We examined the role of reporting bias in hypnotic negative hallucinations by using a paradigm in which reporting bias was assessed independently of perceptual change. In Experiment 1, highly hypnotizable subjects reported significant loudness reductions when tested for hypnotic deafness. Later, however, these subjects biased their reported loudness reductions in the absence of perceptual change, and their reporting bias scores were almost as large as their hypnotic deafness reports. Subjects also biased their ratings of strategy use. In Experiment 2, ratings of blindness given in response to a hypnotic negative visual hallucination suggestion were significantly correlated with reporting bias scores obtained in this paradigm. Although hypnotic blindness and hypnotic deafness correlated significantly, the partial correlation between these variables was nonsignificant when reporting bias scores were statistically controlled. Theoretical implications are discussed.

Carleton University, Ottawa, Ontario, Canada.

J Abnorm Psychol. 1992 Feb;101(1):192-9.

The tendency of highly hypnotizable participants to bias their retrospective perceptual reports in response to instructional demands was reexamined with the addition of low-hypnotizable control participants instructed to simulate hypnosis. Mean scores of high-hypnotizable participants and simulators did not differ, but the responses of simulators to the demand instruction was less variable than those of high-hypnotizable participants, and the shape of the response distribution was different. Unlike simulators, some high-hypnotizable participants who had reported changes in perception that were consistent with a hypnotic suggestion subsequently reported changes opposite to those suggested by a demand instruction. These data were interpreted as suggesting that the responses of high-hypnotizable participants to both the demand instruction and the preceding hypnotic suggestion were not entirely due to compliance.

Department of Psychology, University of Connecticut, Storrs 06269-1020, USA.

J Abnorm Psychol. 1996 Feb;105(1):142-5

This article summarizes data from three studies (Mare, Lynn, Kvaal, Segal, & Sivec, in press; Lynn, Mare, Kvaal, Segal, & Sivec, 1993) designed to extend research on the "hidden observer" to two phenomena of clinical relevance: hypnotic dreams and suggested age regression. Subjects received suggestions for a hypnotic dream or age regression and then received suggestions for a "hidden observer" (i.e., the subject possesses a part of the self that is aware of images and ideas that the conscious mind is unaware of) with respect to the dream or age-regression experience. Hidden reports contained more personally relevant information than the target suggestions (i.e., dream, age regression). Subjectives were also less likely to recall hidden reports. The high rate of hidden-observer responding (> 80%) was also evident in nonhypnotized simulating and relaxed subjects, although they did not exhibit as much primary process thinking in their dream reports as hypnotized subjects. Case studies of a trauma client and a forensic client are used to illustrate the clinical potential of hidden-observer suggestions.

Psychology Department, Ohio University, Athens 45701.

Am J Clin Hypn. 1994 Oct;37(2):130-42

Previous research indicated that high-hypnotizable participants reported more primary-process mentation in hypnotic dreams than low-hypnotizable participants instructed to simulate hypnosis. Differences in primary process were not evidenced in response to instructions for a "hidden part" of the participant to report on the hypnotic dream. This research replicated and extended these findings by showing that high-hypnotizable participants (n = 20) passing the dream suggestion reported more primary process in their dreams than high-hypnotizable participants instructed to remain alert and think and imagine along with suggestions (n = 20). Differences in primary process were not evidenced in response to hidden-observer suggestions, and the frequency of dream (87% hypnosis vs. 96% imagining) and hidden-observer responses (100% in both groups) was equivalent across hypnotic and nonhypnotic groups. The results provided qualified support for a psychoanalytic model of hypnosis: Differences in primary process were apparent in response to the dream but not the hidden-observer suggestion.

Ohio University, USA.

Int J Clin Exp Hypn. 1998 Oct;46(4):351-62.

The Absorption Scale, a measure of imaginative involvement, was administered to 64 subjects in the context of a hypnosis experiment and to an additional 64 subjects in a context unrelated to hypnosis. Expectancies of responding to hypnotic suggestions were assessed both before trance induction and after trance induction but before administration of hypnotic test suggestions. Hypnotic depth was assessed on the Long Stanford Scale (LSS) before the administration of test suggestions, and on the Inventory of Hypnotic Depth (IHD) after the hypnosis session. Absorption was correlated with hypnotic responsivity and expectancy, but only when assesed in the hypnotic context. Completing the Absorption Scale in a hypnotic context appeared to affect hypnotic responsiveness by altering subjects' expectancies. Only postinduction expectancies were uniquely predictive of response to hypnotic test suggestions, and all variables except the LSS were predictive of IHD scores. Results of path analysis supported the hypothesis that trance inductions alter expectancies for responding to hypnotic suggestions and that these altered expectancies determine subsequent hypnotic behavior.

