A book review by Tim Brunson, PhD

Few fields have the same level of misconception as hypnosis. In Understanding Hypnosis: Theory, Scope and Potential, California clinical psychologist, Albert A. Barrios, PhD, attempts to rectify this. In his short, fact-filled book he provides the reader with voluminous information and references to studies involving the use of clinical hypnotherapy for a wide range of applications.

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by Tim Brunson, PhD

Long before I began pursing my current profession I started noticing that the vast bulk of humanity regularly comes up short when it comes to the goals that they wish to achieve. The attrition rates in our schools and universities are very similar to our failures with patients who desperately seek medical advice, which they fail to follow, or those who never seem to respond as hoped to psychotherapy.

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BACKGROUND: Some studies have begun to show benefits of brief in-person mind-body skills training. We evaluated the effects of 1-hour online elective mind-body skills training for health professionals on mindfulness, resilience, and empathy. METHODS: Between May and November, 2014, we described enrollees for the most popular 1-hour modules in a new online mind-body skills training program; compared enrollees' baseline stress and burnout to normative samples; and assessed acute changes in mindfulness, resilience, and empathy. RESULTS: The 513 enrollees included dietitians, nurses, physicians, social workers, clinical trainees, and health researchers; about 1/4 were trainees. The most popular modules were the following: Introduction to Stress, Resilience, and the Relaxation Response (n = 261); Autogenic Training (n = 250); Guided Imagery and Hypnosis for Pain, Insomnia, and Changing Habits (n = 112); Introduction to Mindfulness (n = 112); and Mindfulness in Daily Life (n = 102). Initially, most enrollees met threshold criteria for burnout and reported moderate to high stress levels. Completing 1-hour modules was associated with significant acute improvements in stress (P < .001), mindfulness (P < .001), empathy (P = .01), and resilience (P < .01). CONCLUSION: Online mind-body skills training reaches diverse, stressed health professionals and is associated with acute improvements in stress, mindfulness, empathy, and resilience. Additional research is warranted to compare the long-term cost-effectiveness of different doses of online and in-person mind-body skills training for health professionals. © The Author(s) 2015.

J Evid Based Complementary Altern Med. 2015 Mar 17. pii: 2156587215575816. Kemper KJ(1), Khirallah M(2). Author information: (1)The Ohio State University, Columbus, OH, USA kathi.kemper@osumc.edu. (2)Center for Integrative Health and Wellness and The Office of Geriatrics and Gerontology, The Ohio State University College of Medicine, Columbus, OH, USA.

Functional heartburn (FH) is a benign but burdensome condition characterized by painful, burning epigastric sensations in the absence of acid reflux or symptom-reflux correlation. Esophageal hypersensitivity and its psychological counterpart, esophageal hypervigilance (EHv) drive symptom experience.Hypnotherapy (HYP) is an established and preferred intervention for refractory symptoms in functional gastrointestinal disorders (FGIDs) and could be applied to FH. The objective of this study was to determine the feasibility, acceptability, and clinical utility of 7 weekly sessions of esophageal-directed HYP (EHYP) on heartburn symptoms, quality of life, and EHv. Similar to other work in FGIDs and regardless of hypnotizability, there were consistent and significant changes in heartburn symptoms, visceral anxiety, and quality of life and a trend for improvement in catastrophizing. We would recommend EHYP in FH patients who are either non-responsive to medications or who would prefer a lifestyle intervention. © 2015 International Society for Diseases of the Esophagus.

Dis Esophagus. 2015 Mar 30. doi: 10.1111/dote.12353. Riehl ME(1), Pandolfino JE, Palsson OS, Keefer L. Author information: (1)Division of Gastroenterology and Hepatology, Esophageal Center at Northwestern, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

The February-March 2014 special issue of the American Psychologist featured articles summarizing select contributions from the field of psychology to the assessment and treatment of chronic pain. The articles examined a range of psychosocial and family factors that influence individual adjustment and contribute to disparities in pain care. The reviews also considered the psychological correlates and neurophysiological mechanisms of specific pain treatments, including cognitive-behavioral therapy, hypnosis, acceptance and commitment therapy, mindfulness, and meditation. Although a number of articles emphasized the role that negative states of mind play in pain outcomes, positive emotions were given only brief mention. Here, we provide a rationale for the inclusion of positive emotions in chronic pain research. (c) 2015 APA, all rights reserved).

