On the basis of the psychosomatic model, an interpretation of hypnositherapy is proposed in the psychobiological context as an applicative example of oneness. With this technique a particular state of awareness, which hypnosis is, correlated biologically with considerable subcortical neurophysiological modifications in the individual, is added, as a facilitating context, into the activation of patients psychotherapy.

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by Michelle Beaudry, CHt

Fundamentals of the Mind

The human mind may be subdivided into three parts: the Unconscious, Subconscious and Conscious. These compare to a computer:

• Unconscious - operating system
• Subconscious = hard drive
• Conscious = RAM

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Dean Schrock, Raymond Palmer and Bonnie Taylor looked at the effects of a 6 week psychosocial intervention group on the survival of 21 breast cancer and 29 prostate cancer patients in rural Pennsylvania. The 6 2-hour class topics emphasized imagery and stress reduction techniques, along with covering attitudes, feelings, self-esteem, spirituality, nutrition and exercise.

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Hypnosis is associated with profound changes in conscious experience and is increasingly used as a cognitive tool to explore neuropsychological processes. Studies of this sort typically employ suggestions following a hypnotic induction to produce changes in perceptual experience and motor control.

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Tthere has been a great deal of clinical and experimental interest expressed in dissociative disorders and dissociative states. Theories of mental organization and personality have been formulated as a result of this new emphasis on dissociative phenomena.

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Researchers from the School of Applied Social Sciences, University of Durham in the UK studied the effect of movement and stretching imagery on increases in flexibility in a randomized, controlled trial.

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Investigators from the Pediatric Department of The Georgia Institute for Prevention of Human Diseases and Accidents and The Medical College of Georgia looked at the impact of stress reduction, by way of Transcendental Meditation (TM), on blood pressure (BP) in African-American adolescents averaging 16 years old (aged 16.2 +/- 1.3 years) with high normal systolic BP. Subjects were randomly assigned to either a 4-month TM group (n = 50) or health education control group (n = 50).

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Researchers from Tai Po Hospital in Hong Kong explored the effects of guided imagery and relaxation in people with chronic obstructive pulmonary disease (COPD), using a randomized controlled design. Half of 26 participants were allocated to the treatment group, consisting of six practice sessions of guided imagery, while the control group was instructed to rest quietly during the six sessions. At the seventh session, physiological measures were taken and compared to previously, to see if there were any changes in partial percentage of oxygen saturation, heart rate, upper thoracic surface electromyography, skin conductance and peripheral skin temperature.

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A study from The Georgia Institute for Prevention of Human Diseases and Accidents shows that meditation significantly reduces blood pressure and heart rate (resting and ambulatory) in normal middle school children. In a randomized, controlled study, researchers from The Georgia Institute for Prevention of Human Diseases and Accidents evaluated the impact of a meditation program on resting and ambulatory blood pressure and heart rate in middle school children.

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According to Grunbaum's definition of placebo, a therapeutic procedure can be considered a nonplacebo if it can be demonstrated that its effects are produced according to the theory upon which the therapy is based.

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The experience of conscious will is the feeling that we are doing things. This feeling occurs for many things we do, conveying to us again and again the sense that we consciously cause our actions. But the feeling may not be a true reading of what is happening in our minds, brains, and bodies as our actions are produced. The feeling of conscious will can be fooled.

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In 1998, a research team led by Linda Halpin at the Inova Heart Center of Inova Fairfax Hospital compared cardiac surgical outcomes between two groups of heart patients - with and without guided imagery. A questionnaire was developed to assess the benefits of the guided imagery program to those who elected to participate in it, and, in addition, data from the hospital financial cost-accounting database were collected and matched to the two groups of patients. Analysis of the data revealed that patients who completed the guided imagery program had a shorter average length of stay, a decrease in average direct pharmacy costs, and a decrease in average direct pain medication costs while maintaining high overall patient satisfaction with the care and treatment provided.

Guided imagery is now used as a standard, complementary therapy to help reduce anxiety, pain, and length of stay among the cardiac surgery patients at Inova Fairfax.

According to the theoretical framework relating hypnosis to attention, baseline attentional functioning in highly hypnotizable individuals should be more efficient than in low hypnotizable individuals. However, previous studies did not find differences in Stroop-like tasks in which the measure indicative of the Stroop interference effect was based on response latencies.

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Hypnotherapeutic interactions can be mapped on a continuum from formal hypnosis to hypnotic conversation. Unlike the structured forms of formal hypnosis, hypnotic conversation relies upon utilizing the client's responses, both verbal and non-verbal, to facilitate therapeutic process. In this paper, we illustrate this continuum with a series of anecdotal clinical examples starting with formal hypnosis and moving incrementally towards hypnotic conversation.

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The concept of dissociation has been reviewed and redefined. It was also compared with other mental mechanisms. In the past, the process of dissociation and the content of the dissociation have often been lumped together although they are separate frames of reference. Moreover, very different psychic elements may be dissociated including memories, affects, and psychic structure.

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Spaulding Rehabilitation Hospital in Boston found that physical therapy is most effective for treating migraine when combined with treatments such as thermal biofeedback, relaxation training and exercise. Spaulding Rehabilitation Hospital in Boston conducted a medical literature review of physical therapy treatments for the management of primary headache disorders.

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People have suspected for years that guided imagery is an ideal intervention for people with diabetes. Because it lowers stress and people with Type II Diabetes (also known as Adult Onset Diabetes) are famously responsive to stress, it seems pretty obvious. But not a whole lot of hard-core study has been done on the subject.

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Researchers from the Department of OBGYN at Texas A&M University Health Sciences Center tested the effects of varying the amount of physical practice vs. mental imagery rehearsal for training medical students to perform basic surgical procedures.

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Hypnosis became popular as a treatment for medical conditions in the late 1700s when effective pharmaceutical and surgical treatment options were limited. To determine whether hypnosis has a role in contemporary medicine, relevant trials and a few case reports are reviewed. Despite substantial variation in techniques among the numerous reports, patients treated with hypnosis experienced substantial benefits for many different medical conditions.

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Researchers from the State Research Institute of Physiology at the Russian Academy of Medical Sciences in Novosibirsk, Russia, mounted a controlled, randomized clinical trial to examine how long-term meditation practice can effect EEG activity during non-emotional arousal (eyes-closed and eyes-open periods, viewing emotionally neutral movie clip) and while experiencing experimentally induced negative emotions (viewing an aversive movie clip).

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Hypnosis can be a useful adjunct to other treatment modalities. For example, hypnosis may induce a level of relaxation that allows patients to cooperate more easily with conventional treatment.

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Hypnosis has been used as a therapeutic tool for centuries, but only in the past 50 years have the clinical applications been delineated. As evident in the medical literature, the use of hypnosis by the medical community has increased, partly as a result of a growing awareness of hypnotherapy as an available treatment modality, and also as a result of major improvements in research methodology through strict standardization. Hypnotherapy, once considered to be limited to entertainment, has now proven useful in the treatment of a wide variety of medical illness.

Increasing scientific study and attention is being directed to mind-body interactions, particularly to the interrelationships between the brain and the immune system. This effort has created a new interdisciplinary field, psychoneuroimmunology.

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This study was a pilot project to explore the effect of an autogenic training program (AT; a relaxation intervention) on the health-related quality of life (HRQOL) and well-being for people with multiple sclerosis.

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Although hypnotizability can be conceptualized as involving component subskills, standard measures do not differentiate them from a more general unitary trait, partly because the measures include limited sets of dichotomous items. To overcome this, the authors applied full-information factor analysis, a sophisticated analytic approach for dichotomous items, to a large data set from 2 hypnotizability scales. This analysis yielded 4 subscales (Direct Motor, Motor Challenge, Perceptual-Cognitive, Posthypnotic Amnesia) that point to the building blocks of hypnotic response. The authors then used the subscales as simultaneous predictors of hypnotic responses in 4 experiments to distinguish the contribution of each component from general hypnotizability. This analysis raises interesting questions about how best to conceptualize and advance measurement of the ability to experience hypnosis.

Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada. ewoody@uwaterloo.ca

Although attention is a central theme in psychological science, hypnosis researchers rarely incorporate attentional findings into their work. As with other biological systems, attention has a distinct anatomy that carries out basic psychological functions. Specific brain injuries, states, and drugs can all influence attentional networks. Investigation into these networks using modern neuroimaging techniques has revealed important mechanisms involved in attention. In this age of genomics, genetic approaches can supplement these neuroimaging techniques. As genotyping becomes an affordable and technologically viable complement to phenotyping, exploratory genetic assays offer insights into the genetic bases of both attention and hypnotizability. This paper discusses relevant aspects of attentional mechanisms and their underlying neuroanatomy as they relate to hypnosis. Underlining data from attentional networks, neuroimaging, and genetics, these findings should help to explain individual differences in hypnotizability and the neural systems subserving hypnosis.

