Much of the literature focuses on the pathology that falls to the far right of the Watkins (1997) differentiation-dissociation continuum, such as Dissociative Identity Disorder and Dissociative Disorder NOS. Adding a "far left" to this continuum, as well as a construct of what the "far left" looks like, makes apparent the value of healthy adaptive differentiation for those individuals that fall to the "far left" of the spectrum; those who don't differentiate enough.

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A review article from the Mass. General/Harvard Medical School reports that Cogntive-Behavioral Therapy (CBT) is currently considered a first-line treatment for panic disorder, as well as a strategy for those who do not respond to medication, and a replacement for those who want to discontinue medication.

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Nocturnal enuresis (bedwetting) is a socially disruptive and stressful condition which affects around 15 to 20% of five year olds, and up to 2% of young adults.

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A recent Mt. Sinai Hospital study by posttraumatic stress researcher, Rachel Yehuda, found that infants born to pregnant women who were directly affected by the World Trade Center attacks, showed biological markers - low cortisol levels - indicating effects of PTSD.

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Another new study, this one using neuro-imaging out of the University of Montreal, shows that neurofeedback is very likely highly effective in helping children with attention deficit hyperactivity (ADHD) disorder.

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A group of researchers from the University of Southern Maine took a look the effects of offering Therapeutic Touch (TT) as an adjunct to cognitive behavioral therapy (CBT) for people with chronic pain. Patients were randomized to a relaxation training condition alone or relaxation training plus Therapeutic Touch. All participants attended a relaxation training classes. Preprogram and postprogram data were examined to identify patterns of change in pain intensity, self-efficacy, disability, and perceived distress.

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Strelow and Davidson tested the hypotheses that (a) introverts would produce more vivid imagery than would extraverts, and that (b) introverts would produce better imagery if the background auditory tempo were slow, and extraverts would produce better mental imagery of the background auditory tempo were fast. Participants (N=240) were classified as introverts or extraverts and were randomly assigned one of three tempo conditions: slow, fast, or none.

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An individual developed a lifestyle-limiting case of Panic Disorder that threatened to interfere with her raison d'etre: To participate in the exclusive lifestyle of her community. The panic episodes started to cripple her social calendar and as the "season" came into full swing her coveted role of chairwoman of various philanthropic functions came into peril.

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Many studies have suggested that conflict monitoring involves the anterior cingulate cortex (ACC). We previously showed that a specific hypnotic suggestion reduces involuntary conflict and alters information processing in highly hypnotizable individuals.

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The relevance of hypnosis to the treatment of sexual assault derives from two sources: the fact that hypnotic phenomena are mobilized spontaneously as defenses during assault, becoming part of the syndrome of posttraumatic stress disorder (PTSD) and the usefulness of formal hypnosis in treating PTSD. The role of dissociative defenses during and after traumatic experiences is reviewed; an analogy between the major elements of formally-induced hypnosis--absorption, dissociation, and suggestibility, and the major elements of PTSD--is drawn. Special problems relevant to sexual assault in childhood are discussed, including extreme self-blame and a profound sense of personality fragmentation. Uses of hypnosis in the treatment of sexual assault victims are reviewed, with an emphasis on helping such patients restructure their memories of the experience, both by reviewing them with greater control over their physical sense of comfort and safety and by balancing painful memories with recognition of their efforts to protect themselves or someone else who was endangered. The use of a split-screen technique in hypnosis is described with a clinical example. Special considerations in such treatment, including the traumatic transference and forensic complications of such psychotherapeutic work, are enumerated.

Stanford University School of Medicine, California.

Researchers from the University of Connecticut Health Center in Farmington randomly assigned 128 alcohol dependent men and women receiving 26 weeks of group treatment into one of two modalities: Cognitive-behavioral treatment (CBT) intended specifically to develop coping skills or interactional therapy intended to examine interpersonal relationships. Coping skills and drinking were assessed prior to and after treatment and up to 18 months after intake. Results indicated that both treatments yielded very good drinking outcomes throughout the follow-up period. Increased coping skills was a significant predictor of outcome. However, neither treatment effected greater increases in coping than the other. Specific coping-skills training was not essential for increasing the use of coping skills.

A new perspective on how therapeutic hypnosis and neuroscience may be integrated on the molecular-genomic level is offered as a guide for basic research and clinical applications. An update of Watson and Crick's original formulation of molecular biology is proposed to illustrate how psychosocial experiences modulate gene expression, protein synthesis, and brain plasticity during memory trace reactivation for the reorganization of neural networks that encode fear, stress, and traumatic symptoms. Examples of the scientific literature on DNA microarrays are used to explore how this new technology could integrate therapeutic hypnosis, neuroscience, and psychosocial genomics as a new foundation for mind-body medicine. Researchers and clinicians in therapeutic hypnosis need to partner with colleagues in neuroscience and molecular biology that utilize DNA microarray technology. It is recommended that hypnotic susceptibility scales of the future incorporate gene expression data to include the concept of "embodied imagination" and the "ideo-plastic faculty" on a molecular-genomic level as well as the psychological and behavioral level of ideomotor and ideosensory responses that are currently assessed.

Ernest@ErnestRossi.com

Although conceptualized as a normal reaction to loss and not classified as a mental disorder, grief can be considered a focus of treatment. When grief complicates and becomes pathological by virtue of its duration, intensity, and absence or by bizarre or somatic manifestation, a psychiatric diagnosis is in order. Childhood PTSD in Complicated Bereavement is a condition derived from the loss of a loved one when the nature of death is occasioned through traumatic means. The traumatic nature of the loss engenders trauma symptoms, which impinge on the child's normal grieving process and his/ her ability to negotiate the normal grieving system. The 2 cases presented herein constitute single session treatment with clinical hypnosis of PTSD, a result of the traumatic loss of the paternal figures. The setting in which these cases took place was rural Guatemala. Treatment consisted of single session hypnosis with the Hypnotic Trauma Narrative, a tool designed to address the symptomatology of PTSD. Follow-up a week later and telephone follow-up 2 months later demonstrated the resolution of traumatic manifestations and the spontaneous beginning of the normal grief process.

PhDALEX@aol.com

In a previous study we showed that healthy highly hypnotizable subjects, during the suggestion of a moderately unpleasant situation administered in awake conditions, exhibited a sympathetic response greatly attenuated with respect to non-hypnotizable individuals. This was interpreted as a natural protection of hypnotizable subjects against the cardiovascular effects of cognitive stress. Aim of the present study was to investigate whether the hypnotic trait is able to modulate the autonomic and cerebral activities also in specific phobic awake hypnotizable (Highs) and non-hypnotizable (Lows) subjects. Electroencephalogram, electrooculogram, electromiogram of corrugator muscle, electrocardiogram, respirogram and tonic electrodermal activity were recorded during a guided mental imagery of an animal phobic object. Phobic stimulation induced in both groups the rise of heart and respiratory frequency and the lowering of skin resistance. These changes are less pronounced in Highs than in Lows and are sustained by a different modulation of the sympatho-vagal balance. During phobic stimulation both groups exhibited a similar significant increase of EEG gamma relative power. At variance, significant stimulation-related decrements of alpha1, theta1 and theta2 activities were found only in Highs that exhibited similar changes during the control and phobic stimulation. Results suggest that hypnotizability is able to modulate cerebral and autonomic responses also in specific phobic subjects. However, the presence of a specific phobia attenuates the effectiveness of hypnotizability as a protective factor against possible stress-related cardiac illness.

Department of Physiology and Biochemistry, G. Moruzzi, University of Pisa, Via San Zeno 31, 56127 Pisa, Italy. gemignan@dfb.unipi.it

This paper reports a study to determine the effectiveness of autogenic training in reducing anxiety in nursing students. BACKGROUND: Nursing is stressful, and nursing students also have the additional pressures and uncertainties shared with all academic students. Autogenic training is a relaxation technique consisting of six mental exercises and is aimed at relieving tension, anger and stress. Meta-analysis has found large effect sizes for autogenic trainings intervention comparisons, medium effect sizes against control groups, and no effects when compared with other psychological therapies. A controlled trial with 50 nursing students found that the number of certified days off sick was reduced by autogenic training compared with no treatment, and a second trial with only 18 students reported greater improvement in Trait Anxiety, but not State Anxiety, compared with untreated controls. METHODS: A randomized controlled trial with three parallel arms was completed in 1998 with 93 nursing students aged 19-49 years. The setting was a university college in the United Kingdom. The treatment group received eight weekly sessions of autogenic training, the attention control group received eight weekly sessions of laughter therapy, and the time control group received no intervention. The outcome measures were the State-Trait Anxiety Inventory, the Maslach Burnout Inventory, blood pressure and pulse rate completed at baseline, 2 months (end of treatment), and 5, 8, and 11 months from randomization. RESULTS: There was a statistically significantly greater reduction of State (P<0.001) and Trait (P<0.001) Anxiety in the autogenic training group than in both other groups immediately after treatment. There were no differences between the groups for the Maslach Burnout Inventory. The autogenic training group also showed statistically significantly greater reduction immediately after treatment in systolic (P<0.01) and diastolic (P<0.05) blood pressure, and pulse rate (P<0.002), than the other two groups. CONCLUSION. Autogenic training has at least a short-term effect in alleviating stress in nursing students.

Faculty of Health Studies, Buckinghamshire Chilterns University College, Buckinghamshire, UK. n.kanji@bcuc.ac.uk

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.

jhlinden@cs.com

The paper promotes the view that the alert brain alternates between operating in an action mode, based on frontal lobe function, and a receptive mode, involving cholinergic system activity. Their alternation forms a conversation with the environment. It is hypothesized that competition between the modes centers on control over excitability of neurons in the CA1 field of the hippocampus. Increased excitability enhances the flow of hippocampal output through the subiculum resulting in support for frontal lobe function and the action mode. Decreased excitability, on the other hand, reduces this output and that support, leading to a disconnection between frontal lobes and hippocampus. At the same time, correlated cholinergic activity enhances receptive mode processes, indicated by the occurrence of the hippocampal theta rhythm. It is suggested that the hypothesis provides a conceptual framework for considering various phenomena including REM sleep, schizophrenia, and hypnosis. In REM sleep the receptive mode remains dominant as cholinergic activity supports the hippocampal integration of experience into a composite view of reality. In schizophrenia, the action and receptive modes are not properly coordinated because of a dysfunction in anterior hippocampal output. And hypnosis might be seen as a process in which conditions and suggestions are able to induce in some people a prolonged occurrence of the receptive mode allowing a normal view of reality to be altered.

2021 Jolly Road, Okemos, MI 48864, United States. johns127@msu.edu

This case report discusses a patient who experienced frequent nightmares and chronic low-level anxiety during his 3 1/2 year imprisonment. He developed post traumatic stress disorder (PTSD), in part because he adamantly insisted that he had been wrongfully incarcerated. The literature supports the use of hypnotic imagery rehearsal for treating nightmares that stem from PTSD. Due to the patient's distrust of others and trauma history, it was uncertain whether hypnotic intervention would be effective. It is of note, there is no indication in the literature that hypnosis has been used with people on parole, let alone individuals who believe they were wrongly accused of committing a crime.

NYU Student Health Center 726 Broadway, Ste. 471 New York, NY 10003, USA. brooke.donatone@nyu.edu

Adult Posttraumatic Stress Disorder secondary to childhood sexual abuse is clinically complicated by its increasingly noted deficient linguistic recording of the abuse, perhaps partially explaining consequent difficulties with verbalizing in therapy. A single case illustrates that hypnotically utilizing the body-emotion register of encrypted sexual abuse trauma may not only afford more naturalistic retrieval and purgation of the experience, but may also provide the very medium for the healing narrative required for recovery. The patient's original and continuing therapist was also present as support and observer for all but 1 of 25 hypnosis sessions. Treatment gains were robust at 3-year follow up. This case suggests that effective treatment for sexual abuse PTSD may in some instances reside in more nonverbally sensitive interventions not aiming to prove, probe, or process linguistic reconstructions of memory. This is the first published report of such a bodily narrative in hypnosis.