Am Psychol. 2015 Apr;70(3):283-4. doi: 10.1037/a0038816. Ong AD(1), Zautra AJ(2), Reid MC(3). Author information: (1)Cornell University. (2)Arizona State University. (3)Weill Cornell Medical College.

Full Title: Hypnosis/Relaxation therapy for temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials.

AIMS: To conduct a systematic review and meta-analysis to evaluate the effectiveness of hypnosis/relaxation therapy compared to no/minimal treatment in patients with temporomandibular disorders (TMD). METHODS: Studies reviewed included randomized controlled trials (RCTs) where investigators randomized patients with TMD or an equivalent condition to an intervention arm receiving hypnosis, relaxation training, or hyporelaxation therapy, and a control group receiving no/minimal treatment. The systematic search was conducted without language restrictions, in Medline, EMBASE, CENTRAL, and PsycINFO, from inception to June 30, 2014. Studies were pooled using weighted mean differences and pooled risk ratios (RRs) for continuous outcomes and dichotomous outcomes, respectively, and their associated 95% confidence intervals (CI). RESULTS: Of 3,098 identified citations, 3 studies including 159 patients proved eligible, although none of these described their method of randomization. The results suggested limited or no benefit of hypnosis/relaxation therapy on pain (risk difference in important pain -0.06; 95% CI: -0.18 to 0.05; P = .28), or on pressure pain thresholds on the skin surface over the temporomandibular joint (TMJ) and masticatory muscles. Low-quality evidence suggested some benefit of hypnosis/relaxation therapy on maximal pain (mean difference on 100-mm scale = -28.33; 95% CI: -44.67 to -11.99; P =.007) and active maximal mouth opening (mean difference on 100-mm scale = -2.63 mm; 95% CI: -3.30 mm to -1.96 mm; P < .001) compared to no/minimal treatment. CONCLUSION: Three RCTs were eligible for the systematic review, but they were with high risk of bias and provided low-quality evidence, suggesting that hypnosis/relaxation therapy may have a beneficial effect on maximal pain and active maximal mouth opening but not on pain and pressure pain threshold. Larger RCTs with low risk of bias are required to confirm or refute these findings and to inform other important patient outcomes.

J Oral Facial Pain Headache. 2015 Spring;29(2):115-25. doi: 10.11607/ofph.1330. Zhang Y, Montoya L, Ebrahim S, Busse JW, Couban R, McCabe RE, Bieling P, Carrasco-Labra A, Guyatt GH.

Full title: Hypnosis-induced mental training improves performance on the Fundamentals of Laparoscopic Surgery (FLS) simulator.

BACKGROUND: Mental training (MT) is used extensively by musicians and athletes to improve their performance. Recently, it has been suggested as a training method for surgical trainees. We assessed the influence of MT, induced by hypnosis, on the performance of simulated tasks on a laparoscopic simulator, as compared to a non-specific relaxing intervention. METHODS: 11 surgeons completed a proficiency-based training program on the Fundamentals of Laparoscopic Surgery (FLS) simulator, until they reached performance plateau of the peg transfer task. Thereafter, they received a single music session, as a relaxing intervention, followed by repeating of the peg transfer task. Then they went through a hypnosis session guided by an experienced psychologist, with suggestions of smooth flow of pegs from one position on the board to another, and re-performed the task. RESULTS: Plateau performance was 51.1 ± 6.9 s. After the music session performance improved by 6.3% to 47.9 ± 5.4 s (p = 0.86). After the MT session performance further improved by 15.3% to 40.1 ± 5.8 s (p = 0.009), which was a 21.6% improvement from baseline (p < 0.001). Subject's satisfaction from their performance, without knowledge of the task scores, was 6.0 ± 2.9 on 0-10 VAS after the music and reached as high as 8.5 ± 1.7 after the hypnotic session (p = 0.01). CONCLUSIONS: Hypnosis-induced MT significantly improves performance on the FLS simulator, which cannot be attributed to its relaxing qualities alone. This study contributes evidence to the effectiveness of MT in surgical skills acquisition and suggests that hypnotic techniques should be used in mental preparation processes. There is a need to further study these effects on operating room performance.

Surg Endosc. 2015 May;29(5):1024-9. doi: 10.1007/s00464-014-3786-1. Epub 2014 Oct 11. Sroka G(1), Arnon Z, Laniado M, Schiff E, Matter I. Author information: (1)Department of General Surgery, Bnai-Zion Medical Center, 47 Golomb Street, Haifa, Israel, gideon.sroka@gmail.com.

The readiness potential (RP) is one of the most controversial topics in neuroscience and philosophy due to its perceived relevance to the role of conscious willing in action. Libet and colleagues reported that RP onset precedes both volitional movement and conscious awareness of willing that movement, suggesting that the experience of conscious will may not cause volitional movement (Libet, Gleason, Wright, & Pearl, 1983). Rather, they suggested that the RP indexes unconscious processes that may actually cause both volitional movement and the accompanying conscious feeling of will (Libet et al., 1983; pg. 640). Here, we demonstrate that volitional movement can occur without an accompanying feeling of will. We additionally show that the neural processes indexed by RPs are insufficient to cause the experience of conscious willing. Specifically, RPs still occur when subjects make self-timed, endogenously-initiated movements due to a post-hypnotic suggestion, without a conscious feeling of having willed those movements. Copyright © 2015 Elsevier Inc. All rights reserved.

Conscious Cogn. 2015 May;33:196-203. doi: 10.1016/j.concog.2015.01.002. Epub 2015 Jan 20. Schlegel A(1), Alexander P(2), Sinnott-Armstrong W(3), Roskies A(4), Tse PU(2), Wheatley T(2). Author information: (1)Department of Psychological and Brain Sciences, Dartmouth College, HB 6207 Moore Hall, Hanover, NH 03755, USA. Electronic address: schlegel@gmail.com. (2)Department of Psychological and Brain Sciences, Dartmouth College, HB 6207 Moore Hall, Hanover, NH 03755, USA. (3)Philosophy Department and Kenan Institute for Ethics, Duke University, Box 90432, Durham, NC 27708, USA. (4)Department of Philosophy, Dartmouth College, HB 6035 Thornton Hall, Hanover, NH 03755, USA.

High hypnotic suggestibility is a heterogeneous condition and there is accumulating evidence that highly suggestible individuals may be comprised of discrete subtypes with dissimilar cognitive and phenomenological profiles. This study applied latent profile analysis to response patterns on a diverse battery of difficult hypnotic suggestions in a sample of individuals in the upper range of hypnotic suggestibility. Comparisons among models indicated that a four-class model was optimal. One class was comprised of very highly suggestible (virtuoso) participants, two classes included highly suggestible participants who were alternately more responsive to inhibitory cognitive suggestions or posthypnotic amnesia suggestions, and the fourth class consisted primarily of medium suggestible participants. These results indicate that there are discrete response profiles in high hypnotic suggestibility. They further provide a number of insights regarding the optimization of hypnotic suggestibility measurement and have implications for the instrumental use of hypnosis for the modeling of different psychological conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

Conscious Cogn. 2015 May;33:334-41. doi: 10.1016/j.concog.2015.01.018. Epub 2015 Feb 23. Terhune DB(1). Author information: (1)Department of Experimental Psychology, University of Oxford, UK. Electronic address: devin.terhune@psy.ox.ac.uk.

Full title: Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness.

OBJECTIVE: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. DESIGN: Multi-method randomised control trial (RCT). SETTING: Three NHS Trusts. POPULATION: Nulliparous women not planning elective caesarean, without medication for hype rtension and without psychological illness. METHODS: Randomisation at 28-32 weeks' gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks' gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. MAIN OUTCOME MEASURES: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. RESULTS: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64-1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: OR -0.72, 95% CI -1.16 to -0.28, P = 0.001); fear (OR -0.62, 95% CI -1.08 to -0.16, P = 0.009). Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI -£257.93 to £267.59). CONCLUSIONS: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

BJOG. 2015 May 11. doi: 10.1111/1471-0528.13433. Downe S(1), Finlayson K(1), Melvin C(2), Spiby H(3), Ali S(4), Diggle P(5), Gyte G(6), Hinder S(7), Miller V(8), Slade P(9), Trepel D(4), Weeks A(10), Whorwell P(11), Williamson M(2). Author information: (1)Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, UK. (2)Women & Children's Health Research Team, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK. (3)Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK. (4)Department of Health Sciences, University of York, York, UK. (5)Lancaster Medical School, Lancaster University, Lancaster, UK. (6)Cochrane Pregnancy and Childbirth Group, Department of Women and Childrens' Health, Liverpool Women's NHS Foundation Trust, University of Liverpool, Liverpool, UK. (7)RaFT Research, Clitheroe, Lancashire, UK. (8)University Hospital of South Manchester NHS Foundation Trust, Manchester, UK. (9)Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK. (10)Department of Women's and Children's Health, University of Liverpool, Liverpool, UK. (11)Centre for Gastrointestinal Sciences, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.

