Creative Reframing


A wise old gentleman had retired and bought himself a modest home near a school. He spent the first few weeks of his retirement in peace and contentment. However, when the new school year began, the very next afternoon three young boys, full of youthful exuberance and post school enthusiasm, came down his street, banging merrily on every dustbin they encountered. The crashing percussion continued day after day, until finally the wise old man decided it was time to take some action.

The next afternoon, he walked out to meet the young percussionists as they banged their way down the street. He stopped them and said, “You boys are a lot of fun. I like to see you express your exuberance like that. In fact, I used to do the same thing when I was your age. Will you do me a favour? I’ll give you each a dollar if you’ll promise to come around every day and do your thing.” The kids were elated and continued to do a bang-up job on the dustbins.

After a few days, the old-timer greeted the kids again, but this time he had a sad smile on his face. “This recessions really putting a big dent in my income,” he told them. “From now on, I’ll only be able to pay you 50 cents to beat on the cans.” The noisemakers were obviously displeased, but they accepted his offer and continued their afternoon ruckus. A few days later, the wily retiree approached them again as they drummed their way down the street.

“Look,” he said, “I haven’t received my Social Security check yet, so I’m not going to be able to give you more than 25 cents. Will that be okay?” “A quarter?” the drum leader exclaimed. “If you think were going to waste our time, beating these cans around for a quarter, you’re mad! No way, we quit!” And the old man enjoyed peace and serenity for the rest of his days.

What is Mental Strength and Do You Have It?


general-patton-quotescreenshot-2016-11-01-16-14-33

I’m fairly certain that most people would like to think that they have what it takes to succeed; determination, grit, Mental Strength, resilience.

But how do you know for sure? After all you can’t improve what you can’t measure.

Until recently Mental Strength (toughness) was generally subjective. We would look at a business person, an athlete, or an artist achieve great success in the face of adversity and say, “WOW…they must be really mentally strong to get through that!”

We would determine a person’s Mental Strength by their success. Unfortunately, we didn’t have a way to measure this.

So What is Mental Strength?

An excellent place to start is defining what mental toughness is. Until recently there hasn’t been a solid description of what mental toughness is. Then in 2012 after numerous case studies and research Clough & Strycharczyk developed this widely accepted definition of mental toughness.

“Mental Toughness is a personality trait which determines in large part how people deal with challenge, stressors and pressure …. irrespective of prevailing circumstances.”

It is also defined as:

“An ability to overcome adversity and persevere through difficult and challenging situations or circumstances, to remain focused on the process.”

What is So Important About Mental Strength?

Through research, several benefits of being mentally strong have emerged. They are:

  • Performance: Individuals perform more effectively in terms of volume and quality of work.
  • Positive Behavior: The higher the level of Mental Strength, the more the individual demonstrates positive behaviors.
  • Well-being: The greater the level of Mental Strength, the greater the sense of well-being.
  • Aspirations: Studies show that Mental Strength appears to be positively correlated with career aspirations and aspirations in general.
  • Employability: There is a clear relationship between an individual’s Mental Strength and their ability to not only get a job, but to get the job they want.
  • Completion Rates: A mentally strong person is more likely to complete a project on time and on target.
  • Other Considerations: Developing psychological or emotional resilience and Mental Strength is a very important life skill.

What Exactly Makes Up Mental Strength?

There are four major components of Mental Strength and they are:

Control – Control means having a sense of self-worth and describes the extent to which a person feels in control of their life and their circumstances. Importantly, it also describes the extent to which they can control the display of their emotions.

A mentally strong person will usually “get on with it” irrespective of how they feel and their positive approach can often lift the spirits of those around them.

Commitment – Commitment is about goal orientation and ‘stickability’ and describes the extent to which someone is prepared to set goals for what they need to do and make measurable promises that, once made, they will work hard to deliver on.

Control and Commitment, when combined, are what most people mean when they think of resilience. They are indeed a solid response to adversity, but resilience is largely a passive quality and is only one part of Mental Strength.

Challenge – Challenge describes the extent to which the individual will push back their boundaries, embrace change and accept risk. It’s also about how they see all outcomes – good and bad.

Mentally strong people view challenges, change and adversity as opportunities rather than threats and will relish the chance to learn and grow in new and unknown situation. Someone whose challenge score is high will typically enjoy new places, new people, innovation and creativity.

Confidence – Confidence completes the picture and describes the self-belief an individual has in their own abilities and the interpersonal confidence they have to influence others and deal with conflict and challenge. When faced with a challenge, mentally strong people scoring high in confidence, will possess the self-belief to deal with the situation and the inner strength to stand their ground when needed. Their confidence enables them to represent their view boldly and be comfortable in handling objections.

To be Mentally Strong there are four main areas in which you need to excel at. They are:

1. Control: Individuals who score high on this scale feel that they are in control of their work and of their work environment. At the high end of the scale they will be able to handle lots of things at the same time. At the other end, they may only be comfortable handling one thing at a time.

  • Control (emotion) – Individuals scoring highly on this scale are better able to control their emotions. They are better able to keep anxieties in check.
  • Control (life) – Individuals scoring higher on this scale are more likely to believe that they control their lives. They feel that they can make a difference.

