Full title: A99: Symptom and Treatment Characteristics of Juvenile Primary Fibromyalgia Syndrome in the CARRA Registry: Are Males and Females Created Equal?

BACKGROUND/PURPOSE: Children and adolescents with juvenile primary fibromyalgia syndrome (JPFS) often present to pediatric rheumatologists for evaluation. Limited data are available on the characteristics of and treatments used for JPFS, particularly in males. METHODS: We evaluated deidentified data from baseline visits of JPFS patients entered in the Childhood Arthritis & Rheumatology Research Alliance (CARRA) registry between May 2010 and September 2013. Data regarding demographics, symptoms, functional measures and treatment are compared as a function of gender. RESULTS: There were 172 patients (27 males), ages 8-21 years (Mean (M) = 15.4 +/- 2.3). Patients were symptomatic for a mean of 1.7 +/- 2.2 years prior to their first visit, with no significant difference between males and females (M = 2.2 vs. 1.6 respectively, t(169) = 1.19, p = .2). Widespread pain (89%), fatigue (83%), disordered sleep (77%), headaches (61%), and extremity numbness/tingling (32%) were the most commonly reported symptoms. Females had more numbness and tingling (35% vs. 13% respectively, ?(2) = 4.4, p = 0.04). Table lists treatments used. Males were significantly more likely to have used gabapentin (26% vs. 8%, ?(2) = 7.6, p <0.01). Of the 63 patients using non-pharmacologic treatment, females were significantly more likely to have used massage and yoga. Over 50% of patients received education on JPFS, sleep hygiene, and general counseling. Graded aerobic activity and physical therapy were commonly prescribed. Less then 10% of patients tried opioids, serotonin norepinephrine reuptake inhibitors, craniosacral therapy, hypnosis, and biofeedback. [Table: see text] Mean pain scores were moderate to severe (6.3 +/- 2.5/10) and were significantly positively related to Childhood Health Assessment Questionnaire (CHAQ) scores (r = .3, p <.01), patient ratings of impairment in health-related quality of life (HRQOL) (r = .4, p < .01), and patient ratings of impairment in overall well-being (r = .6, p < .01) both for males and females. Males were more disabled based on subjective (patient/parent report) functioning measures (HRQOL and CHAQ), although no differences were observed on physician report measures (physician global assessment and ACR functional class). CONCLUSION: Based on data from the largest known cohort of JPFS patients, there are few significant gender differences in physician assessment of disease activity. However, higher levels of disability reported by male patients suggest the need to consider gender when evaluating and treating JPFS patients. Possible explanations for the discrepancies in treatment include effects of gender on physician's perception of patient's pain leading to more medication use among males or females being more willing to try non-pharmacologic modes of treatment. Future studies on gender and treatment outcomes are needed to improve care for these patients.

Arthritis Rheumatol. 2014 Mar;66 Suppl 11:S134. doi: 10.1002/art.38516. Weiss JE(1), Schikler K, Boneparth A, Hoffart C, Connelly M. Author information: (1)Joseph M Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ.

Copyright © 2014 by the American College of Rheumatology.

by Tim Brunson, PhD

Whether part of our formal education, professional development, or the improvement of skills related to a hobby, in order to more efficiently acquire information we seldom focus on the need to improve our learning skill. Yes, we focus on content and pretty much ignore the need to improve our learning processes. However, our ability to master the tasks related to an endeavor depends almost entirely on our improving our ability to acquire knowledge.

Learning is a process skill that was established first at the infant and young child period of our lives. Our methods were habituated at a time when our immature brains were rapidly developing. Some of the ways that we encoded procedural and declarative memories are as valid in our adult life as they were in those early years. Nevertheless, as a mature human with several decades of knowledge acquisition under our hats, we now have numerous additional learning advantages that are ignored should we continue to use methods that were appropriate prior to our brain fully developing.

[More]

Garrett Buttel, MA, CH, is the Board Certified Director of the Monmouth Hypnosis Center in Middletown, NJ. Garrett has lived in New Jersey all his life. After being discharged from the Air Force in 1971, he accepted a position as Veterans Counselor on Campus and spent many years helping Vietnam Veterans and their dependents.

This experience sparked an interest in further developing his counseling skills and he returned to college to obtain an advanced degree in counseling. Garrett spent many years counseling and helping incompetent veterans and their families.

Garrett is certified by the Banyan Hypnosis Center for Training & Services, Inc. as a Certified 5-path Hypnotherapist and 7th path Self-Hypnosis Instructor. He also has completed courses at Omni-Hypnosis Center in Deland, Florida and the New Jersey Institute of Hypnotherapy.