OBJECTIVE: Empirical evidence concerning the efficacy of hypnosis to reduce anxiety in dental patients is limited. Hence we conducted a controlled trial in patients undergoing tooth removal. The study aims at assessing patient's attitude toward hypnosis and comparing the course of dental anxiety before, during and subsequent to tooth removal in patients with treatment as usual (TAU) and patients with treatment as usual and hypnosis (TAU+HYP). METHODS: 102 patients in a dental practice were assigned to TAU or TAU+HYP. Dental anxiety was assessed before, during and after treatment. All patients were asked about their experiences and attitudes toward hypnosis. RESULTS: More than 90% of patients had positive attitudes toward hypnosis. Dental anxiety was highest before treatment, and was decreasing across the three assessment points in both groups. The TAU+HYP group reported significantly lower levels of anxiety during treatment, but not after treatment compared with TAU group. CONCLUSION: Our findings confirm that hypnosis is beneficial as an adjunct intervention to reduce anxiety in patients undergoing tooth removal, particularly with regard to its no-invasive nature. PRACTICAL IMPLICATION: The findings underline that hypnosis is not only beneficial, but also highly accepted by the patients. Implementation of hypnosis in routine dental care should be forwarded. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Patient Educ Couns. 2015 May 24. pii: S0738-3991(15)00228-1. doi: 10.1016/j.pec.2015.05.007. Glaesmer H(1), Geupel H(2), Haak R(3). Author information: (1)Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany. Electronic address: Heide.Glaesmer@medizin.uni-leipzig.de. (2)Private dental practice, Gera, Germany. (3)Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany.

Full title: Chaos-chaos transition of left hemisphere EEGs during standard tasks of Waterloo-Stanford Group Scale of hypnotic susceptibility.

A recent study, recurrence quantification analysis of EEG signals during standard tasks of Waterloo-Stanford Group Scale of hypnotic susceptibility investigated recurrence quantifiers (RQs) of hypnotic electroencephalograph (EEG) signals recorded after hypnotic induction while subjects were doing standard tasks of Waterloo-Stanford Group Scale (WSGS) of hypnotic susceptibility to distinguish subjects of different hypnotizability levels. Following the same analysis, the current study determines the capability of different RQs to distinguish subjects of low, medium and high hypnotizability level and studies the influence of hypnotizability level on underlying dynamic of tasks. Besides, EEG channels were sorted according to the number of their RQs, which differed significantly among subjects of different hypnotizability levels. Another valuable result was determination of major brain regions in observing significant differences in various task types (ideomotors, hallucination, challenge and memory).

J Med Eng Technol. 2015 May 22:1-5. Yargholi E(1), Nasrabadi AM. Author information: (1)School of Biomedical Engineering, Islamic Azad University, Science and Research Branch , Tehran , Iran and.

OBJECTIVE: Insomnia both as a symptom and as part of chronic insomnia disorder is quite common in menopause. Comorbid conditions, such as restless legs syndrome and obstructive sleep apnea, occur with high prevalence among perimenopausal women with insomnia. Insomnia in this population group is associated with adverse health outcomes, and there are no clear standards on how to treat it. METHODS: Based on extensive literature search, 76 articles were identified. Two authors independently graded evidence according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. RESULTS: Evaluation and treatment of other comorbid sleep disorders are recommended, as is cognitive-behavioral therapy for insomnia. Hormone therapy, eszopiclone, escitalopram, gabapentin, isoflavones, valerian, exercise, and hypnosis are suggested. Zolpidem, quiteiapine XL, citalopram, mirtazapine followed by long-acting melatonin, ramelteon, Pycnogenol, Phyto-Female Complex, yoga, and massage may be considered. Kampo formulas are not recommended. Acupuncture may not be suggested, and cognitive-behavioral therapy that is not tailored for insomnia probably should not be considered. CONCLUSIONS: Although a variety of interventions are shown to be helpful in improving sleep in menopause, there is a need for well-designed head-to-head trials with uniform outcome measures.