2. Challenge (sometimes called change orientation): Describes the extent to which individuals see problems as opportunities. At one end of the scale we find those who thrive in continually changing environments. At the other end, we find those who prefer to minimize their exposure to change and the problems that come with that.

3. Commitment: Sometimes described as “stickability”, this describes the ability for an individual to carry out tasks successfully despite any problems or obstacles which arise whilst achieving the goal. Consequently, an individual who scores at the high end of the scale will be able to handle and achieve things to tough unyielding deadlines.

4. Confidence: Individuals who are high in confidence have the self-belief to successfully complete tasks, which may be considered too difficult by individuals with similar abilities but with lower confidence. At the other end of the scale individuals will be unsettled by setbacks and will feel undermined by these.

  • Confidence (abilities): Individuals scoring highly on this scale are more likely to believe that they are truly worthwhile.
  • Confidence (interpersonal): Individuals scoring highly on this scale tend to be more assertive. They are less likely to be intimidated in social settings and are more likely to cope with difficult or awkward people.

strength-doesnt-come-from-what-you-can-do

Can You Develop Mental Strength?

Absolutely, yes you can!

Mental Strength is a malleable personality trait which means it can be developed.

Developing Mental Strength generally happens by teaching you to handle stress more effectively through making fundamental changes to the way you think about problems and by teaching you the tactics and strategies that mentally tough people use.

Either approach can work, although the program needs to be tailored as you will likely have a unique profile with different strengths and development needs. The Mental Strength Programme offers reflection and a conversation with an experienced Mental Strength Coach, you would commit to a purposeful practice using the appropriate techniques. These techniques fall into 5 categories:

  1. Positive Thinking: There are many techniques for developing a “can do” mindset which include self-talk and stopping or reframing negative thoughts.
  2. Mental Rehearsal: This involves developing your ability to first imagine something in your head to help you deal with a real event.
  3. Energy Management: Breathing exercises and relaxation techniques will enable you to deal with those panic moments when things seem out of control, producing a physiological reaction.
  4. Goal Setting: Tools and techniques that support the development of your sense of purpose and how to set about achieving it.
  5. Attention Control: Used extensively in sports to teach athletes how to focus better and longer, as well as developing mindfulness, which is learning how to notice what is happening around you.

How to Measure Mental Strength

Now that we know each component of Mental Strength, the next step is to measure it. This is done by assessing Readiness to Change and Emotional Intelligence.

These Questionnaires are a dynamic and revealing diagnostic test that identifies the resilience and mental toughness of individuals. The tool can be used to enable a program of interventions to help the learner change their Mental Strength, or it can show someone how to adopt the behaviours that a mentally strong person would have.

These Questionnaires are online assessments and are accessed via links and takes just 20-30 minutes to complete. Results are generated quickly and presented in Pdf reports that are emailed to you immediately ofter completion of each assessment.

Where is Mental Strength Useful?

Being Mentally Strong has been proven to be beneficial in improving performance, increasing positivity and aspirations, creating greater well-being as well as a calmer and lower stress response to change.

As a result, the Mental Toughness Questionnaire has many useful applications. Especially for people and organizations that are subject to pressures and challenges or wherever performance, behavior and well-being is an issue.

The Mental Strength Assessment is Widely Used in Businesses for:

  • Training & Development
  • Leadership Development
  • Coaching
  • Organisation Development
  • Performance
  • Talent Management
  • Career Transition and Outplacement
  • Work-Life Balance

The Mental Strength Assessment is Widely Used in Sport

The beneficial impact of Mental Strength is well understood by most coaches and athletes. The key areas are:

  • Performance
  • Positive Behaviour
  • Well-being
  • Aspirations

The Mental Strength Assessment is extremely effective in the Sports sector using language applicable in the sporting world. The results enable coaches, trainers and athletes to make better assessments and identify why they do or do not perform under pressure.

It can also explain why some athletes are better suited at contact sports and why some perform better in team sports than in solitary sports. It also explains why an athlete of lesser ability can often and will often beat an athlete of greater ability.

There are assessments for specific sports so your report can be geared precisely to give you the competitive advantage.

even-on-my-weakest-days

In Summary

We have:

  • The ability to define and describe an important aspect of our personality – Mental Strength.
  • A concept which is accessible to everyone and which helps to explain performance, well-being and behaviour.
  • Psychometric assessments which measure an individual’s Mental Strength for readiness to change and emotional intelligence.
    A Mental Strength Development program which delivers measurable results.

 

If you feel you want to develop the level of mental strength you want/need in order to live life like a warrior being  kind, compassionate, ruthless in your determination to succeed yet remaining ethically and morally sound, resilient to failures and cheerful when the shit hits the fan. Then get in touch with me to discuss the options below.

  1. Self directed – go through the assessments yourself and the online course in your own time with no input from me
  2. 8 Week coaching Programme – go through the assessments and the online course, plus 8 weekly coaching calls to fine tune your progress and development and ensure you achieve your aim.

Whatever you decide I salute you for considering your options and making an informed decision for yourself and your future.

Here’s to your success and your mental strength.