Antioch New England Graduate School, 40 Avon Street, Keene, NH 03431, USA. Victor_Pantesco@antiochne.edu

Two groups of tinnitus patients (n=93) were recruited, one of which was treated with standard infusion therapy and further acute medical intervention, while the other obtained an additional psychotherapeutic intervention. Questionnaires and interviews were taken at beginning of the treatment, and 9 days and 3 years after treatment. The accompanying psychotherapeutic intervention consisted primarily of client-centered counseling, guided relaxational techniques from clinical hypnosis, and some standard and tinnitus-related methods for a better coping with stress. After 9 days, both treatment groups showed significant improvement in several psychological characteristics. However, there was no evidence for the superiority of the combined treatment with psychological intervention. Psychotherapeutic treatment accompanying the acute medical treatment probably shows better effectiveness in an ambulant setting with both patients and medical healthcare professionals rating it as 'very helpful'.This pilot study has contributed initial results for the integrated treatment of the acute tinnitus and has helped in the development of further therapeutic strategies as well as an evidence based concept for further evaluation. This study received one of the two scientific first prizes of the "German Tinnitus League".

Fachbereich Psychologie, Universitat Hamburg

The long-term benefits of cognitive behaviour therapy (CBT) for trauma survivors with acute stress disorder were investigated by assessing patients 3 years after treatment. Civilian trauma survivors (n=87) were randomly allocated to six sessions of CBT, CBT combined with hypnosis, or supportive counselling (SC), 69 completed treatment, and 53 were assessed 2 years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician-Administered PTSD Scale. In terms of treatment completers, 2 CBT patients (10%), 4 CBT/hypnosis patients (22%), and 10 SC patients (63%) met PTSD criteria at 2-years follow-up. Intent-to-treat analyses indicated that 12 CBT patients (36%), 14 CBT/hypnosis patients (46%), and 16 SC patients (67%) met PTSD criteria at 2-year follow-up. Patients who received CBT and CBT/hypnosis reported less re-experiencing and less avoidance symptoms than patients who received SC. These findings point to the long-term benefits of early provision of CBT in the initial month after trauma.

School of Psychology, University of New South Wales, NSW 2052, Sydney, Australia. r.bryant@unsw.edu.au

The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. METHODS: A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7-17). When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. RESULTS: Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. CONCLUSION: Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

Department of Pediatrics, University Hospital, State University of New York Upstate Medical University, Syracuse, NY, USA. anbarr@upstate.edu

Patients who present with severely impaired memory functioning without a discernable neurological cause typically have experienced one or more severely stressful life events. These patients, who are described as having "psychogenic" or "dissociative" amnesia, typically differ from patients with the neurologic amnestic syndrome in that memory for their personal life histories is much more severely affected than is their ability to learn and retain new information; that is, they have isolated retrograde amnesia. Recent cognitive and brain imaging research has begun to reveal some of the cerebral mechanisms underlying functional amnesia, but this disorder remains best conceptualized as a relatively rare form of illness-simulating behavior rather than a disease. Neuropsychological assessment is often useful in revealing the circumscribed nature of the patient's performance deficits, the spared functions that can be brought to bear in rehabilitation, and the emotional disorders requiring psychiatric treatment. Controlled treatment trials are nonexistent, but case reports suggest that supportive psychotherapy, systematic relaxation training, hypnosis, and sedative/anxiolytic medications are useful in facilitating recovery. These treatments are often combined with a psychoeducational approach that essentially reteaches the patient his or her life story.

Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland 21287-7218, USA.

This study investigated the roles of hypnotizability and hypnosis in suggested emotional numbing. Thirty-two high hypnotizable and 32 low hypnotizable participants were administered either a hypnotic or wake induction and were then presented with emotionally distressing and neutral images during a suggestion for emotional numbing or a control condition. Emotional response was indexed through self-report and EMG corrugator-muscle activity. High hypnotizable participants, in both the hypnosis and wake conditions, reported more diminished emotional responses on self-report and EMG corrugator-muscle activity than low hypnotizable participants during the emotional-numbing suggestion. These findings suggest that elevated hypnotic susceptibility, rather than hypnosis, is an important mediator of emotional numbing. The importance of individual differences in emotional numbing is discussed.

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

Previous research suggests that mirror-gazing is efficacious for the facilitation of anomalous experiences. The present experiment tested the hypothesis that the incidence of such experiences is a function of the demand characteristics of the procedure. Participants were randomly allocated to one of two conditions and completed a battery of trait and state measures. Individuals who were given suggestions for anomalous experiences, relative to those who were not, reported a greater number of visual, and a suggestively greater number of vocal, hallucinations. The experience of a descriptively dissociative phenomenological state was the strongest predictor of the reporting of anomalous experiences, but only correlated with the experience of anomalous perceptions in the suggestion condition. Experients of visual apparitions were found to significantly differ from nonexperients in their preference for a visual cognitive style independently of condition.

Division of Psychiatry, Boston University School of Medicine, Boston, Massachusetts 02118, USA. devin.terhune@gmail.com

Somatic symptoms have been conceptualized in many different ways in literature. Current classifications mainly focus on the numbers of symptoms, with relative neglect of the underlying psychopathology. Researchers have emphasized the importance of a number of experiential, perceptual and cognitive-behavioural aspects of somatization. This review focuses on existing literature on the role of somatosensory amplification, attribution styles, and illness behaviour in somatization. Evidence suggests that somatosensory amplification is neither sensitive nor specific to somatizing states, and that other factors like anxiety, depression, neuroticism, alexithymia may also have an influence. Attribution research supports the existence of multiple causal attributions, which are related to the numbers of somatic symptoms. While somatizing patients have more organic attributions, depressed patients have more psychological attributions. A global somatic attribution style is associated with the number of obscure somatic symptoms, while a psychological attribution style is associated with both--psychological and somatic-- symptoms of depression and anxiety. There are conflicting findings with respect to the role of normalizing attributions in reducing physician recognition of anxiety and depression. Specific symptom attributions appear to explain physician recognition of psychological distress, but global attribution styles do not appear to explain any further variance in physician recognition beyond that explained by specific causal attributions. Illness behaviour has been studied in two distinct ways in literature. Research focusing on attendance rates as a form of illness behaviour suggests that somatization is associated with high levels of health care utilization. There is also some evidence that health care utilization, amplification and attributions styles may be interrelated among somatizing patients. More structured ways to assess illness behaviour have found high levels of abnormal illness behaviour in this population. Overall, research appears to suggest a complex (and as yet unclear) relationship between somatic symptoms and underlying cognitions/illness behaviours. While it is clear that somatization is closely related to a number of perceptual and cognitive-behavioural factors, the precise nature of these relationships are yet to be elucidated.

Avondale unit, Royal Preston Hospital, Preston, UK. duddu.venu@gmail.com

Source identification tests provide a stringent method for testing the suggestibility of memory because they reduce response bias and experimental demand characteristics. Using the techniques and materials of Maria Zaragoza and her colleagues, we investigated how state anxiety affects the ability of undergraduates to identify correctly the source of misleading post-event information. The results showed that individuals high in state anxiety were less likely to make source misattributions of misleading information, indicating lower levels of suggestibility. This effect was strengthened when forgotten or non-recognised misleading items (for which a source identification task is not possible) were excluded from the analysis. Confidence in the correct attribution of misleading post-event information to its source was significantly less than confidence in source misattributions. Participants who were high in state anxiety tended to be less confident than those lower in state anxiety when they correctly identified the source of both misleading post-event information and non-misled items. The implications of these findings are discussed, drawing on the literature on anxiety and cognition as well as suggestibility.

Department of Psychology, London South Bank University, UK. ridleyam@lsbu.ac.uk

Autogenic training is a widely recognised psychotherapy technique. The British School of Autogenic Training cites a large list of disorders, states, and changes, where autogenic training may prove to be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adults. Our sample consisted of a homogeneous group of 35 individuals, with an average age of 39.3 +/- 1.6 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. AIM: The aim of our study was to research the effectiveness of autogenic training as a therapy for adjustment disorder in adults, by checking the influence of autogenic training on the biophysical and biochemical indicators of adjustment disorder. METHOD: We measured the indicators of adjustment disorder and their changes in three phases: before the beginning, immediately after the beginning, and six months after the completion, of a practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rate as well as the levels of cortisol in plasma, of cholesterol in blood, and of glucose. During that period, autogenic training functioned as the sole therapy. RESULTS: The study confirmed our preliminary assumptions. The measurements we performed demonstrated that arterial blood pressure, pulse rate, concentration of cholesterol and cortisol, after the application of autogenic training among the subjects suffering from adjustment disorder, were lower in comparison to the initial values. These values remained lower even six months after the completion of the practical course in autogenic training. CONCLUSION: Autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and helps adults to cope with stress, facilitating their recuperation.

Studies about the psychology of childhood asthma have revealed that parenting difficulties are related to the development of asthma in some children. Disruptions in maternal-infant bonding are highly correlated with pediatric asthma and are presented as a cause for these parenting problems. Bonding problems are known to be caused most often by physical separation at birth or by some recent trauma in the mother's life. By using hypnosis to remove the pain of the separation or trauma in the mother, and by creating a new birth history in her imagination, some children's asthmatic symptoms have been shown to remit or greatly improve. The hypnotic method for this treatment is described.

madrid@sonic.net

Psychological comorbidity with medical illness is associated with poor health status, complicated medical management, and increased utilization and greater costs of medical services. Hypnosis practitioners in specialty psychological or psychiatric treatment settings infrequently treat such patients, since there is a greater likelihood of patients' psychological problems being treated solely in primary medical care. Referring patients from primary care to the mental health system will most likely not result in patients initiating psychological or hypnotic treatment. At the same time, integrated provision of medical and psychological treatment in the medical office has demonstrated much higher rates of initiation of treatment and improved medical outcomes. Although hypnosis has been found to be an empirically effective treatment for many medical problems, when hypnosis practitioners do not practice in these medical sites then patients do not have access to effective hypnotic interventions for cotreatment of medical problems.

Berlin Family Health and Central Vermont Medical Center, Berlin, Vermont, USA. rodger.kessler@hitchcock.org

Mental or emotional stress-induced ventricular arrhythmias and sudden cardiac death are thought to be mediated by the autonomic nervous system and ischemia. In the absence of ischemia, increased inhomogeneity of repolarization is thought to be important. We tested the hypotheses that in the absence of ischemia, mental stress may modulate repolarization by changing autonomic balance; and mental relaxation induced by hypnosis may offset the potentially adverse effects of stress on the cardiac electrophysiology. METHODS: Twelve healthy volunteers (6 male, age 18-35, mean 25 years) experienced a series of different emotions intended to induce a wide range of autonomic response (42 test epochs) on two separate occasions, with and without hypnosis, with continuous electrocardiogram recording. Low- (LF) and HF (high-frequency) heart rate variability was measured and ventricular repolarization was assessed using the relative T-wave residua (proportion of nondipolar components of the T wave) calculated for the T-onset - T peak (TWR-peak T), T peak -T end (TWR-end T), and the whole T wave (TWR). RESULTS: Emotionally induced changes in LF and LF/HF ratio correlated with changes in TWR, e.g., (R = 0.51, p < .001; R = 0.59, p < .0001; and R = 0.59, p < .0003, for LF/HF versus TWR, TWR-Peak T, and TWR-end T, respectively. Mental relaxation induced by hypnosis increased LF power (1,205 ms2) versus 624 ms2, p < .003 for hypnotized versus nonhypnotized state), HF power (1,619 ms2 versus 572 ms2), p < .0004), and reduced LF/HF ratio (1.0 versus 1.5, p = .052) and was associated with a marked reduction in the changes in repolarization in response to emotion, e.g., 10.7 x 10(-6) versus 5.0 x10(-6), p < .03 for TWR. CONCLUSIONS: a) Mental stress in the absence of ischemia altered repolarization inhomogeneity via change in the autonomic balance. b) Mental relaxation induced by hypnosis greatly reduced the effect of mental stress on repolarization. c) These findings may have implications for arrhythmogenesis.