Columbia University College of Physicians & Surgeons and New York State Psychiatric Institute, New York, NY 10032, USA. ar2241@columbia.edu

Alternative descriptors of the capacity to experience hypnosis, intended to describe the same phenomenon, appear in the current literature. Published members of the Society for Clinical and Experimental Hypnosis (SCEH) were surveyed to determine their preferences. The descriptors were empirically derived from recent International Journal of Clinical and Experimental Hypnosis articles and input from the executive committee of SCEH. Participants also indicated their primary theoretical conceptualization of hypnosis. Hypnotizability was chosen nearly 4 times more frequently than the next most favored choice (susceptibility) as a descriptor of hypnotic talent. Hypnosis as an "identifiable state" was chosen more than 4 times more frequently than the socio-cognitive version. This latter finding suggests that the notion of the continued debatability of hypnosis as primarily a state is now shared by only a few.

Washington State University, Pullman 99164-2114, USA. ciara_christensen@yahoo.com

A study at the University of Kansas compares music, relaxation and silence on the energy levels, tension, fatigue, calmness and working memory of older adults.

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Twelve mentally healthy women aged 21-38 years were studied in the state of consciousness and hypnosis. The main study method was electroencephalography with assessment of the spatial synchronization of brain biopotentials (SSBP). Suggestion of high-intensity attention delivered to subjects in the hypnotic state was found to lead to significant reorganization of SSBP, with increases in SSBP between both occipital areas, the right temporal area, and other parts of the brain. The dynamics of brain SSBP in intense attention were opposite in the hypnotic and conscious states, which appears to result from the temporary exclusion in the hypnotic state of the functions of the frontal areas of the cortex responsible for conscious control and regulation of ongoing activity.

Neurosci Behav Physiol. 2005 Jul;35(6):643-7

That auditory hallucinations are voices heard in the absence of external stimuli implies the existence of endogenous neural activity within the auditory cortex responsible for their perception. Further, auditory hallucinations occur across a range of healthy and disease states that include reduced arousal, hypnosis, drug intoxication, delirium, and psychosis. This suggests that, even in health, the auditory cortex has a propensity to spontaneously "activate" during silence. Here we report the findings of a functional MRI study, designed to examine baseline activity in speech-sensitive auditory regions. During silence, we show that functionally defined speech-sensitive auditory cortex is characterized by intermittent episodes of significantly increased activity in a large proportion (in some cases >30%) of its volume. Bilateral increases in activity are associated with foci of spontaneous activation in the left primary and association auditory cortices and anterior cingulate cortex. We suggest that, within auditory regions, endogenous activity is modulated by anterior cingulate cortex, resulting in spontaneous activation during silence. Hence, an aspect of the brain's "default mode" resembles a (preprepared) substrate for the development of auditory hallucinations. These observations may help explain why such hallucinations are ubiquitous.

Sheffield Cognition and Neuroimaging Laboratory (SCANLab), Academic Clinical Psychiatry, Division of Genomic Medicine, University of Sheffield, Sheffield S5 7JT, United Kingdom. m.d.hunter@sheffield.ac.uk

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.

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

Researchers from The University of Cincinnati analyzed data from ten different guided imagery studies to assess the trajectory of effect size with continued imagery practice, and the relationship between practice duration and strength of outcomes. .

Statistical findings of the ten different studies of various durations were converted to "d" statistics and plotted against the duration of study. The results showed an increase in the effect size of guided imagery over the first 5 to 7 weeks. However, it appeared that the effect was decreased at 18 weeks.

Citation: Van Kuiken D. A meta-analysis of the effect of guided imagery practice on outcomes. Journal of Holistic Nursing. 2004 Jun; 22 (2): pages 164-79.

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.

Department of Psychology, University of Tennessee, Knoxville, Tennessee 37996, USA. Jwinkel@utk.edu

Hypnotic suggestions describing an altered perception induce congruent changes in the subject's experience and behavior. However, it is not known whether an implicit suggestion, only indirectly referring to an altered perception, induces a behavioral response corresponding to that of the real situation. In this study, an implicit suggestion of backward falling (IMP) was given to high hypnotizable participants not exposed (W-Highs) and exposed (H-Highs) to a hypnotic induction and a group of low hypnotizable individuals (W-Lows). Their posture was evaluated through an elite system. The results after the IMP were compared with those after an explicit suggestion of backward falling (EXP). In both W-Highs and H-Highs, the IMP elicited the backward body sway expected in the corresponding real situation, whereas no response was found in W-Lows. The results are discussed in terms of a possible equivalence of imagery and perception or of a lack of the motor inhibition normally associated with motor imagery.