Simon

Hypnosis and Fear of Dentists


stay-connectd

Unsurprisingly for many of you, a fear of dentists and dental treatment is a very common phobia in the UK and elsewhere around the world.

  • Almost half of UK adults have a fear of the dentist.
  • 12% of these suffers from an extreme dental anxiety.
  • Women are more likely to suffer from extreme dental anxiety than men.
  • Visiting the Dentist is ranked number one (22%) for making people nervous, even more popular than heights (19%).

Direct experience is the most common way people develop dental fears. Most people report that their dental fear began after a traumatic, difficult, and/or painful dental experience. However, painful or traumatic, dental experiences alone do not explain why people develop dental phobia. The perceived manner of the dentist is an important variable. Dentists who were considered “impersonal”, “uncaring”, “uninterested” or “cold” may develop high dental fear in patients, even in the absence of painful experiences, whereas some patients who had had painful experiences failed to develop dental fear if they perceived their dentist as caring and warm.

Indirect experiences

  • Vicarious learning
  • Dental fear may develop as people hear about others’ traumatic experiences or negative views of dentistry (vicarious learning).
  • Mass media

The negative portrayal of dentistry in mass media and cartoons may also contribute to the development of dental fear. This negative portrayal may come from such films as the 1932 comedy film The Dentist, the unrelated horror film The Dentist, its sequel, the 1933 cartoon The Merry Old Soul, and Marathon Man (the antagonist, Dr. Christian Szell, is a Nazi war criminal who tortures with dental equipment).

Stimulus Generalisation

Dental fear may develop as a result of a previous traumatic experience in a non-dental context. For example, bad experiences with doctors or hospital environments may lead people to fear white coats and antiseptic smells, which is one reason why dentists nowadays often choose to wear less “threatening” apparel. People who have been sexually, physically or emotionally abused may also find the dental situation threatening.

Helplessness and Perceived Lack of Control

If a person believes that they have no means of influencing a negative event, they will experience the feeling of helplessness. Research has shown that a perception of lack of control leads to fear. The opposite belief, that one does have control, can lead to lessened fear. For example, the belief that the dentist will stop when the patient gives a stop signal lessens fear. Helplessness and lack of control may also result from direct experiences, for example an incident where a dentist wouldn’t stop even when the person was in obvious pain.

Diagnosis of Phobia
Phobia of dental care is sometimes diagnosed using a fear measurement instrument like Corah’s Dental Anxiety Scale or the Modified Dental Anxiety Scale

It would be very interesting to read your experiences of dentists and how you feel about your 6 monthly appointment. In the meantime here are some case studies and also additional references at the end.

 

Study 1: Hypnosis in Pediatric Dental Treatment Using elements of hypnosis prior to or during pediatric dental treatment.

http://www.ncbi.nlm.nih.gov/pubmed/23635894

Results: A review of the relevant research and literature shows that the advantages of using hypnotic elements and hypnosis in pediatric dentistry are evident.

Notes: Most dental practitioners are familiar with pediatric patients expressing dental fear or anxiety. Occasionally, the dentist may encounter a situation where all behavioral techniques fail, while, for some reason, premedication or general anesthesia are contraindicated or rejected by the patient or his/her parents and a different approach is required. Hypnosis may solve the problem in some cases. The purpose of this study was to review the literature about techniques that use elements of hypnosis and hypnotic techniques prior to or during pediatric dental treatment. There is a limited amount of literature regarding the use of hypnosis and hypnotic elements in pediatric dentistry. Induction techniques, reframing, distraction, imagery suggestions, and hypnosis are identified, although mostly anecdotally.

Pediatr Dent. 2013 Jan-Feb;35(1):33-6
By: B. Peretz, R. Bercovich, S. Blumer, Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel

Study 2: Hypnosis for Dental Procedure Pain
Effects of Hypnosis as an Adjunct to Intravenous Sedation for Third Molar Extraction: A Randomized, Blind, Controlled Study
http://www.tandfonline.com/doi/abs/10.1080/00207140903310782?journalCode=nhyp20#preview

Results: Intraoperative Propofol administration, patient postoperative pain ratings, and postoperative prescription pain reliever consumption were all significantly reduced in the hypnosis treatment group compared to the control group.

Notes: This study aimed to evaluate the use of hypnosis/therapeutic suggestion as an adjunct to intravenous (IV) sedation in patients having 3rd molar removal in an outpatient setting. The patients were randomly assigned to a treatment (n = 46) or control (n = 54) group. The treatment group listened to a rapid conversational induction and therapeutic suggestions via headphones throughout the entire surgical procedure along with a standard sedation dose of intravenous anesthetic. The control group listened to only music without any hypnotic intervention. Intraoperative Propofol administration, patient postoperative pain ratings, and postoperative prescription pain reliever consumption were all significantly reduced in the treatment compared to the control group. Implications of these results are discussed.

International Journal of Clinical and Experimental Hypnosis, Volume 58, Issue 1, 2009
By: Edward F. Mackey, West Chester University of Pennsylvania, West Chester, Pennsylvania, USA

Study 3: Use of Imagery to Make Easier Injection of Anesthesia for Dental Work
The use of imagery suggestions during administration of local anesthetic in pediatric dental patients.
http://www.ncbi.nlm.nih.gov/pubmed/10997242

Results: The authors of this study conclude that imaging/imagery techniques may be successfully utilized in the administration of local anesthesia to young children (from three years of age) in an effort to mitigate untoward, pain-related stress.

Notes: The aim of this study was to evaluate the effects of suggestion before and during the administration of local anesthesia to children. Eighty children between the ages of three and sixteen years and who required at least one injection of local anesthesia were monitored. Retrospective examinations of their dental records provided the information regarding the behavior and dental treatment histories of the patients. All other data were provided through observation during the dental treatment phase. During the first treatment session, before the injection, each child was asked to select a favorite, pleasant memory or image. Where children had difficulty in identifying an image, one was proposed by the dentist. After an image had been chosen, the patients were asked to concentrate on the image and to visualize it during the procedure. The majority of children had chosen their own images, and significantly visualized the same images throughout the injection procedures. Image selection and visualization had no association with gender, age, the parent’s assessment of the child’s behavior, previous dental experience, behavior (both past and present) or, management techniques (both past and present).

ASDC J Dent Child. 2000 Jul-Aug;67(4):263-7, 231
By: B. Peretz, E. Bimstein, Department of Pediatric Dentistry, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel

References

  1. Bracha HS, Vega EM, Vega CB (2006). “Posttraumatic dental-care anxiety (PTDA): Is “dental phobia” a misnomer?” (PDF). Hawaii Dent J. 37 (5): 17–9. PMID 17152624.
  2. Milgrom P, Weinstein P, Getz T (1995). Treating Fearful Dental Patients: A Patient Management Handbook (2nd ed.). Seattle, Wash.: University of Washington, Continuing Dental Education. doi:10.1111/j.1600-0528.1996.tb00893.x. ISBN 1-880291-01-0.
  3. Erten H, Akarslan ZZ, Bodrumlu E (April 2006). “Dental fear and anxiety levels of patients attending a dental clinic”. Quintessence Int. 37 (4): 304–10. PMID 16594362.
  4. Stabholz A, Peretz B (April 1999). “Dental anxiety among patients prior to different dental treatments”. Int Dent J. 49 (2): 90–4. doi:10.1111/j.1875-595x.1999.tb00514.x. PMID 10858738
  5. Locker D, Shapiro D, Liddell A (June 1996). “Negative dental experiences and their relationship to dental anxiety”. Community Dent Health. 13 (2): 86–92. PMID 8763138
  6. Bernstein DA, Kleinknecht RA, Alexander LD (1979). “Antecedents of dental fear”. J Public Health Dent. 39 (2): 113–24. doi:10.1111/j.1752-7325.1979.tb02932.x. PMID 287803
  7. Hilton IV, Stephen S, Barker JC, Weintraub JA (December 2007). “Cultural factors and children’s oral health care: a qualitative study of carers of young children”. Community Dent Oral Epidemiol. 35 (6): 429–38. doi:10.1111/j.1600-0528.2006.00356.x. PMID 18039284
  8. http://www.dentalfearcentral.org/abuse_survivors.html
  9. Lundgren J, Carlsson SG, Berggren U (May 2006). “Relaxation versus cognitive therapies for dental fear—a psychophysiological approach”. Health Psychol. 25 (3): 267–73. doi:10.1037/0278-6133.25.3.267. PMID 16719597

Life Design


For a long time I thought I was happy with my job, I was doing what I’d set to do in joining the Royal Marines. I worked with like-minded people, got paid to stay exceptionally fit, got fed four times a day and was provided with a roof over my head. The trade-off was that I was expected to do what I was told do whether I liked it or not and, some of the things I was asked to do I really didn’t like. However I was still happy living my dream.

Or so I thought.

Continue reading Life Design

Hypnosis and Erectile Dysfunction


causes-and-symptoms-of-erectile-dysfunction

Erectile dysfunction is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have it to some degree.

Why does erectile dysfunction happen?
Erectile dysfunction can have a range of causes, both physical and psychological. Physical causes include: Continue reading Hypnosis and Erectile Dysfunction

Hypnosis and Claustrophobia


Claustrophobia is usually defined as the irrational fear of confined spaces. It can be rational to fear being trapped when circumstances carry genuine threat. However, in claustrophobia, people experience fear even when there is no obvious or realistic danger in a particular situation.

People who experience claustrophobia generally go out of their way to avoid a long list of confined spaces, including lifts, tunnels, tube trains, revolving doors, public toilets, MRI scanners, and even don’t like to wear crash helmets. Unfortunately, avoidance may reinforce the fear.

Claustrophobia may arise from a one-off trauma at any age, developed when the person was a child (for example growing up with one or more claustrophobic parents) or emerge as someone gets older. Around 10% of the population may experience claustrophobia during their lifetime.

Simple Self Diagnosis

If you can answer YES to most of the questions it is likely that you are affected by claustrophobia.

During the past 6 months, did any of the following make you feel anxious:

  • Being in a confined space such as being in a tunnel, on the underground etc.?
  • Being in crowded places?
  • Did you avoid being in any of the above situations?

Physical Symptoms

Panic attacks are common among people with claustrophobia. They can be very frightening and distressing and symptoms often occur without warning.
As well as overwhelming feelings of anxiety, a panic attack can also cause:

  • sweating
  • trembling
  • hot flushes or chills
  • shortness of breath or difficulty breathing
  • a choking sensation
  • rapid heartbeat
  • chest pain or a feeling of tightness in the chest
  • a sensation of butterflies in the stomach
  • nausea
  • headaches and dizziness
  • feeling faint
  • numbness or pins and needles
  • dry mouth
  • a need to go to the toilet
  • ringing in your ears
  • feeling confused or disorientated

Psychological Symptoms
People with severe claustrophobia may also experience psychological symptoms such as:

  • fear of losing control
  • fear of fainting
  • feelings of dread
  • fear of dying

For many people, the aspect of embarrassment over their phobia is as debilitating as the the phobic condition itself. Some sufferers recognise that their fears are overblown and irrational, but cannot seem to stay in control. The reason for this is because phobias are rooted deep within the unconscious, which no amount of conscious effort can be fully effective in controlling. This makes treating phobias particularly challenging.

Claustrophobia is usually treated with anti-anxiety drugs or counseling. Hypnotherapy is an ideal, safe and non-invasive form of therapy with no harmful side effects. It works by pinpointing the root causes of fear in the unconscious to rapidly cure a phobia. In particular, a program that utilises Ericksonian hypnotherapy techniques and Neuro-Linguistic Programming (NLP) can be used to cure a phobia. This uses numerous hypnotic techniques to help people beat their fears.

The initial step in curing a phobia is helping the sufferer feel relaxed and anxiety-free. Hypnotherapy has long been used as a form of stress-reducing therapy, to help people clear their minds and focus deeply.

Conventional hypnosis techniques have used direct, post-hypnotic suggestions to help cure phobias. The disadvantage of the direct approach is that the mind tends to reject being merely “told” how to behave. Many people put up mental blocks and ignore suggestions. In today’s society, both children and adults are especially likely to ignore direct suggestions since we are mostly independent people who question authority.

Deep relaxation is the essence of the hypnotic state. Once in the relaxed state, instead of using direct post-hypnotic suggestions, a better approach known as systematic desensitisation can help extinguish a phobia through visual imagery.

Ericksonian hypnotherapy uses a more innovative approach than conventional techniques. It utilises indirect suggestions concealed in captivating stories and metaphors to interest the unconscious and convince it to adopt a desirable, phobia-free line of thinking. Due to the fact that indirect suggestions don’t need to be adapted to a single phobia like direct suggestions do, a single good Ericksonian hypnotherapy program will work to beat any phobia or even multiple phobias.

NLP, Neuro-Linguistic Programming, is an innovative form of therapy that many well trained hypnotherapists have begun to use. The best NLP technique for overcoming a phobia is called the Visual – Kinesthetic Disassociation, also referred to as the V/K. The V/K is recognised as the single session phobia cure, and for good reason. Phobic or panic reactions (attacks) occur because traumatic experiences are attached to and aggravated by mental images. With the V/K, the traumatic experiences are disconnected from the mental images – often in one simple session, and the fear is essentially extinguished.

Those fighting with claustrophobia can find relief with hypnotherapy. The combination of Ericksonian hypnosis therapy with NLP techniques will help all people beat their phobias. Hypnosis therapy has helped countless users feel safe and secure in situations where earlier, they would’ve suffered a breakdown. Hypnosis techniques have provided phenomenal benefits for people afflicted with phobias and continue to improve lives each and every day.

Study 1: Hypnosis and Claustrophobia in Magnetic Resonance Imaging (MRIs)

Hypnosis for management of claustrophobia in magnetic resonance imaging (Study developed at Hospital e Maternidade São Camilo Pompeia, São Paulo, SP, Brazil)
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842010000100007&lng=en&nrm=iso&tlng=en

Results: Out of the sample, 18 (90%) patients were susceptible to the technique. Of the 16 hypnotizable subjects who were submitted to magnetic resonance imaging, 15 (93.8%) could complete the examination under hypnotic trance, with no sign of claustrophobia and without need of sedative drugs.

Conclusion: Hypnosis is an alternative to anesthetic sedation for claustrophobic patients who must undergo magnetic resonance imaging.

Notes: The objective was to evaluate the efficacy of hypnosis for management of claustrophobia in patients submitted to magnetic resonance imaging (MRI). Twenty claustrophobic patients referred for magnetic resonance imaging under sedation were submitted to hypnosis The patients susceptible to hypnosis were submitted to magnetic resonance imaging under hypnotic trance without using sedative drugs.

After hypnotic induction, the patients underwent ideosensory activities, with induction of vivid, pleasant visual and kinesthetic sensations (walk through a relaxing, safe and welcoming landscape) associated with a sensation of peace, tranquility and safety. After the establishment of the hypnogenic signal, the patients were dehypnotized for assessment of the depth and efficacy of the induced hypnotic trance. Subsequently, hypnosis was induced again, this time by means of the hypnogenic signal. In this second procedure (double induction technique), the patients were introduced to the different phases of the MRI examination which are resignified and associated with the relaxing sensation achieved in the previous ideosensory activity. On the occasion of the procedure, the patient was hypnotized with utilization of the hypnogenic signal in a preparation room, and taken on a wheelchair to the MRI equipment, being dehypnotized once the procedure was completed.

Radiologia Brasileira, Vol. 43, No. 1, São Paulo Jan./Feb. 2010
By: Luiz Guilherme Carneiro Velloso (Maternidade São Camilo Pompeia, São Paulo, SP, Brazil); Maria de Lourdes DupratII (Psychologist, Group of Medical Hypnosis and Hypnotherapy of Hospital e Maternidade São Camilo Pompeia, São Paulo, SP, Brazil); Ricardo Martins (Biomedical Scientist, Unit of Imaging Diagnosis – Hospital e Maternidade São Camilo Pompeia, São Paulo, SP, Brazil); Luiz Scoppetta (MD, Radiologist, Unit of Imaging Diagnosis – Hospital e Maternidade São Camilo Pompeia, São Paulo, SP, Brazil)

Study 2: More Hypnosis for MRI Procedures
Magnetic Resonance Imaging: Improved Patient Tolerance Utilizing Medical Hypnosis
http://www.ncbi.nlm.nih.gov/pubmed/2270840

Results: Magnetic Resonance Imaging (MRI) is a medical procedure where patients are required to lie on their backs in a tight cylinder (with only a few inches of space between their face and the top of the chamber) for up to an hour. Between one and ten percent of patients experience feelings of panic and other claustrophobic reactions. Many are unable to complete the procedure. This study reports on how hypnosis was used to help ten claustrophobic patients successfully undergo this procedure.

Am J Clin Hypn. 1990 Oct;33(2):80-4
By: P. J. Friday, W. S. Kubal , Shadyside Hospital, Pittsburgh, PA, USA

Study 3: More Hypnosis for MRI Procedures
Hypnosis Using a Communication Device to Increase Magnetic Resonance Imaging Tolerance with a Claustrophobic Patient.
http://www.ncbi.nlm.nih.gov/pubmed/9922650

The paper reports on the case of a woman who was unable to have an MRI because she was claustrophobic and panicked in such confined environments. She was then hypnotized twice and given post-hypnotic suggestions to increase her sense of comfort and relaxation and gain control over her body’s responses. She was then hypnotized through headphones when she entered the MRI unit where she was able to complete the procedure. This patient was successfully able to cope with this procedure and reported great satisfaction with treatment.

Mil Med. 1999 Jan;164(1):71-2
By: E. P. Simon, Clinical Psychology Department, Tripler Army Medical Center, Honolulu, HI 96859, USA

There’s More to Maintaining Your Ideal Body than Just Input and Output


For some reason, even with all the science and information available out there, diet and exercise are still the main focus of attention when it comes to fat loss. The thing is as important a part as they do play in the process, it’s just not as simple as “burn more calories than you consume.” I still meet people on a regular basis who live by this misguided rule, now I’m not saying it doesn’t work, however, it generally only works in the short to medium term, not indefinitely. It’s an outdated model because there’s so much more to fat loss than just diet and exercise.

During my research and development for my book I discovered a number of things that, when factored into your fat loss and maintenance programme, make a huge difference in your ability to achieve and hold onto your desired outcome. So here I want to share with you four key elements that I drill into all my clients from day one to ensure that they continue to make progress.

Sleeping Baby

1. Quality Deep Restorative sleep. Sleep Like a Baby.
Now I know some of you may be thinking, what is he on about, sleep is sleep. Well there is a big difference and there is a common misunderstanding about sleep, and that is how much do we need and also that it should be constant sleep throughout the night. When we sleep we go through different depths during a 90 minute cycle called the ‘Ultradian Rhythm’. What this means is that we drift off into a light sleep, drop down into REM or Dream Sleep and then into Deep Restorative Sleep and this is where your brain and body recharge, repair and restore themselves. Without this quality deep restorative sleep we can wake up more tired than when we went to bed because we have been dreaming too much and never getting into that deep sleep. When we remain in that light sleep and REM sleep states we can be interrupted by our dreams and by outside noises that bring us up into conscious awareness and break that natural sleep pattern. I want you to understand that this is a normal part of the cycle and it is why we don’t have 7-8 hours of completely uninterrupted sleep, we wake up and go back to sleep a few times throughout the night. What is really important is that we go into the Deep Restorative Sleep state and recharge, repair and restore. This is why sleep is one of the first things I discuss with a new client, because it really is that important.

If you’re really serious about optimising your health and/or losing fat, then you really need to pay more attention to your sleep patterns and habits and make changes here first before doing anything else in order to get maximum benefit from your training and nutrition.

If my client’s fat loss stalls and/or they’re losing momentum and energy, I don’t start analysing their nutrition plan or increasing their exercise frequency or intensity. I look at their sleep quality and quantity, and their chronic stress level to see where we can make some changes.

As a society we are chronically sleep-deprived and over-stressed. Individually these elements can cause severe health problems and hinder fat loss. When you combine them they are disastrous for your overall health and your fat loss goals

Have you noticed that when you are exhausted you feel hungrier than usual? This is not your imagination. Not getting enough sleep affects leptin and ghrelin, which are  your hunger hormones.

A consistent lack of sleep will make you hungrier and much more impulsive, and you will have an almost insatiable craving for high-carbohydrate foods. This makes avoiding the muffins and cakes at the coffee shop or turning down the bacon rolls at the office a nearly impossible feat. Being chronically sleep-deprived also significantly elevates your cortisol levels  and insulin resistance and this affects your fat loss and your overall physical and mental health.

If this doesn’t make you want to go to bed a bit earlier, another reason is that adequate sleep is also crucial for cognitive function, maintaining a positive outlook, and having a steady supply of energy so that you can keep up with your kids, run around with your dog, lift heavier weights, run faster/longer and all the other active things you love to do.

Reflective Questions:
• Am I getting quality deep restorative sleep each night within an average of 7 hours sleep?
• If not, what am I prepared to change to ensure I get that quality sleep? (For example: Stop watching TV in bed. No phones, kindles, iPads etc in the bedroom at night to avoid the temptation to stay up interacting with social media)

Train Smart

2. Don’t Train Harder, Train Smarter. That Includes Variety.
When I was serving in the Royal Marines, particularly during basic training, I couldn’t eat enough because the amount of physical exercise was phenomenal. It was almost impossible to consume enough calories in a day to match my output. The same thing happened when I was racing in Triathlons, the problem was that it increased my appetite so much that all wanted I to do was eat and sometimes I simply didn’t have the time.

I finally understood a few years ago that high-intensity, steady-state exercise is not the best model for me, it turns me into a black hole for food. It was potentially far too easy for me to “out-eat” my training, which meant I was breaking even at best and running myself into the ground.

I recommend to my clients applying the Minimum Effective Dose Model to their training. Meaning, I totally understand that you love exercise and it’s important that you do just enough to elicit the desired results while keeping your hormones happy and your appetite in check.

For most people (who train regularly), this typically means two or three heavy strength-training days, one or two short-duration HIIT (high-intensity interval training) sessions, and no more than a couple of moderate-intensity, steady-state cardio sessions per week.
Getting too aggressive with exercise and doing an obscene amount of cardio, spending hours in the weight room each day, or doing two-a-day training sessions can lead to a voracious appetite, run down your immune system and lead to overtraining, which I’m guessing is probably not in line with your goals.

Reflective Questions:

  •  Is any type of exercise that I’m doing increasing my appetite to the point that it may be sabotaging, instead of supporting, my goals?
  •  What kind of exercise can I do instead to see how that makes me feel? (Example: Instead of running for 45 minutes, how about trying 15 minutes of intervals? Instead of that 60-minute Spin class, how about breaking it up into two 30-minute moderate-intensity cardio sessions throughout the week?)

Healthy eating

3. Eat Food That You Enjoy, Is Nutritious and Fills you Up.
When you think of fat loss, do you think it means eating the same boring foods, every day? Chicken breast, sweet potato, broccoli, egg whites, oats, and protein powder, day in and day out?

This absolutely can work because there’s nothing nutritionally wrong with it, in fact it’s full of great nutrients. What I can promise you is this. It won’t work for long, unless you actually love to eat like this and truly feel satisfied. Generally we can only tolerate so much bland, boring food that we don’t necessarily enjoy before we frantically wave the white flag and dive into a pile of junk food, never to return to it again…until the next time we want to lose fat!!

The key to making  your nutrition a sustainable part of your lifestyle is to ensure that you love what you’re eating. You have to enjoy your food in order to be satisfied and for me food is meant to be enjoyed. If you force down a meal that you hate because someone told you or you read somewhere that this is the way to lose fat, there is a high probability that you’ll be raiding your cupboards and fridge afterward for something to satisfy your palate.

Emjoy your meal

Fortunately on the Internet, there are millions of recipes right at your fingertips. While it may take you 20 minutes to bake a week’s worth of bland chicken breasts, it would only take you an additional few minutes to whip up a tasty sauce for them, try a new seasoning blend, or another way of cooking them. You can bake, broil, roast, slow cook, grill, steam, or sauté your food into an explosion of flavour with just a tiny bit more thought and effort. Trust me, it’s worth it.

Reflective Questions:

  • Am I currently eating foods I can’t stand but eat them anyway because I feel like I’m “supposed” to?
  • What can I do to those foods, or what can I substitute, to make eating an enjoyable experience again?
  • Can I spare an extra 20 minutes per day to improve the taste of my food? ( The answer is yes by the way.)

4. Choose the Right Form of and Amount of Cardio.
Cardio is a funny thing. For a while, it’s all many people wanted to do. Thankfully, times have changed and in particular, women have embraced the empowering feeling and advantages of strength training. The only downside to that is that cardio has started to get kicked to the curb to a degree. Cardio, like most forms of exercise, can be a wonderful tool when used correctly.
Is cardio necessary for everyone who wants to get leaner? Not really. But if you find that you’re a bit stuck, incorporating a couple of sessions per week could help.

Moderate-intensity, steady-state cardio is a way to burn calories, sure. More importantly, it improves work capacity, which can mean improved training. It can also aid in recovery from your strength workouts.

This is not a pass for a cardio free-for-all. Whatever form of cardio you choose, please make sure you’re doing the type that keeps stress low and your hunger under control.

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Reflective Questions:

  • What kind of cardio do I enjoy most? Walking, biking, cycling, swimming, rowing, running?
    Can I spare 20 minutes 2-3 times a week to incorporate some moderate-intensity cardio?
  • Am I prepared to do fasted cardio (train before eating to boost your fat burning capabilities) in the morning?
  • How did that cardio make me feel? Do I feel in control of my appetite? Do I feel energised? If the answer to those questions is yes, stick with it for a few weeks and see what changes you notice.

As you can see, when it comes to fat loss, there is more to the equation than simply restricting food intake and doing more exercise. If you find yourself stuck and not making any progress, take a look at these four things and see if making a few changes can help push you forwards and out of your rut.

As always, making changes in  your body begins with making changes in your brain in terms of how you think about and perceive all the different elements required to achieve your aim. Without starting with your brain and mind, you are almost certainly going to fail backwards at some point and have to start again and fall foul of the Yo-Yo process that millions of us get trapped in year after year.

One last but important note: Once you make a change, stick with it for at least four weeks, and then evaluate your progress before making any more changes.

For more advice and to find out about my Lifestyle Coaching Program that works your from the top down so that you make the changes in your brain/mind first setting you on the right path, with the right mindset right from the beginning, you can email me directly  at simon@simonmaryan.com

Have a fantastic weekend

Simon

Hypnosis and Cancer


Cancer-patients-use-hypnosis-in-healing

There is a huge body of research into the use of hypnosis with cancer patientsAs with many types of complementary therapy, one of the main reasons people with cancer use hypnotherapy is to help them relax and cope better with symptoms and treatment. Hypnotherapy can help people to feel more comfortable and in control of their situation.

People with cancer most often use hypnotherapy for sickness or pain. There is some evidence that hypnotherapy helps with these symptoms. It can also help with depression, anxiety and stress.

Some doctors and dentists have training in hypnotherapy. They may use this alongside conventional treatments such as chemotherapy or radiotherapy.

Research into Hypnotherapy in People With Cancer
Some reports show that hypnosis can help people to reduce their blood pressure, stress, anxiety, and pain. Hypnosis can create relaxing brain wave patterns. Some clinical trials have looked at how well hypnotherapy works for people with cancer.

Research has looked at the following areas:

Hypnosis and Cancer Pain
A report from the American National Institute for Health in 1996 stated that hypnosis can help to reduce some kinds of cancer pain. A large review in 2006 looked at using hypnotherapy to control distress and pain from medical procedures in children with cancer. The review found that hypnotherapy did seem to help to reduce the children’s pain and distress, but it recommended more research. You can look at this cancer pain review on the Research Council for Complementary medicine website.

In 2012, researchers in Spain again reviewed studies of children with cancer and found that hypnosis appeared to help reduce pain and distress from cancer or from medical procedures.

Hypnosis and Sickness
A large review in 2006 looked at research into hypnotherapy for feeling or being sick from chemotherapy. Most of the studies in this area have been in children. Overall, the studies did show that hypnotherapy might be able to help with chemotherapy sickness in children. There has only been 1 study looking at hypnotherapy for sickness after chemotherapy in adults, so we need more research into this. You can look at this cancer and sickness review on the Research Council for Complementary medicine website.

One study found that hypnosis can help to reduce anticipatory nausea and vomiting. Anticipatory nausea or vomiting happens when people have had nausea or vomiting due to cancer drugs and they then have nausea or vomiting just before their next dose.

Hypnosis and Hot Flushes
A clinical trial in America in 2008 found that women having breast cancer treatment who had hypnosis had fewer hot flushes and the flushes were less severe. The women also had less anxiety, depression, and interference with daily activities, and better sleep.

Hypnosis and Breast Cancer Surgery
A study in 2007 in America gave hypnotherapy to a group of women before breast surgery. The researchers found that hypnotherapy lowered the amount of pain, sickness, tiredness and upset that the women had after surgery. Another American study in 2006 found that hypnotherapy helped to lower anxiety and pain during a biopsy for suspected breast cancer.

Hypnotherapy for Symptom Control in Advanced Cancer
In 2005 researchers carried out a review of studies into hypnotherapy for treating symptoms in people with advanced cancer. There were 27 studies but all were small or of poor quality. So it is not possible to tell whether hypnotherapy can help people with advanced cancer. We need research to find this out and this research below goes a long way in helping medical science discover ways to treat and alleviate the symptoms of cancer.

 

Study 1: Cancer and Hypnosis – 2013 Overview

Hypnosis for cancer care: Over 200 years young
http://onlinelibrary.wiley.com/doi/10.3322/caac.21165/full

Notes: Hypnosis has been used to provide psychological and physical comfort to individuals diagnosed with cancer for nearly 200 years. The goals of this review are:

1) to describe hypnosis and its components and to dispel misconceptions

2) to provide an overview of hypnosis as a cancer prevention and control technique (covering its use in weight management, smoking cessation, as an adjunct to diagnostic and treatment procedures, survivorship, and metastatic disease)

3) to discuss future research directions. Overall, the literature supports the benefits of hypnosis for improving quality of life during the course of cancer and its treatment.

CA: A Cancer Journal for Clinicians, