency to dissociate is a frequently reported characteristic of patients with functional neurological symptoms and syndromes (FNSS), which account for a substantial part of all neurological admissions. This review aims to investigate what heart rate variability (HRV), EEG and neuroimaging data (MRI) reveal about the nature of dissociation and related conditions.

METHODS: Studies reporting HRV, EEG and neuroimaging data related to hypnosis, dissociation and FNSS were identified by searching the electronic databases Pubmed and ScienceDirect.

RESULTS: The majority of the identified studies concerned the physiological characteristics of hypnosis; relatively few investigations on dissociation related FNSS were identified. General findings were increased parasympathetic functioning during hypnosis (as measured by HRV), and lower HRV in patients with FNSS. The large variety of EEG and functional MRI investigations with diverse results challenges definite conclusions, but evidence suggests that subcortical as well as (pre)frontal regions serve emotion regulation in dissociative conditions. Functional connectivity analyses suggest the presence of altered brain networks in patients with FNSS, in which limbic areas have an increased influence on motor preparatory regions.

CONCLUSIONS: HRV, EEG and (functional) MRI are sensitive methods to detect physiological changes related to dissociation and dissociative disorders such as FNSS, and can possibly provide more information about their aetiology. The use of such measures could eventually provide biomarkers for earlier identification of patients at risk and appropriate treatment of dissociative conditions.

J Neurol Neurosurg Psychiatry. 2012 Nov 22. van der Kruijs SJ, Bodde NM, Carrette E, Lazeron RH, Vonck KE, Boon PA, Langereis GR, Cluitmans PJ, Feijs LM, Hofman PA, Backes WH, Jansen JF, Aldenkamp AP. Epilepsy Centre Kempenhaeghe, , Heeze, The Netherlands.

Abstract Objectives: The aim of this study was to investigate the effect of ear-press needle acupuncture on Yintang point for preoperative anxiety. Design: This was a prospective, randomized, single-blind, controlled study. Settings/location: The study setting was the Department of Anesthesiology in Ankara Training and Research Hospital of Ministry of Health, Ankara, Turkey. Subjects: The study comprised 52 adult surgical patients. Interventions: A single, 20-minute session of single-point acupuncture was applied on Yintang (acupuncture group) or sham point (sham acupuncture group). Outcome measures: The efficacy of acupuncture was evaluated by means of the changes in bispectral index (BIS) and STAI (State-Trait Anxiety Index). Results: BIS values in the acupuncture group were significantly lower than in the sham group in all time intervals (p<0.0042). BIS values were lower than baseline in the study group during the entire study period (p<0.0004) while no such effect has been observed in the sham group (p>0.0004). Mean values of state anxiety (STAI-S) decreased after acupuncture in the study group (p=0,018), while no change was observed in trait anxiety (STAI-T) (p=0.156). Patients of the sham group showed no change in both parameters (p=0.387 and p=0,116). Conclusions: Ear-press needle acupuncture on Yintang point reduces preoperative anxiety in adult surgical patients.

J Altern Complement Med. 2012 Dec 27. Acar HV, Cuvas O, Ceyhan A, Dikmen B. Department of Anesthesiology and Intensive Care, Ankara Training and Research Hospital of Ministry of Health , Ankara, Turkey .