Siena University, Siena, Italy.

In the aftermath of the human genome project, genotyping is fast becoming an affordable and technologically viable complement to phenotyping. Whereas attempts to characterize hypnotic responsiveness have been largely phenomenological, data emanating from exploratory genetic data may offer supplementary insights into the genetic bases of hypnotizability. We outline our genetic and neuroimaging findings and discuss potential implications to top-down control systems. These results may explain individual differences in hypnotizability and propose new ideas for studying the influence of suggestion on neural systems.

Two studies investigated management of conflict in hypnosis by subtly increasing the brightness of a visual stimulus during a suggestion for hypnotic blindness to the stimulus. In Study 1, 23 high hypnotizable participants were administered a hypnotic suggestion for blindness to a projected light. For half the participants, the brightness of the light was intensified during the suggestion. Behavioral ratings and online analog-dial measurement indicated that participants reported decreased hypnotic blindness during the increased conflict condition. In Study 2, 20 participants were administered the nonexperimental procedure to investigate the impact of demand characteristics in this paradigm. Parallel findings in Studies 1 and 2 indicated that demand characteristics may explain the response to hypnotic conflict. Limitations in applying the nonexperimental procedure to this paradigm and the need for further investigation are discussed.

University of New South Wales, Sydney, Australia. r.bryant@unsw.edu.au

Individual differences in wound healing have long been recognized. Clinical observation has suggested that negative mood or stress is associated with slow wound healing. Basic mind-body research is now confirming this observation. Matrix metalloproteinases (MMPs) and the tissue inhibitors of metalloproteinases (TIMPs), whose expression can be controlled by cytokines, play a role in wound healing. Using a blister chamber wound model on human forearm skin exposed to ultraviolet light, researchers have demonstrated that stress or a change in mood is sufficient to modulate MMP and TIMP expression and, presumably, wound healing. Activation of the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal medullary (SAM) systems can modulate levels of MMPs, providing a physiological link among mood, stress, hormones, and wound healing. This line of basic research suggests that activation of the HPA and SAM axes, even in individuals within the normal range of depressive symptoms, could alter MMP levels and change the course of wound healing in blister wounds.

When a hypnotist appears on screen, expect evil. If his induction features 'magnetic' hand passes, he's probably about to compel someone to commit a crime. Ifhe hypnotizes with an intense stare, his intent is likelier seduction-in fact many screen inductions are identical to the eye contact ethologists have labeled "the copulatory gaze." This paper explores to role of hypnosis in more than 230 films in which it has been depicted and categorizes the--mostly negative--stereotypes about it. A handful of exceptions in which hypnosis is positive and/or realistic are examined. The discussion compares this to the role of psychotherapy and dreams in cinema. It discusses why hypnosis is so maligned and whether there is anything practitioners can do to alter the stereotype.

Harvard Medical School, USA. Deirdre_Barrett@hms.Harvard.edu

Much research indicates that attempts to suppress thoughts lead to increased accessibility of those thoughts, especially when additional cognitive load is present. On the premise that hypnosis may permit more effective management of cognitive load, it was hypothesized that hypnosis may enhance more effective thought suppression. The present research examined whether the obstacle of cognitive load could be bypassed using hypnosis to facilitate successful thought suppression. Thirty-nine high and 40 low hypnotizable participants were hypnotized and received either a suppression instruction or no instruction for a memory of an embarrassing experience and subsequently completed a sentence-unscrambling task that indexed accessibility of embarrassing thoughts. Whereas lows instructed to suppress displayed a delayed increase in suppressed thoughts, highs did not. These findings support the proposition that hypnosis facilitates thought suppression.

School of Psychology, University of New South Wales, Sydney, Australia. r.bryant@unsw.edu.au

This paper attempts to understand the relationship between the clinical efficacy of hypnosis and its negative perception among many medical educators, practitioners and the general public. By exploring the history of hypnosis, an attempt was made to point out several events that may have led to both the past and current misperception of hypnosis which the author believes have caused hypnosis to become "medicine's dirty word".

University of South Florida, USA. wupshaw@hsc.usf.edu