Garrett Buttel is a member of The National Guild of Hypnotists and The International Association of Medical and Dental Hypnotherapy, and he is a Board Certified Member of the National Board of Hypnosis Education and Certification.

For more information, visit www.MonmouthHypnosisCenter.com

Because acute procedural pain tends to increase with procedure time, assessments of pain management strategies must take that time relationship into account. Statistical time-course analyses are, however, complex and require large patient numbers to detect differences. The current study evaluated the abilities of various single and simple composite measures such as averaged pain or individual patient pain slopes to detect treatment effects. Secondary analyses were performed with the data from 3 prospective randomized clinical trials that assessed the effect of a self-hypnotic relaxation intervention on procedural pain, measured every 10-15minutes during vascular/renal interventions, breast biopsies, and tumor embolizations. Single point-in-time and maximal pain comparisons were poor in detecting treatment effects. Linear data sets of individual patient slopes yielded the same qualitative results as the more complex repeated measures analyses, allowing the use of standard statistical approaches (eg, Kruskal-Wallis), and promising analyses of smaller subgroups, which otherwise would be underpowered. With nonlinear data, a simple averaged score was highly sensitive in detecting differences. Use of these 2 workable and relatively simple approaches may be a first step towards facilitating the development of data sets that could enable meta-analyses of data from acute pain trials.

Pain. 2014 Jul;155(7):1365-73. doi: 10.1016/j.pain.2014.04.013. Lang EV(1), Tan G(2), Amihai I(2), Jensen MP(3). Author information: (1)Hypnalgesics LLC, Brookline, MA, USA. Electronic address: drevlang@hypnalgesics.com. (2)Department of Psychology, National University of Singapore, Singapore. (3)Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.

Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

The Berlin physician Albert Moll (1862-1939) was an advocate of hypnotic suggestion therapy and a prolific contributor to the medical, legal and public discussions on hypnotism from the 1880s to the 1920s. While his work in other areas, such as sexology, medical ethics and parapsychology, has recently attracted scholarly attention, this paper for the first time comprehensively examines Moll's numerous publications on hypnotism and places them in their contemporary context. It covers controversies over the therapeutic application of hypnosis, the reception of Moll's monograph Der Hypnotismus (1889), his research on the rapport between hypnotizer and subject, his role as an expert on 'hypnotic crime', and his views on the historical influence of hypnotism on the development of psychotherapy. My findings suggest that Moll rose to prominence due to the strong late-nineteenth-century public and medical interest in the phenomena of hypnosis, but that his work was soon overshadowed by new, non-hypnotic psychotherapeutic approaches, particularly Freud's psychoanalysis.

Hist Psychiatry. 2014 Mar;25(1):3-19. doi: 10.1177/0957154X13500596. Maehle AH. Author information: Durham University.

Dr. Starr is the author of four books that help readers to improve their lives and to achieve their personal goals. She is the director of the New England Insitute of Hypnotherapy. She is known as the "Hypnotherapist to the Stars" for her recent work with celebrities, and holds degrees in Education, English, and Hypnotherapy, and has been empowering students and graduates for over 27 years.

BACKGROUND: Although headaches in childhood are common, there are few data available on their long-term prognosis. We have monitored a group of patients since diagnosis in 1983. METHODS: Patients who were part of the 20-year follow-up study in 2003 were contacted, and data were collected using a standardized telephone interview. Details of headache characteristics and identified precipitants and alleviating factors were gathered. The most effective means of controlling the headaches were also recorded. RESULTS: Follow-up was achieved for 28 of 60 patients (47%). Over the 30 years since diagnosis, eight patients (29%) reported a complete resolution of headaches, including three whose headaches resolved between the 20- and 30-year follow-up studies. The type of headache varied over the 30-year time interval with only three patients maintaining the same headache type at all four time periods of 1983, 1993, 2003, and 2013. Only one patient used prescription medication as the primary method for controlling headaches. The most commonly used intervention was nonprescription analgesia, self-relaxation and/or hypnosis, and precipitant avoidance. CONCLUSIONS: Headaches persist in approximately 70% of children 30 years after diagnosis. Encouraging children to manage their headaches with simple analgesia and precipitant avoidance appears to have long-term benefits.

Pediatr Neurol. 2014 Jul;51(1):85-7. doi: 10.1016/j.pediatrneurol.2014.02.022. Dooley JM(1), Augustine HF(2), Brna PM(2), Digby AM(2). Author information: (1)Department of Pediatrics, Pediatric Neurology Division, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: jdooley@dal.ca. (2)Department of Pediatrics, Pediatric Neurology Division, Dalhousie University, Halifax, Nova Scotia, Canada.