J Pers Soc Psychol. 1986 Jan;50(1):182-9

We conducted an initial screening session in which hypnosis was presented as a "test of imagination" and administered with other imagination measures. In a second session, we instructed high- and low-hypnotizable subjects to imagine along with suggestions but to resist responding to motoric suggestions. Subjects received either instructions to use goal-directed fantasies (GDFs) or no facilitative instructions. Sizable individual difference effects were secured. Hypnotizable subjects exhibited more suggestion-related movements and reported greater involuntariness than did low-hypnotizable subjects. With GDF instructions, low- and high-hypnotizable subjects reported equivalent GDF absorption and frequencies. However, hypnotizable subjects exhibited greater responsiveness and reported greater involuntariness than did those low in hypnotizability, even when their GDFs were equivalent. Thus, no support was generated for the hypotheses that sustained, elaborated suggestion-related imagery mediates response to suggestion (Arnold, 1946) or that absorption in suggestions is of particular importance for low-hypnotizable subjects (Zamansky & Clark, 1986). Our finding that measures of response expectancy paralelled responding and reports of nonvolition support the hypothesis that expectancies mediate the relation between imagination, involuntariness, and responding (Kirsch, 1985; Spanos, 1982). Hypnotizable imagining subjects in the study discussed here exhibited greater responsiveness than a comparable sample of subjects did in a previous countersuggestion study (Lynn, Nash, Rhue, Frauman, & Stanley, 1983) in which no attempt was made to foster an association between imagining and involuntary responding in the initial screening session.

Psychology Department, Ohio University, Athens 45701.

J Pers Soc Psychol. 1987 Nov;53(5):933-8.

3 types of "posthypnotic suggestion," based upon factor analytic studies, were administered to high hypnotizable Ss (reals) and to low hypnotizable Ss instructed to simulate hypnosis (simulators) (N = 12 high and 6 low hypnotizable Ss per suggestion). The "posthypnotic suggestions" consisted of instructions given to Ss following a hypnotic induction that, when the posthypnotic cue was later given, they would re-enter the hypnotic state and perform a certain task at that time. Ss were then tested 6 times for durability of "posthypnotic response" during an 8-week period. Responses to the "suggestions" were rated by research assistants (objective scores) and by Ss themselves (subjective scores). There was a significant Trials x Type of "Suggestion" interaction for both types of scores for the reals but not for the simulators, indicating different rates of decline with time for the different "suggestions" for the hypnotic Ss. Depth of reported hypnotic trance during the assessment sessions was found to be strongly related to performance of the "posthypnotic suggestion" for both real and simulating Ss.

Washington University, St. Louis, Missouri. Int J Clin Exp Hypn. 1991 Jan;39(1):24-38.

2 experiments were carried out to assess the relative contributions of dissociation and absorption as cognitive strategies employed by high and low hypnotizable Ss in responding successfully to hypnotic suggestions. Of special interest was the manner in which Ss deal with conflicting information typically inherent in hypnotic suggestions. In the first experiment, Ss rated their attentional focus and the involuntariness of their experience after responding to a number of hypnotic suggestions administered in the usual manner. In the second experiment, the level of conflict was varied by instructing some Ss to imagine a circumstance that was congruent and other Ss to imagine a circumstance that was incongruent with the suggested behavioral response. The results of the 2 experiments were consistent in suggesting that, depending upon the nature of the hypnotic suggestion, high hypnotizable Ss are able to employ dissociation or absorption in order to respond successfully. Low hypnotizable Ss, on the other hand, seem to be relatively ineffective dissociators. When the structure of the hypnotic suggestion precludes the use of absorption, the performance of low hypnotizables deteriorates.

Department of Psychology, Northeastern University, Boston, MA 02115.

Int J Clin Exp Hypn. 1990 Jul;38(3):168-82

This study hypothesized that highly hypnotizable Ss who remained amnesic for posthypnotic suggestions to improve body attitude would show greater changes than Ss who were not amnesic. Ss given simulating instructions were used as a comparison group to assess experimental demands. 48 females were screened with the Harvard Group Scale of Hypnotic Susceptibility, Form A (Shor & E. Orne, 1962) and assigned to one of 4 conditions: (a) high hypnotizable with amnesia suggestions, (b) high hypnotizable without suggested amnesia, (c) low hypnotizable simulators with amnesia, and (d) low hypnotizable simulators without suggested amnesia. A fifth group was formed of those high hypnotizable Ss who remembered the suggestion despite instructions to the contrary. The Body Attitude Scale (Kurtz, 1966) was administered prior to and 3 days after the experimental suggestions. Results generally demonstrated that high hypnotizable amnesic Ss manifested the greatest attitudinal and phenomenological changes as a result of the posthypnotic suggestion, although conclusions were tempered by performance of simulating Ss. The implications for hypnosis research and clinical practice are discussed.

Int J Clin Exp Hypn. 1989 Jan;37(1):15-30.

Participants received 1 of 3 instructional sets designed to manipulate their performance standards (i.e., criteria used to evaluate hypnotic performance): (a) stringent set (n = 33), these subjects were told that responsive subjects respond immediately to hypnosis and imagine realistically, (b) lenient set (n = 30), these subjects were told that responsive subjects do not necessarily respond immediately or imagine realistically, and (c) control set (n = 34), standard prehypnotic information. As expected, compared to controls, stringent set participants were less responsive to hypnosis, as indexed by measures of actual and estimated suggestibility, subjective involvement, involuntariness, quickness of responding, satisfaction, and imaginative ability. Stringent set participants estimated they passed fewer suggestions, were less satisfied with their performance, and reported less subjective involvement than individuals in the lenient condition.

Psychology Department, State University of New York at Binghamton, New York 13902, USA. slynn@binghamton.edu

Int J Clin Exp Hypn. 2003 Jan;51(1):51-65

We compared participants' responsiveness to a standard administration of a hypnotic suggestibility scale (CURSS; Spanos, Radtke, Hodgins, Bertrand, Stam, & Moretti, 1983) that defined the ability to experience hypnosis in terms of cooperation (SI; standard induction, N = 27) with a version of the same scale administered with all references to cooperation removed (CR; cooperation removed, N = 34) and with a version of the scale with the "induction" removed (NI; no induction, N = 35). In a fourth condition, participants were informed that the ability to experience hypnosis depended on their ability to achieve an altered state of consciousness or "trance" (AS; altered state, N = 33). Removing instructions for cooperation had an effect on objective (CR < SI) but not on subjective hypnotic responding. Removing the hypnotic induction had no appreciable effect on any dimension of hypnotic responsivity. Consistent with predictions derived from performance standards theory (Lynn & Rhue, 1991), participants who received the altered state set responded to fewer suggestions than did participants who received the standard induction (SI). Estimates of suggestions passed that were assessed before and after test suggestions were administered were, respectively, weakly to moderately correlated with objective and subjective measures of hypnotic suggestibility.

Psychology Department, State University of New York at Binghamton, Binghamton, NY 13902, USA.

Am J Clin Hypn. 2002 Jan-Apr;44(3-4):231-40.

by Casey Chua, Ph.D.
I am an Ordained Minister of Religion and is a Christian by confession. I served as Christ's ambassador (or some may say, 'servant' which is what I embrace joyfully) as a pastor in Perth, Western Australia. I was also an adjunct bible school/seminary professor in theology, psychology and counseling for many years.

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Five cases are presented wherein hypnosis was used by the emergency physician either as the primary mode of treatment or as an adjuvant to standard medical care. Common hypnotic phenomena (eg, anesthesia, analgesia), as well as novel effects, are reported. The technique used for trance induction and utilization is briefly outlined, and criteria are set forth for the bedside recognition of hypnotic trance.

Emergency Department, Scripps Memorial Hospital, Encinitas, CA.

Am J Emerg Med. 1989 Mar;7(2):238-42.

Myths about hypnosis have interfered with its use in emergency settings. Specifically, included are myths about who induces the hypnotic state, the length of induction time, and the traumatized patient's inability to concentrate on a focal point. It is suggested, however, that altered states of awareness occur rapidly and spontaneously in the patient who has experienced acute trauma and/or pain. Two cases are presented that illustrate spontaneous trancelike states occurring in traumatic situations. The cases also show how the recognition of these altered states can facilitate the patient's care and treatment in an emergency setting.

Gen Hosp Psychiatry. 1986 Jan;8(1):19-22

The autonomic and EEG correlates of the response to a cognitive unpleasant stimulation (US) verbally administered to awake hypnotizable and non hypnotizable subjects were studied. They were compared with the values obtained during a resting condition immediately preceding the stimulus and with those produced by a cognitive neutral stimulation (NS), also administered after a basal resting period. Results showed hypnotic trait effects on skin resistance, heart and respiratory rate as well as on EEG theta, alpha, beta and gamma relative power changes. The autonomic and EEG patterns observed indicated different strategies in the task execution for hypnotizable and non hypnotizable subjects and a discrepancy between the autonomic and EEG changes associated to the US in susceptible subjects. Results support dissociation theories of hypnosis and suggest for hypnotizable persons an active mechanism of protection against cardiac hazard.

Department of Physiology and Biochemistry G. Moruzzi, University of Pisa, Via S. Zeno 31, 56127 Pisa, Italy.

Brain Res Bull. 2003 Apr 15;60(1-2):151-60

The purpose of the present research was to find physiological and cognitive correlates of hypnosis, imaginative suggestibility and emotional experiences. After the administration of a standard hypnotic induction, the EEG and heart rate (HR) were recorded during self-generated happy and sad emotions using a relaxation condition as a control. Physiological recordings were also obtained during three eyes-open and eyes-closed baseline periods: (1) waking rest; (2) early-rest in hypnosis (just after the hypnotic induction); (3) late-rest hypnosis (at the end of hypnotic condition). EEG was recorded at frontal (F3, F4), central (C3, C4), and posterior sites (middle of O1-P3-T5 and O2-P4-T6 triangles). Using log transform of mean spectral amplitude, eight EEG frequency bands (4-44 Hz) were evaluated. High hypnotizable subjects, as compared to the lows, produced a higher theta1 amplitude (4-6 Hz) across both left- and right-frontal and right-posterior areas. These subjects also produced smaller alpha1 amplitude (8.25-10 Hz) over both left and right frontal recording sites. High suggestible subjects, during resting conditions, disclosed higher theta2 (6.25-8 Hz) and alpha1 amplitudes in eyes-closed as compared to an eyes-open condition than did low suggestible subjects. High suggestible subjects also showed, in hypnosis-rest condition, higher 40-Hz amplitudes (36-44 Hz) and HR activity than did low suggestible subjects. Hypnotizability and not suggestibility was found to moderate emotional processing: high hypnotizable individuals self-reported greater levels of emotional experiences than did low hypnotizables especially in terms of negative emotion. High hypnotizables, during processing of emotional material, also disclosed opposite 40-Hz hemispheric asymmetries over anterior and posterior regions of the scalp. These subjects during happiness showed an increased production of 40-Hz activity in the left frontal and central regions of the scalp, while during sadness they showed an increased activity in the right central and posterior regions. The hemispheric asymmetries for relaxation condition were similar, but less marked, to those obtained for happiness. No significant interactions involving both hypnotizability and imaginative suggestibility were found for physiological variables considered in this study. This demonstrates that hypnotizability and suggestibility reflect different underlying psychophysiological activities.

Department of Psychology, University of Rome, Italy.

Int J Psychophysiol. 1998 Aug;29(3):255-75

This study evaluates the effects of hypnotic analgesia and hypnosis on bilateral EEG activity recorded from frontal, central and posterior areas during three painful electrical stimulation conditions: waking, hypnosis/no-analgesia, hypnosis/analgesia. Eight high-hypnotizable and eight low-hypnotizable (right handed) subjects participated in the experiment. The following measures were obtained: pain and distress tolerance ratings; EEG spectral amplitudes for the frequency bands: delta (0.5-3.75 Hz), theta 1 (4-5.75 Hz), theta 2 (6-7.75 Hz), alpha 1 (8-9.75 Hz), alpha 2 (10-12.75 Hz), beta 1 (13-15.75 Hz), beta 2 (16-31.75 Hz), total band (0.5-31.75 Hz), '40-Hz' (36-44 Hz); cardiac interbeat interval (ms); mid-frequency and high-frequency peaks from power spectral analysis of heart period variability. During hypnosis/analgesia, high hypnotizable subjects displayed significant reductions in pain and distress scores compared to hypnosis/no-analgesia and waking conditions. In each experimental condition these subjects displayed significant lower total and beta 1 amplitudes compared to low hypnotizables. High hypnotizables, on central and posterior recording sites, during both hypnosis/analgesia and hypnosis/no-analgesia conditions also showed total and delta EEG amplitude reductions in both hemispheres and a theta 1 amplitude reduction in the left hemisphere. However, for total, delta and beta 1 bands in the hypnosis/analgesia condition the amplitude reduction was more pronounced in the right hemisphere as shown by hemispheric asymmetry in favor of the left hemisphere. Low hypnotizables, on posterior recording sites, displayed a delta amplitude reduction during hypnosis/no-analgesia and hypnosis/analgesia conditions. These subjects also showed, for all recording sites, a reduction in theta 1 amplitude during hypnosis/no-analgesia compared to the waking condition. Lows, however, failed in evidencing amplitude differences between hypnosis/no-analgesia and hypnosis/analgesia conditions. During hypnotic analgesia the hemispheric asymmetry found in high hypnotizables was parallel to a significant reduction in the spectral mid-frequency peak of heart period variability which indicated a decrease in the level of sympathetic activity. In contrast, during hypnosis/no-analgesia the EEG amplitude reduction was not paralleled by a decrease in sympathetic activity.

Department of Psychology, University of Rome La Sapienza, Italy.

Int J Psychophysiol. 1996 Feb-Mar;21(2-3):163-75.

EEG was recorded monopolarly at frontal (F3, F4), central (C3, C4) and posterior (in the middle of O1-P3-T5 and O2-P4-T6 triangles) derivations during the hypnotic induction of the Stanford Hypnotic Clinical Scale (SHCS) and during performance following suggestions of hypnotic dream and age-regression as expressed in the before-mentioned scale. 10 low-hypnotizable and 9 highly-hypnotizable and right-handed female students participated in one experimental session. Evaluations were Fast-Fourier spectral analyses during the following conditions: waking-rest in eyes-open and eyes-closed condition; early, middle, and late phases of hypnotic induction; rest-hypnosis in eyes closed condition; hypnotic dream and age regression. After spectral analysis of 0 to 44 Hz, the mean spectral amplitude estimates across seven Hz bands (theta 1, 4-6 Hz, theta 2, 6-8 Hz; alpha 1, 8-10 Hz; alpha 2, 10-13 Hz; beta 1, 13-16 Hz; beta 2, 16-20 Hz; beta 3, 20-36 Hz) and the 40-Hz EEG band (36-44 Hz) for each experimental condition were extracted. In eyes-open and -closed conditions in waking and hypnosis highly-hypnotizable subjects produced a greater 40-Hz EEG amplitude than did low hypnotizable subjects at all frontal, central and posterior locations. In the early and middle hypnotic induction highly-hypnotizables displayed a greater amount of beta 3 than did low hypnotizables and this difference was even more pronounced in the left hemisphere. With posterior scalp recordings, during hypnotic dream and age regression, high hypnotizables displayed, as compared with the rest-hypnosis condition, a decrease in alpha 1 and alpha 2 amplitudes. This effect was absent for low hypnotizables. Beta 1, beta 2 and beta 3 amplitudes increased in the left hemisphere during age regression for high hypnotizables; low hypnotizables, in contrast, displayed hemispheric balance across imaginative tasks. High hypnotizables during the hypnotic dream also displayed in the right hemisphere a greater 40-Hz EEG amplitude as compared with the left hemisphere. This difference was even more evident for posterior recording sites. This hemispheric trend was not evidenced for low hypnotizable subjects. Theta power was never a predictor of hypnotic susceptibility, 40-Hz EEG amplitude displayed a very high main effect (p < 0.004) for hypnotizability in hypnotic conditions by displaying a greater 40-Hz EEG amplitude in high hypnotizables with respect to lows.

Department of Psychology, University of Rome La Sapienza, Italy.

Int J Psychophysiol. 1993 Sep;15(2):153-66

Subjects highly (Highs) and low susceptible to hypnosis (Lows) show different imagery and attentional capabilities and also peculiar somatomotor, vegetative and electroencephalographic differences in basal and task conditions. Since attention is one of the main component of hypnotic susceptibility and also a relevant factor for postural control, the aim of the experiment was to study actual differences between Highs and Lows at the eyes closure during upright stance. Visual and motor imagery as well as attentional/disattentional capabilities were evaluated through psychological tests. Posture was monitored though Elite systems during upright stance with open and closed eyes. At the eyes closure, Highs and Lows exhibited a different body sway modulation. Possible different compensation mechanisms are suggested for the two groups and interactions between attentional/arousal systems responsible of hypnotic phenomenology and postural control are underlined.

Department of Physiology and Biochemistry, University of Pisa, Italy. enricals@dfb.unipi.it

Arch Ital Biol. 2004 May;142(3):285-96

by Annie H. Spencer, Ph.D.

You have healing power! This is a truism that everyone can honor if they will let the energy flow. Mother's rub their babies back and the little child falls into a peaceful sleep. Nurses stroke infants in Intensive Care and they rest easily. Daddies kiss skinned knees and they are all better. Sisters hold the dying and they slip into heavenly bliss. Therapists touch clients and relaxation occurs. What is this "Mystical Power?"

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Many theories of hypnotic responding have proposed that differences in hypnotic trait rely on differences in frontal attentional functions. Evidence of hypnotizability-related attentional abilities are, however, very scant. This study was designed to investigate the relationship between hypnotizability and executive control components of attention in the spatial domain. We chose the Attention Network Test that enables to analyze alerting, orienting and executive control functions by measuring reaction times (RTs) to targets cued for different locations in space. According to Posner theory, alerting, orienting and executive control effects were found in both groups. No differences between highly susceptible (Highs) and low susceptible individuals (Lows) on executive control functions were found. However, in Highs alerting was significantly smaller than in Lows and Highs were significantly faster than Lows in the no and central cue conditions. These findings suggest that Highs would be endowed with a basal higher efficiency in achieving and maintaining their readiness to respond to incoming stimuli. This relation between hypnotizability and alerting, is discussed in terms of a possible more efficient noradrenergic activity driven by frontal attentional systems.

Castellani E, D'Alessandro L, Sebastiani L. Department of Physiology and Biochemistry, University of Pisa, Via S. Zeno 31, 56127 Pisa, Italy.

Anticipatory nausea and vomiting (ANV) is associated with a significant reduction in the quality of life for many chemotherapy patients. The use of 5-hydroxytryptamine type 3 receptor antagonists provides some relief for chemotherapy-induced nausea and vomiting, but does not seem to control ANV. Nonpharmacologic approaches, which include behavioral interventions, may provide the greatest promise in relieving symptoms. Little evidence supports the use of complementary and alternative methods, such as acupuncture and acupressure, in relieving ANV. Behavioral interventions, especially progressive muscle relaxation training and systematic desensitization, should be considered important methods for preventing and treating ANV.

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by Casey Chua, MDiv PhD CH CI BCH MNCH(UK)

It is well known that the brain is an electrochemical organ. Researchers have speculated that a fully functioning brain can generate as much as 10 watts of electrical power (enough to light a flash light bulb).

When the brain is working, millions of nerve cells communicate with each other, with the help of tiny electrical impulses. In this way, the brain is electrically active night and day throughout one's life.

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Use of mind-body therapies in psychiatry and family medicine faculty and residents: attitudes, barriers, and gender differences.

BACKGROUND: Mind-body medicine (MBM) approaches to many health problems have been well documented in the literature, including through multiple meta-analyses. Efficacy has been well demonstrated in conditions such as headache, irritable bowel syndrome, anxiety, fibromyalgia, hypertension, low back pain, depression, cancer symptoms, and postmyocardial infarction. However, an apparent disconnect (ie, translational block) prevents more widespread adoption of such therapies into practice. Biofeedback, relaxation therapy, hypnosis, guided imagery, cognitive behavioral therapy, and psychoeducational approaches are the domain of MBM we examined in assessing physician attitudes, beliefs, and practices. METHODS: Using a Web-based survey, we obtained responses from 74 faculty and resident physicians in the Department of Family Medicine and the Department of Psychiatry. Our response rate was 69%. We conducted descriptive statistics, bivariate analysis, and multivariate analysis using a logistic regression model. Various statistics were chosen depending on the nature of analyzed variables. Synoptic tables are presented. RESULTS: Comparing these cohorts, we found little difference between physicians in the two specialties, but substantial reports that barriers to the use of MBM were largely based on lack of training, inadequate expertise, and insufficient clinic time. Lack of expertise and insufficient clinic time were higher among family physicians than among psychiatrists. There was a high interest in both groups in learning relaxation techniques and meditation and lower interest in biofeedback and hypnosis. Female physicians were significantly more likely to use MBM, both with patients and for their own self-care, and were less likely to be concerned that recommending these therapies would make patients feel that their symptoms were being discounted. Female physicians also had significantly higher beliefs about the benefits of MBM on health disorders in several of the conditions examined, with a consistent though nonsignificant trend in others.

Sierpina V, Levine R, Astin J, Tan A. University of Texas Medical Branch, Galveston, TX 77555-1123, USA. vssierpi@utmb.edu

The aim of this study was to determine national patterns and correlates of complementary and alternative medicine (CAM) use among adults with diabetes. METHODS: The authors compared CAM use in 2474 adults with and 28,625 adults without diabetes who participated in the most comprehensive national survey on CAM use (2002 National Health Interview Survey). Eight CAM use categories were created, including dietary, herbal, chiropractic, yoga, relaxation, vitamin, prayer, and other (acupuncture, Ayurveda, biofeedback, chelation, energy healing or Reiki therapy, hypnosis, massage, naturopathy, and homeopathy). An overall CAM use category also was created that excluded vitamins and prayer. Patterns of use were compared with chi-square and independent correlates of CAM use with multiple logistic regression controlling for relevant covariates. STATA was used for analysis to account for the complex survey design. RESULTS: Prevalence of overall use of CAM did not differ significantly by diabetes status (47.6 versus 47.9%, p = 0.81). Diabetes was not an independent predictor of overall use of CAM (OR 0.93, 95% confidence interval [CI] 0.83, 1.05). However, persons with diabetes were more likely to use prayer (OR 1.19, 95% CI 1.05, 1.36), but less likely to use herbs (OR 0.86, 95% CI 0.75, 0.99), yoga (OR 0.56, 95% CI 0.43, 0.72), or vitamins (OR 0.82, 95% CI 0.72, 0.93) than people without diabetes after controlling for relevant covariates. Independent correlates of overall use of CAM differed by age, income, employment, comorbidity, and health status between people with and without diabetes. CONCLUSIONS: This study found that there has been a dramatic increase in overall use of CAM in adults with diabetes; diabetes was not an independent predictor of overall use of CAM; and people with diabetes were more likely to use prayer, but less likely to use herbs, yoga, or vitamins compared to persons without diabetes.

Garrow D, Egede LE. Department of Medicine, Division of General Internal Medicine and Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC 29425, USA.

The present paper intends to briefly review the most important concepts of the modern neuropsychology of the frontal lobes, and to relate these findings to the phenomenology usually encountered in hypnosis research and practice. The frontal lobes have been studied very intensively during the last several years and some of the results, including the syndromes described in frontal-lobe lesions and psychiatric patients, demonstrate striking similarity with hypnotic phenomena. Based on these similarities, an alternative neuropsychophysiological definition of hypnosis/suggestion is proposed, viewing hypnosis/suggestion as the process of external manipulation with frontal-lobe functions with consequent effects upon the entire brain potential of the subject.

Muzur A. Department of Family Medicine, School of Medicine, University of Rijeka, Rijeka, Croatia. amirmuzur@yahoo.com

Thirty years ago, the integration of complementary medicine into cancer care almost was dismissed as quackery. Today, a whole range of complementary and alternative medicine (CAM) techniques have been integrated into the management of cancer, which are often of benefit to patients, when conventional treatment is deemed to have failed or caused intolerable side effects. Health care workers need to inquire about the use of CAM in their patients routinely in a sensitive and nonjudgmental way, and may need to advise patients to stop certain therapies. Yet in advanced cancer, a sensible balance needs to be struck between fear about adverse effects and interactions and the importance of making the remaining weeks/days/months as comfortable and enjoyable as possible.

Filshie J, Rubens CN. Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, UK. jacqueline.filshie@binternet.com

The present study closely examines subject response to the arm-rigidity item of the HGSHS:A. Subject behavior, subject self-report, and surface EMG of the biceps and triceps muscles were monitored. Two distinct ways of passing the item were observed and verified by EMG recordings: some subjects (tremblers) exerted muscular effort to bend the arm and kept it rigidly straight. Others (nontremblers) passively kept the arm straight without exerting muscular effort to bend, even though they reported exerting effort to bend their arm. These two behaviorally and physiologically different methods of passing the item support the idea of individual differences in hypnotic responding and suggest that subjects may be using different mental processes to pass the item.

Winkel JD, Younger JW, Tomcik N, Borckardt JJ, Nash MR. Department of Psychology, University of Tennessee, Knoxville, Tennessee 37996, USA. Jwinkel@utk.edu

Neuroscience documents the activity of "mirror neurons" in the human brain as a mechanism whereby we experience empathy and recognize the intentions of others by observing their behavior and automatically matching their brain activity. This neural basis of empathy finds support in research on dysfunctions in the mirror systems of humans with autism and fMRI research on normal subjects designed to assess intentionality, emotions, and complex cognition. Such empathy research now appears to be consistent with the historical and research literature on hypnotic induction, rapport, and many of the classical phenomena of suggestion. A preliminary outline of how mirror neurons may function as a rapport zone mediating between observing consciousness, the gene expression/protein synthesis cycle, and brain plasticity in therapeutic hypnosis and psychosomatic medicine is proposed. Brain plasticity is generalized in the theory, research, and practice of utilizing mirror neurons as an explanatory framework in developing and training new skill sets for facilitating an activity-dependent approach to creative problem solving, mind-body healing, and rehabilitation with therapeutic hypnosis.

Rossi EL, Rossi KL. Ernest@ErnestRossi.com

Theories about dreams have shaped our thinking about mind-body unity and the influence of thought on the body. In this article, the authors review the sparse literature regarding the use of hypnosis with children's dreams and nightmares, summarize how hypnotically induced dreams have been used to resolve psychological symptoms, and note five themes in the literature worthy of further investigation. Building on the value of both dreams and hypnosis for working through conflicts, the authors united mind-body medicine and hypnotically induced dreaming in a pediatric pulmonary practice. A case series is presented of 11 patients who were offered an opportunity to review their reported nightmares through hypnosis in order to uncover their potential meaning. The recurrent nightmares among these patients decreased greatly in frequency or resolved following the hypnosis enhanced dream review. Thus, we demonstrate that hypnotically induced dream review may be useful in a pediatric population.

Linden JH, Bhardwaj A, Anbar RD. jhlinden@cs.com

This paper clears up some misunderstandings of Woodard's Phenomenological and Perceptual Research Methodology presented by Beshai in a recent critique. Beshai's critique helps demonstrate and validate a number of themes in Woodard's Perceptually Oriented Hypnosis. First, for each of us, our historical learnings provide the basis for scientific progress but at the same time may impede new views and even a more comprehensive understanding of hypnosis. Second, hypnosis is fundamentally a process of differentiating personal meanings that can be vastly different for various individuals. Third, Beshai uses a quantitatively based approach to understanding phenomenon different from Woodard's qualitative research process. Last, holistic understanding of hypnosis is impeded when aspects of the phenomenal field are taken quantitatively out of context.

Woodard FJ. Woodard Hypnosis and Research, Inc, USA. Fredwoodard@aol.com

A thorough investigation of the neural effects of psychotherapy is needed in order to provide a neurobiological foundation for widely used treatment protocols. This paper reviews functional neuroimaging studies on psychotherapy effects and their methodological background, including the development of symptom provocation techniques. Studies of cognitive behavioural therapy (CBT) effects in obsessive-compulsive disorder (OCD) were consistent in showing decreased metabolism in the right caudate nucleus. Cognitive behavioural therapy in phobia resulted in decreased activity in limbic and paralimbic areas. Interestingly, similar effects were observed after successful intervention with selective serotonin reuptake inhibitors (SSRI) in both diseases, indicating commonalities in the biological mechanisms of psycho- and pharmacotherapy. These findings are discussed in the context of current neurobiological models of anxiety disorders. Findings in depression, where both decreases and increases in prefrontal metabolism after treatment and considerable differences between pharmacological and psychological interventions were reported, seem still too heterogeneous to allow for an integrative account, but point to important differences between the mechanisms through which these interventions attain their clinical effects. Further studies with larger patient numbers, use of standardised imaging protocols across studies, and ideally integration with molecular imaging are needed to clarify the remaining contradictions. This effort is worthwhile because functional imaging can then be potentially used to monitor treatment effects and aid in the choice of the optimal therapy. Finally, recent advances in the functional imaging of hypnosis and the application of neurofeedback are evaluated for their potential use in the development of psychotherapy protocols that use the direct modulation of brain activity as a way of improving symptoms.

Linden DE. School of Psychology, University of Wales Bangor, Bangor, UK. d.linden@bangor.ac.uk

Procedures for estimating hypnotic depth have been used for more than 70 years. This study predicted self-reported hypnotic depth from the phenomenological and behavioral variables of the Phenomenology of Consciousness Inventory-Hypnotic Assessment Procedure (PCI-HAP). Participants were divided into 2 groups; 1 was used to generate regression equations, and the other group was used for cross-validation. Both imagery vividness during hypnosis (imagoic suggestibility) and the PCI pHGS measure of hypnotic depth (hypnoidal state) accounted for most of the variance in self-reported hypnotic depth. The above results, further supported by correlational and 3-D visual analyses, are consistent with other researchers' observations that ratings of hypnotic depth are a function of: (a) alterations in subjective experience, and (b) the perception of responsiveness to suggestions. The findings are also congruent with J. Holroyd's hypothesis that suggestibility and altered-state effects interact to produce hypnotic effects.

Pekala RJ, Kumar VK, Maurer R, Elliott-Carter NC, Moon E. Coatesville Veterans Administration Medical Center, Coatesville, Pennsylvania, USA. Ronald.Pekala@med.va.gov

The hypothesis that water "treated" with intention can affect ice crystals formed from that water was pilot tested under double-blind conditions. A group of approximately 2,000 people in Tokyo focused positive intentions toward water samples located inside an electromagnetically shielded room in California. That group was unaware of similar water samples set aside in a different location as controls. Ice crystals formed from both sets of water samples were blindly identified and photographed by an analyst, and the resulting images were blindly assessed for aesthetic appeal by 100 independent judges. Results indicated that crystals from the treated water were given higher scores for aesthetic appeal than those from the control water (P = .001, one-tailed), lending support to the hypothesis.

Radin D, Hayssen G, Emoto M, Kizu T. Institute of Noetic Sciences, Petaluma, CA 94952, USA. dean@noetic.org

This research explored whether hypnotic suggestion could produce a subjective mindbody condition similar to that produced by the psychoactive drug methylenedioxy methamphetamine (MDMA, Ecstasy). Twelve participants received posthypnotic instructions to re-experience an MDMA-like state posthypnotically, similar to one in their prior experience, for one hour. Three separate self report measures and qualitative self reports showed that the posthypnotic condition effectively mimicked an MDMA-like experience, lasting an hour at a stable level. Participant ratings in real time and in retrospect ranged from 36% to 100% similarity to a drug-induced experience. The qualitative reports and rating scales enabled a phenomenological description of the subjective experience. Scores on the Tellegen Absorption Scale correlated significantly with the strength of the posthypnotic condition (Spearman rho .87, p = .0003). The participants successfully carried out various intentional activities during this time (e.g., self reflection, talking with partners about relationships, artwork, walking in nature). Applications for this technique as an adjunct to therapy and health treatments are discussed.

Hastings A. Institute of Transpersonal Psychology, 1069 East Meadow Circle, Palo Alto, CA 94303-4231, USA.

Silverman in 1983 held that the unconscious encoding of MOMMY AND I ARE ONE triggers a fantasy of symbiotic union with the good mother of early childhood. In contrast, later Sohlberg and Birgegard contended that MOMMY AND I triggers associations to similarity issues with mother, associations that may be influenced by the words following MOMMY AND I. Although their messages produce, lmost invariably, no reportable sensation, Sohlberg and Birgegard claimed strong evidence for the influence of such messages on perception, motivation, and memory, 10 ays poststimulation and suggestive evidence 4 mo. later. Their findings are not compelling evidence for these claims; and there is no evidence that any result was associated with the unconscious encoding of the psychodynamic meaning of a multiword message.

Fudin R. Psychology Department, Long Island University, Brooklyn Campus, Brooklyn, New York 11201, USA. robert.fudin@liu.edu

Using microelectrode recordings of postganglionic sympatheticaction potentials, the authors studied the effects of hypnotic suggestion on sympathetic outflow targeted to skin during static handgrip exercise. All subjects performed sustained handgrip at 33% maximal voluntary contraction (MVC) for 2 minutes during 3 consecutive trials. Two subjects randomly assigned to a hypnosis condition received suggestions that the 2nd trial was more difficult and the last trial was less difficult than the first trial. Two subjects randomly assigned to the control condition received no hypnosis or suggestions about task difficulty. In the nonhypnosis condition, skin sympathetic nerve activity (SNA) increased by 6% from baseline during the 2nd trial and 13% from baseline during the 3rd trial. In the hypnosis condition, skin SNA increased by 25% during the 2nd trial (suggestion of increased difficulty) and returned to baseline during the 3rd condition (suggestion of decreased difficulty). Therefore, the impact of central command on skin SNA is suggested by these results.

Robinson RC, Crasilneck H, Garofalo JP, Whitfill T. Baylor University Medical Center, Dallas, Texas 75246, USA. RichardR@BaylorHealth.edu

Exploratory factor analysis and psychometric properties of the valencia scale on attitudes and beliefs toward hypnosis. Therapist version. This investigation examines the psychometric properties and factor structure of the Valencia Scale on Attitudes and Beliefs toward Hypnosis-Therapist version. Data from 775 professional psychologists belonging to the Spanish Association of Psychologists were used for the exploratory factor analysis (EFA). Retest included data from 426 participants who answered to the test. The EFA revealed eight factors (Fear, Memory, Help, Control, Collaboration, Interest, Magic and Marginal). Each factor showed good internal consistency and reliability, similar to the client version of this scale. ANOVA indicate that some variables (having scientific knowledge, having received practical information on hypnosis, to use hypnosis, and to show interest in receiving more theoretical and practical information on hypnosis), tend to reduce inadequate beliefs and negative attitudes toward hypnosis. Our results provide the basis for carrying out confirmatory factor analysis and studies of convergent validity on the scale, and of the sensitivity of the scale to change.

Capafons A, Morales C, Espejo B, Cabanas S. Faculty of Psychology, Universidad de Valencia, 46010 Valencia, Spain. antonio.capafons@uv.es

The negative effects of false information presented either prior to (proactive interference; PI) or following (retroactive interference; RI) true information was examined with word definitions (Experiment 1) and trivia facts (Experiment 2). Participants were explicitly aware of which information was true and false when shown, and true-false discrimination was evaluated via multiple-choice tests. Negative suggestion, defined as poorer performance on interference items than noninterference (control) items, consistently occurred when the wrong information followed the correct information (RI) but not when it preceded the correct information (PI). These effects did not change as a function of retention interval (immediate, 1 week, or 3 weeks) or number of incorrect alternatives (1 or 3). Implications of this outcome for experiencing incorrect information in both academic and nonacademic situations are considered.

Brown AS, Brown CM, Mosbacher JL, Dryden WE. Department of Psychology, Dedman College, Southern Methodist University, Dallas, TX 75275, USA. abrown@smu.edu

Between 60 and 90% of patients consult their family doctor for stress-associated complaints. Not infrequently, a considerable number of these patients already have elevated blood pressure. The positive effect on high blood pressure of relaxation techniques has been confirmed in various studies. Accordingly, stress management should now have a permanent place in effective antihypertensive treatment. Appropriate relaxation techniques include, for example, autogenic training, progressive muscle relaxation, visualization and breathing exercises, chi gong and yoga.These practices are incorporated in various lifestyle programs.They act in different ways, and can be offered to the patient in accordance with his/her individual wishes.

Schwickert M, Langhorst J, Paul A, Michalsen A, Dobos GJ. Abt. Innere V Naturheilkunde und Integrative Medizin, Kliniken Essen-Mitte. M.Schwikert@kliniken-essen-mitte.de