Department of Cardiology, The Hatter Institute and Centre for Cardiology, University College London Hospitals, Grafton Way, London WC1E 6DB, UK. peter.taggart@uclh.org

Post-ischaemic flow mediated dilation of peripheral arteries (FMD) is transiently reduced during mental stress. This experiment was aimed at assessing whether hypnosis, which is a powerful relaxation technique, modulated the FMD response to mental stress in subjects with different hypnotic susceptibility. Results showed that hypnotic relaxation prevented the expected stress-related reduction of FMD only in highly hypnotizable subjects, suggesting a protective role of hypnotisability against vascular damage.

National Council of Research, Institute of Clinical Physiology, Pisa, Italy.

Autogenic training is a widespread technique used in psychotherapy. The British school of autogenic training cites a large list of diseases, health states, and life changes, in which autogenic training can be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adolescents. The sample consisted of a homogeneous group of 31 individuals, with an average age of 17.3 +/- 0.2 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. OBJECTIVE: The aim of our work was to figure out the influence of autogenic training on adjustment disorder, through biophysical and biochemical indicators, and to research the efficiacy of autogenic training as a therapy for adjustment disorder in adolescents. METHOD: We observed adjustment disorder indicators and their changes in three phases, using initial, final, and control values, which we measured immediately before the beginning, immediately after the completion, and six months after the completion, of the practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rates, cortisol levels in plasma, cholesterol levels in blood, as well as glucose concentrations. During that period, autogenic training was employed as the sole therapy. RESULTS: The study confirmed our preliminary assumptions. The measurements we performed showed that arterial blood pressure, pulse rates, cholesterol and cortisol concentrations, after the application of autogenic training among adolescents suffering from adjustment disorder, were lower than the initial values. They remained lower even six months after the completion of the practical course in autogenic training. CONCLUSION: We concluded that autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and eases the adaptation of adolescents to stress, helping with recovery.

PMID: 16640187 [PubMed

There are many similarities between the symptoms of conversion hysteria and phenomena produced in hypnotic contexts. This paper reviews some of those similarities and considers more general features associated with both hypnotic phenomena and conversion hysteria symptoms such as lack of concern, perceived involuntariness, the display of ''implicit knowledge'' and their apparently compliant nature. Neurophysiological and brain-imaging studies of hypnotically produced effects and conversion symptoms are described, which implicate frontal cortical structures in moderating the respective changes elsewhere in the brain, particularly in cingulate cortex. A recurrent theme is the apparent paradox which exists between, on the one hand, the subjective reality and involuntariness of both hypnotic phenomena and the symptoms of conversion hysteria and, on the other, the fact that objectively they appear to be role-congruent enactments responsive to the manipulation of motivational factors, expectancy, and social influence. A model of consciousness and self-awareness is presented which attempts to resolve that paradox whilst describing similar mechanisms underlying hypnotic phenomena and conversion hysteria symptoms. The model develops the idea of a central executive structure, similar to the notion of a supervisory attentional system, acting outside self-awareness but at a late stage of information processing which can be directly influenced from both internal and external sources to produce the relevant phenomena. The paper ends by proposing that as conversion disorder, pain disorder, and the dissociation disorders appear to be linked by a common mechanism they should be classified together under the heading of auto-suggestive disorder.

Hypnosis Unit, Department of Psychology, University College London, UK. oakley@the-croft.demon.co.uk

The dissociative disorders are characterized by difficulties in the integration of memory and/or identity. Typically this is manifested by amnesia and either the development of alternate identities or an estrangement from one's own identity. Spontaneous and self-generated dissociative states and phenomena sharing much in common with those that can be induced with hypnosis are thought to play a major role in their development, symptomatology, and perpetuation. Medical heterohypnosis offers a powerful tool to reestablish a functional continuity of memory and identity in many such cases. The application of hypnotic interventions in the treatment of such conditions will be discussed, explored, and illustrated with clinical vignettes.

Institute of Pennsylvania Hospital, Philadelphia.