Copyright © 2014 Elsevier Inc. All rights reserved.

PURPOSE: Persons who stutter (PWS) should be referred to the most effective treatments available, locally or regionally. A prospective comparison of the effects of the most common stuttering treatments in Germany is not available. Therefore, a retrospective evaluation by clients of stuttering treatments was carried out. METHOD: The five most common German stuttering treatments (231 single treatment cases) were rated as to their perceived effectiveness, using a structured questionnaire, by 88 PWS recruited through various sources. The participants had received between 1 and 7 treatments for stuttering. RESULTS: Two stuttering treatments (stuttering modification, fluency shaping) showed favorable and three treatments (breathing therapy, hypnosis, unspecified logopedic treatment) showed unsatisfactory effectiveness ratings. The effectiveness ratings of stuttering modification and fluency shaping did not differ significantly. The three other treatments were equally ineffective. The differences between the effective and ineffective treatments were of large effect sizes. The typical therapy biography begins in childhood with an unspecified logopedic treatment administered extensively in single and individual sessions. Available comparisons showed intensive or interval treatments to be superior to extensive treatments, and group treatments to be superior to single client treatments. CONCLUSION: The stuttering treatment most often prescribed in Germany, namely a weekly session of individual treatment by a speech-language pathologist, usually with an assorted package of mostly unknown components, is of limited effectiveness. Better effectiveness can be expected from fluency shaping or stuttering modification approaches, preferably with an intensive time schedule and with group sessions. EDUCATIONAL OBJECTIVES: Readers will be able to: (a) discuss the five most prevalent stuttering treatments in Germany; (b) summarize the effectiveness of these treatments; and (c) describe structural treatment components that seem to be preferable across different kinds of treatments.

J Fluency Disord. 2014 Mar;39:1-11. doi: 10.1016/j.jfludis.2014.01.002. Euler HA(1), Lange BP(2), Schroeder S(3), Neumann K(4). Author information: (1)Department of Phoniatrics and Pediatric Audiology, Clinic of Otolaryngology, Head and Neck Surgery, St. Elisabeth Hospital, Ruhr-University Bochum, Bleichstr. 16, D-44787 Bochum, Germany. Electronic address: euler@uni-kassel.de. (2)Department of Medical Psychology and Medical Sociology, Georg-August-University Goettingen, Waldweg 37, D-37073 Goettingen, Germany. Electronic address: benjamin.lange@med.uni-goettingen.de. (3)Max Planck Institute for Human Development, Lentzeallee 94, D-14195 Berlin, Germany; Institute of Psychology, University of Kassel, Hollaendische Str. 36-38, D-34127 Kassel, Germany. Electronic address: sascha.schroeder@mpib-berlin.de. (4)Department of Phoniatrics and Pediatric Audiology, Clinic of Otolaryngology, Head and Neck Surgery, St. Elisabeth Hospital, Ruhr-University Bochum, Bleichstr. 16, D-44787 Bochum, Germany. Electronic address: Katrin.Neumann@rub.de.

Copyright © 2014 Elsevier Inc. All rights reserved.

by Tim Brunson, PhD

Over the past several decades I have studied numerous people who have achieved mastery in one or more physical or mental skills. Among them were athletes, musicians, scholars, scientists, and even spiritual adepts. I even included in this austere group those who have overcome terminal illnesses miraculously by changing their thought processes. While some of them have translated misfortune or even physical deformities into opportunities to develop specific habits, many were average people for whom circumstances led them to focus on allowing greatness to occur.

During my research into the origins of masterful performance, much was learned when looking at extreme cases. This included individuals who were introduced to particular endeavors very early in life, as well as those that pursued specific interests later in life and were able to focus during thousands of hours of practice. However, some of the most interesting case studies involved the amazing abilities of prodigious savants such as Kim Peek (mnemonist, speed reader, and calculator), Daniel Tammet (mathematical synesthesia, language absorption, and memory), and Alonzo Clemmons (clay sculptor). Another phenomena that I became interested in were innovations in neuroplasticity, which shows the brain's ability to reorganize, and the seemingly related concept regarding innovations in stroke recovery – especially the work of Edward Taub, PhD, at the University of Alabama, Birmingham.