Menopause. 2015 Jun;22(6):674-84. doi: 10.1097/GME.0000000000000348. Attarian H(1), Hachul H, Guttuso T, Phillips B. Author information: (1)From the 1Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL; 2Departments of Psychobiology and Gynecology, Universidade Federal de São Paulo, São Paulo, Brazil; 3Department of Neurology, University at Buffalo School of Medicine, State University of New York, Buffalo, NY; and 4Department of Medicine, University of Kentucky College of Medicine, Lexington, KY.

BACKGROUND: Past studies have shown that U.S. Veterans are consumers of CAM. However, more than 75% of Veteran non-users report they would utilize these treatment options if made available. Thus, Veterans may not be fully aware of the CAM options currently available to them in the current U.S. VA health care system. OBJECTIVES: The current study tested the hypothesis that Veterans would report an increase in CAM utilization after completing a formal pain education program in a VA medical center. DESIGN: The study used a quasi-experimental, one-group, pre/post-test design. SETTING: Midwestern, U.S. VA Medical Center. PARTICIPANTS: The responses from 103 Veterans who elected to participate in the program and the assessment measures were included in the outcome analyses. INTERVENTION: "Pain Education School" is a 12-week, educational program that is open to all Veterans and their families. It is a comprehensive program that introduces patients to 23 different disciplines at the VA Medical Center that deal with chronic, non-cancer pain. MAIN OUTCOME MEASURES: An adaptation of the Complementary and Alternative Medicine Questionnaire(©), SECTION A: Use of Alternative Health Care Providers. RESULTS: There was a significant difference found in overall utilization of CAM after completing the pain education program. The most utilized CAM modality was the chiropractor; the least utilized were hypnosis and aromatherapy. CONCLUSIONS: Not all health care systems or providers may have access to an education-focused, professionally driven program as an amenity. However, lessons can be learned from this study in terms of what pain providers may be able to accomplish in their practice. Published by Elsevier Ltd.

Complement Ther Med. 2015 Jun;23(3):413-22. doi: 10.1016/j.ctim.2015.04.005. Epub 2015 Apr 28. Cosio D(1), Lin EH(2). Author information: (1)Anesthesiology/Pain Clinic, 820 S. Damen #124, Chicago, United States. Electronic address: david.cosio2@va.gov. (2)Pharmacy/Pain Clinic, 820 S. Damen #119, Chicago, United States. Electronic address: erica.lin@va.gov.

Deidre Madsen, is the award-winning author of Happily Inner After - A Guide to Getting and Keeping Your Knight in Shining 'Amour'. She is a lecturer, instructor, spiritual counselor and life coach. She is a self styled quantum activist, following the theories of monastic idealism and tenured as a Supra-consciousness Imagery Guide supported by quantum energetics and phenomenology. Deidre holds private consultations, group seminars and retreats upon request.

For more information, visit www.DeidreMadsen.com.

FOR IMMEDIATE RELEASE

Full Headline: Women Sufferers of the Incurable Fibromyalgia Syndrome Targeted in a New Program Developed by The International Hypnosis Research Institute Founder

Anniston, Alabama. (October 21, 2010) - The International Hypnosis Research Institute announced its approval of a nine-week hypnotherapy program specifically designed to achieve symptom reduction for the over 5 million women in the United States who suffer from the incurable Fibromyalgia Syndrome (FMS). The program was authored and produced by Tim Brunson, PhD, the Institute's Executive Director and founder. He is a leading authority on complementary health care issues.

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Dr. Steven Vazquez has dedicated his life's work to the relief of human suffering and the acquisition of wholeness, love, and understanding. His mind-body approach allows you to get to the core of a problem quickly while being comfortably supported with compassion. Dr. Vazquez has developed state-of-the-art methods in treating:

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Harry Oldfield, inventor, scientist, thinker and somewhat eccentric seeker after new and forgotten knowledge is an explorer of undiscovered realms. For Harry, 'not possible' generally translates as 'let's have a look'.

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Donald Michael Kraig graduated from UCLA with a degree in philosophy. He has also studied public speaking and music (traditional and experimental) on the university level. After a decade of personal study and practice, he began ten years of teaching courses in the Southern California area on such topics as Kabalah, Tarot, Magic, Tantra, and Psychic Development. He has been a member of many spiritual and magical groups and is an initiated Tantric.