[More]

Erika Duffy graduated from The Institute of Transformational Studies with a Doctorate in C.O.R.E.™ Education, is a Certified Hypnotherapist and is a registered member of the National Guild of Hypnotherapists; specializing in weight reduction, smoking, Attention Deficit Disorder, Attention Deficit Hyperactive Disorder, scholastic improvements and self esteem. Erika has been featured on the front cover of "Applaud" magazine and is also a Certified Holistic Counselor and a Certified Enneagram Counselor specializing in helping people release old destructive patterns of emotions and thoughts that prevent them from being happier, healthier and successful. She is a member of the American Society of Alternative Therapists (ASAT), and is registered with the International Center for Reiki Training in Southfield, Michigan. Erika is also a Certified Life Between Life Therapist, personally trained by Dr. Michael Newton, author of "Journey of Souls" and "Destiny of Souls". She is also a newspaper columnist featured regularly in the Kaleidescope Journal and the Goffstown Spirit Newspaper. Erika is also a three time bestselling co-author of "Wake Up and Live the Life You Love, Living on Purpose", "Seizing Your Success" ad "A Search For Purpose" with Deepak Chopra, Dr. Wayne Dyer, and Mark Victor Hansen (author of the Chicken Soup of the Soul Series).

[More]

BACKGROUND: With increasing survival estimates for individuals with cystic fibrosis, long-term management has become an important focus. Psychological interventions are largely concerned with adherence to treatment, emotional and social adaptation and health-related quality of life. We are unaware of any relevant systematic reviews. OBJECTIVES: To determine whether psychological interventions for people with cystic fibrosis provide significant psychosocial and physical benefits in addition to standard medical care. SEARCH METHODS: Studies were identified from two Cochrane trials registers (Cystic Fibrosis and Genetic Disorders Group; Depression, Anxiety and Neurosis Group), Ovid MEDLINE and PsychINFO; unpublished trials were located through professional networks and Listserves. Most recent search of the Cystic Fibrosis and Genetic Disorders Group's register: 19 December 2013.Most recent search of the Depression, Anxiety and Neurosis Group's register: 12 November 2013. SELECTION CRITERIA: Randomised controlled studies of a broad range of psychological interventions evaluating subjective and objective health outcomes, such as quality of life or pulmonary function, in individuals of all ages with cystic fibrosis and their immediate family. We were interested in psychological interventions, including psychological methods within the scope of psychotherapeutic or psychosomatic mechanism of action (e.g. cognitive behavioural, cognitive, family systems or systemic, psycho-dynamic, or other, e.g. supportive, relaxation, or biofeedback), which were aimed at improving psychological and psychosocial outcomes (e.g. quality of life, levels of stress or distress, psychopathology, etc.), adaptation to disease management and physiological outcomes. DATA COLLECTION AND ANALYSIS: Three authors were involved in selecting the eligible studies and two of these authors assessed their risk of bias. MAIN RESULTS: The review includes 16 studies (eight new studies included in this update) representing data from 556 participants. Studies are diverse in their design and their methods. They cover interventions with generic approaches, as well as interventions developed specifically to target disease-specific symptoms and problems in people with cystic fibrosis. These include cognitive behavioural interventions to improve adherence to nutrition or psychosocial adjustment, cognitive interventions to improve adherence or those associated with decision making in lung transplantation, a community-based support intervention and other interventions, such as self-hypnosis, respiratory muscle biofeedback, music therapy, dance and movement therapy, and a tele-medicine intervention to support patients awaiting transplantation.A substantial proportion of outcomes relate to adherence, changes in physical status or other specific treatment concerns during the chronic phase of the disease.There is some evidence that behavioural interventions targeting nutrition and growth in children (4 to 12 years) with cystic fibrosis are effective in the short term. Evidence was found that providing a structured decision-making tool for patients considering lung transplantation improves patients' knowledge of and expectations about the transplant, and reduces decisional conflict in the short term. One study about training in biofeedback-assisted breathing demonstrated some evidence that it improved some lung function measurements. Currently there is insufficient evidence for interventions aimed at other aspects of the disease process. AUTHORS' CONCLUSIONS: Currently, insufficient evidence exists on psychological interventions or approaches to support people with cystic fibrosis and their caregivers, although some of the studies were promising. Due to the heterogeneity between studies, more of each type of intervention are needed to support preliminary evidence. Multicentre studies, with consequent funding implications, are needed to increase the sample size of these studies and enhance the statistical power and precision to detect important findings. In addition, multicentre studies could improve the generalisation of results by minimizing centre or therapist effects. Psychological interventions should be targeted to illness-specific symptoms or behaviours to demonstrate efficacy.

Cochrane Database Syst Rev. 2014 Jun 18;6:CD003148. Goldbeck L(1), Fidika A, Herle M, Quittner AL. Author information: (1)Dptm. Child and Adolescent Psychiatry/Psychotherapy, University Clinic Ulm, Steinhoevelstr. 5, Ulm, Baden-Württemberg, Germany, D-89075.

Chronic pain is common, and the available treatments do not provide adequate relief for most patients. Neuromodulatory interventions that modify brain processes underlying the experience of pain have the potential to provide substantial relief for some of these patients. The purpose of this Review is to summarize the state of knowledge regarding the efficacy and mechanisms of noninvasive neuromodulatory treatments for chronic pain. The findings provide support for the efficacy and positive side-effect profile of hypnosis, and limited evidence for the potential efficacy of meditation training, noninvasive electrical stimulation procedures, and neurofeedback procedures. Mechanisms research indicates that hypnosis influences multiple neurophysiological processes involved in the experience of pain. Evidence also indicates that mindfulness meditation has both immediate and long-term effects on cortical structures and activity involved in attention, emotional responding and pain. Less is known about the mechanisms of other neuromodulatory treatments. On the basis of the data discussed in this Review, training in the use of self-hypnosis might be considered a viable 'first-line' approach to treat chronic pain. More-definitive research regarding the benefits and costs of meditation training, noninvasive brain stimulation and neurofeedback is needed before these treatments can be recommended for the treatment of chronic pain.

Nat Rev Neurol. 2014 Mar;10(3):167-78. doi: 10.1038/nrneurol.2014.12. Jensen MP(1), Day MA(1), Miró J(2). Author information: (1)Department of Rehabilitation Medicine, University of Washington, Harborview Medical Center, 325 9th Avenue, Seattle, WA 98104-2499, USA. (2)Department of Psychology, Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007 Tarragona, Spain.

Dr. Freeman earned her degree in psychology with an emphasis in mind-body therapies (i.e., meditation, relaxation, and imagery) as medical intervention for chronic disease. In 2006, she completed a Phase I study of imagery as intervention with women recovering from breast cancer treatment. This National Institutes of Health/National Cancer Institute-funded study produced statistically and clinically significant improvements in quality of life, mood state and functionality.

In 2007, Dr. Freeman and Mind Matters Research were awarded a TREND grant to test videoconference technology for delivery of mind-body treatments at remote locations with limited bandwidth. Technology was also tested for its presentation of 'human qualities' (e.g., voice tone, skin tone, pupil dilation) and the sense of the trainer's presence. The grant was completed in November, 2007. Outcomes were submitted as pilot data for a Phase II, National Cancer Institute grant on imagery as intervention for breast cancer survivors. In the Phase II NCI grant, imagery training will be delivered both in person, and live via videoconference. Outcomes will be compared between these groups, as well as compared to waitlist control groups.

Full title: A randomized controlled trial of hypnosis compared with biofeedback for adults with chronic low back pain.

BACKGROUND: Chronic low back pain (CLBP) is common and results in significant costs to individuals, families and society. Although some research supports the efficacy of hypnosis for CLBP, we know little about the minimum dose needed to produce meaningful benefits, the roles of home practice and hypnotizability on outcome, or the maintenance of treatment benefits beyond 3 months. METHODS: One hundred veterans with CLBP participated in a randomized, four-group design study. The groups were (1) an eight-session self-hypnosis training intervention without audio recordings for home practice; (2) an eight-session self-hypnosis training intervention with recordings; (3) a two-session self-hypnosis training intervention with recordings and brief weekly reminder telephone calls; and (4) an eight-session active (biofeedback) control intervention. RESULTS: Participants in all four groups reported significant pre- to post-treatment improvements in pain intensity, pain interference and sleep quality. The hypnosis groups combined reported significantly more pain intensity reduction than the control group. There was no significant difference among the three hypnosis conditions. Over half of the participants who received hypnosis reported clinically meaningful (=30%) reductions in pain intensity, and they maintained these benefits for at least 6 months after treatment. Neither hypnotizability nor amount of home practice was associated significantly with treatment outcome. CONCLUSIONS: The findings indicate that two sessions of self-hypnosis training with audio recordings for home practice may be as effective as eight sessions of hypnosis treatment. If replicated in other patient samples, the findings have important implications for the application of hypnosis treatment for chronic pain management.

© 2014 European Pain Federation - EFIC®

Eur J Pain. 2014 Jun 17. doi: 10.1002/ejp.545. Tan G(1), Rintala DH, Jensen MP, Fukui T, Smith D, Williams W. Author information: (1)Department of Psychology, National University of Singapore, Singapore.

Hypnotherapy is an often misunderstood yet effective therapy. It has been reported to be useful within the field of paediatric respiratory medicine as both a primary and an adjunctive therapy. This article gives a brief overview of how hypnotherapy is performed followed by a review of its applications in paediatric patients with asthma, cystic fibrosis, dyspnea, habit cough, vocal cord dysfunction, and those requiring non-invasive positive pressure ventilation. As the available literature is comprised mostly of case series, retrospective studies, and only a single small randomized study, the field would be strengthened by additional randomized, controlled trials in order to better establish the effectiveness of hypnosis as a treatment, and to identify the processes leading to hypnosis-induced physiologic changes. As examples of the utility of hypnosis and how it can be taught to children with respiratory disease, the article includes videos that demonstrate its use for patients with cystic fibrosis.

Paediatr Respir Rev. 2014 Mar;15(1):82-5. doi: 10.1016/j.prrv.2013.09.002. McBride JJ(1), Vlieger AM(2), Anbar RD(3). Author information: (1)Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA. (2)Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands. (3)Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA. Electronic address: anbarr@upstate.edu.

Copyright © 2013 Elsevier Ltd. All rights reserved.

by Tim Brunson, PhD

Cognitive neuroscientists continue to seek further relationships between neural structures and behavior (Raz et al. 2006). The previous chapter discusses that neuroplasticity explains how the brain can reorganize. This occurs normally when dormant (or less used) parts of the brain take over a function of another part of the brain due to events such as a stroke. Scientists involved in researching the savant syndrome recognize that prodigious savants somehow tap these hidden reserves of the mind (Treffert, 1989; Walsh & Pascual-Leone, 2003; Evans, 2007). So it is reasonable to deduce that a brain can easily entrain since it has this dormant or hidden potential readily available.

[More]

Daniel F. Cleary, is an internationally recognized, certified Hypnosis Instructor and a certified Master Practitioner of NeuroLinguistic Psychology. Teaching Hypnosis and Hypnotic Techniques throughout the United States and Europe to Doctors, Psychologists, Therapists and other Hypnotists, his specialties include Pain Relief and Personal Transformation.

Daniel is the founder and director of Hypnosis for Health Learning Center, based in North Palm Beach, Florida. He established and serves as president of The Palm Beach Hypnosis Group. He is a regular member of the teaching faculty at many of the national and international Hypnosis conferences and has provided specialized training for Hypnotists and licensed professional therapists since 1996.

For more information, visit www.danclearyhypnosis.com

Energy and Mind/Body/Performance Transformation

by Tim Brunson, PhD

The future of mental health, medicine, and human performance coaching resides in a much better understanding of the role that energy plays in both our demise and our positive transformation. Energy is the only true common denominator that permeates our neurophysiology, our personalities, our thoughts and behavior, and our fears, hopes, and dreams. So whatever the medical protocol, the alphabet acronym used to refer to psychological interventions, or technique that inspires us, somehow energy is involved. Thus it behooves us to understand the nature and function of energy much better as we seek answers to both human maladies and potential.

[More]

OBJECTIVE: To assess the efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome by a meta-analysis of randomized controlled trials. METHODS: Studies were identified by a literature search of the databases Allied and Complementary Medicine Database, Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycINFO, and Scopus (from inception to June 30, 2013). Primary outcomes were adequate symptom relief, global gastrointestinal score, and safety. Summary relative risks (RRs) with number needed to treat (NNT) and standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated using random-effects models. RESULTS: Eight randomized controlled trials with a total of 464 patients and a median of 8.5 (7-12) hypnosis sessions over a median of 12 (5-12) weeks were included into the analysis. At the end of therapy, hypnosis was superior to control conditions in producing adequate symptom relief (RR, 1.69 [95% CI = 1.14-2.51]; NNT, 5 [3-10]) and in reducing global gastrointestinal score (SMD, 0.32 [95% CI = -0.56 to -0.08]). At long-term follow-up, hypnosis was superior to controls in adequate symptom relief (RR, 2.17 [95% CI = 1.22-3.87]; NNT, 3 [2-10]), but not in reducing global gastrointestinal score (SMD, -0.57 [-1.40 to 0.26]). One (0.4%) of 238 patients in the hypnosis group dropped out due to an adverse event (panic attack). CONCLUSION: This meta-analysis demonstrated that hypnosis was safe and provided long-term adequate symptom relief in 54% of patients with irritable bowel syndrome refractory to conventional therapy.

Psychosom Med. 2014 Jun 4. Schaefert R(1), Klose P, Moser G, Häuser W. Author information: (1)From the Department of General Internal Medicine and Psychosomatics (R.S.), University of Heidelberg, Heidelberg, Germany; Department of Internal and Integrative Medicine (P.K.), Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany; Department of Internal Medicine III (G.M.), Medical University of Vienna, Vienna, Austria; Department of Internal Medicine I (W.H.), Klinikum Saarbrücken, Saarbrücken, Germany; and Department of Psychosomatic Medicine (W.H.), Technische Universität München, München, Germany.

A child or adolescent can suffer from chronic pain. Whatever the causes, it can trap the child in a specific process whereby they focus on the pain, fearing that it will appear and experiencing anxiety. Hypno-analgesia and hypnotherapy enable them to escape this process and find within themselves the capacity to face up to the pain. Moreover, these techniques offer them an autonomy which they can use in all areas of their life.

Soins Pediatr Pueric. 2014 Mar-Apr;(277):36-8. Célestin-Lhopiteau I.

Full title: Systematic Review and Meta-Analysis: Distraction and Hypnosis for Needle-Related Pain and Distress in Children and Adolescents.

OBJECTIVE: To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and a dolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy. METHODS: 26 distraction and 7 hypnosis trials were included and self-report, observer-report, and behavioral pain intensity and distress examined. Distraction studies were coded for 4 intervention characteristics, and all studies coded for child age and study risk of bias. RESULTS: Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however. Characteristics of distraction interventions, child age, and study risk of bias showed some influence on treatment efficacy. CONCLUSIONS: Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved.

Pediatr Psychol. 2014 Jun 2. pii: jsu029. Birnie KA(1), Noel M(2), Parker JA(2), Chambers CT(3), Uman LS(4), Kisely SR(2), McGrath PJ(3).

© The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

BACKGROUND: Psychogenic non-epileptic seizures, also known as non-epileptic attack disorder (NEAD), have the outward appearance of epilepsy in the absence of physiological or electroencephalographic correlates. Non-epileptic seizures can occur in isolation or in combination with epileptic seizures. The development and maintenance of non-epileptic seizures has been well documented and there is a growing literature on the treatment of non-epileptic seizures which includes non-psychological (including anti-anxiety and antidepressant pharmacological treatment) and psychological therapies (including cognitive behavioural therapy (CBT), hypnotherapy and paradoxical therapy). Various treatment methodologies have been tried with variable success. The purpose of this Cochrane review was to establish the evidence base for the treatment of non-epileptic seizures with behavioural and psychological therapies only. OBJECTIVES: To assess whether behavioural or psychological treatments for non-epileptic seizures or NEAD result in a reduction in the frequency of seizures or improvement in quality of life, or both, and whether any treatment is significantly more effective than others. SEARCH METHODS: We searched the Cochrane Epilepsy Group's Specialised Register (4 February 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 1) (January 2013), MEDLINE (1946 to 4 February 2013), PsycINFO (4 February 2013) and SCOPUS (4 February 2013). No language restrictions were imposed. We checked the reference lists of retrieved studies for additional reports of relevant studies SELECTION CRITERIA: Randomised controlled trials (RCTs) and before and after controlled and non-controlled studies were eligible for inclusion. Studies were required to assess one or more types of behavioural or psychological interventions, or both, for the treatment of non-epileptic seizures. Studies of childhood non-epileptic seizures were excluded from our review. DATA COLLECTION AND ANALYSIS: Two review authors (JM, JP) independently assessed the trials for inclusion and extracted data. Outcomes included reduction in seizure frequency and improvements in quality of life. MAIN RESULTS: Twelve studies, with a total of 343 participants, met our inclusion criteria (four RCTs and eight before and after non-controlled studies). Of the four RCTs, one examined patients with non-epileptic seizures and three had a mixed diagnosis (pseudoseizures, conversion disorder and somatisation disorder). Most of the non-randomised studies used non-epileptic seizure patients exclusively. Overall, five studies examined the effectiveness of psychotherapy, three examined CBT, two investigated hypnosis, one assessed paradoxical intention and one had a mixed intervention design. We classified two included studies as low risk of bias, one as unclear and nine as high risk of bias. Meta-analysis could not be undertaken due to the heterogeneity of design and interventions. Most included studies reported improved outcomes for the intervention under investigation. One RCT investigating the effectiveness of CBT in this patient group found a significant reduction in seizure frequency compared to controls (P < 0.001). AUTHORS' CONCLUSIONS: There is little reliable evidence to support the use of any treatment, including CBT, in the treatment of non-epileptic seizures. Further randomised controlled trials of CBT and other interventions are needed.

Cochrane Database Syst Rev. 2014 Feb 11;2:CD006370. doi: 10.1002/14651858.CD006370.pub2. Martlew J(1), Pulman J, Marson AG. Author information: (1)Department of Neuropsychology, The Walton Centre, Jubilee House, 10th Avenue, Fazakerley, Liverpool, Mersyside, UK, L9 7AL.

Update of Cochrane Database Syst Rev. 2007;(1):CD006370.

by Tim Brunson, PhD

The feedback loop between the mind and body is extremely strong. Consider the phantom limb syndrome. When a person loses an arm or leg, the related areas of the somatosensory cortex are still present. Additionally, as the insula plays an important role in sensing the body, it also plays a critical role in the mind holding an awareness of the lost limb. Clearly, the structure and activity within the brain reflect structures present in the body. And since a structure (i.e. a neuro-physiological pattern) is also integrated (i.e. receives input and provides feedback) with other non-neurological structures of the body, the state of one system is reflected in and is somewhat a reflection of the states (i.e. weights of elements) of others.

[More]

Hypnosis has had a gradual conceptual emergence from an alleged mystical experience, to sleep, to a psychological shift in concentration that activates a preexisting neuro-physiological circuitry. Data are presented to support the thesis that hypnotizability exists on a spectrum that has biological as well as psychosocial components. When there is synchrony between the bio-psychosocial components of hypnotizability as measured by the Hypnotic Induction Profile (an intact flow), psychotherapy is the primary treatment strategy, with medication secondary or not at all. When measurement reveals a lack of synchrony between biological factors as measured by the Eye-Roll sign and psychosocial responsivity (a nonintact flow), medication will be primary, with different degrees of psychosocial support.

Int J Clin Exp Hypn. 2007 Oct;55(4):387-410.

Spiegel H. College of Physicians & Surgeons, Columbia University, New York, New York, USA.

This article provides an illustrative overview of neurophysiological changes related to acute and chronic pain involving structural and functional brain changes, which might be the targets of psychological interventions. A number of psychological pain treatments have been examined with respect to their effects on brain activity, ranging from cognitive- and operant behavioral interventions, meditation and hypnosis, to neuro- and biofeedback, discrimination training, imagery and mirror treatment, as well as virtual reality and placebo applications. These treatments affect both ascending and descending aspects of pain processing and act through brain mechanisms that involve sensorimotor areas as well as those involved in affective-motivational and cognitive-evaluative aspects. The analysis of neurophysiological changes related to effective psychological pain treatment can help to identify subgroups of patients with chronic pain who might profit from different interventions, can aid in predicting treatment outcome, and can assist in identifying responders and nonresponders, thus enhancing the efficacy and efficiency of psychological interventions. Moreover, new treatment targets can be developed and tested. Finally, the use of neurophysiological measures can also aid in motivating patients to participate in psychological interventions and can increase their acceptance in clinical practice.

Am Psychol. 2014 Feb-Mar;69(2):188-96. doi: 10.1037/a0035254. Flor H. Author information: Central Institute of Mental Health.

Dr. Zeig is the Founder and Director of the Milton H. Erickson Foundation, having studied intermittently with Dr. Erickson for more than six years, He edited, co-edited, authored, or coauthored more than 20 books that appear in twelve foreign languages. His current area of interest is extracting implicit codes of influence from various arts, including movies, music, painting, poetry and fiction that can be used to empower professional practice, and everyday communication.Dr. Zeig is the architect of The Evolution of Psychotherapy Conferences, considered the most important conferences in the history of psychotherapy.

The empirical support for hypnosis for chronic pain management has flourished over the past two decades. Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals. The findings from these clinical trials also show that hypnotic treatments have a number of positive effects beyond pain control. Neurophysiological studies reveal that hypnotic analgesia has clear effects on brain and spinal-cord functioning that differ as a function of the specific hypnotic suggestions made, providing further evidence for the specific effects of hypnosis. The research results have important implications for how clinicians can help their clients experience maximum benefits from hypnosis and treatments that include hypnotic components.

PsycINFO Database Record (c) 2014 APA, all rights reserved.

Am Psychol. 2014 Feb-Mar;69(2):167-77. doi: 10.1037/a0035644. Jensen MP, Patterson DR. Author information: Department of Rehabilitation Medicine, University of Washington.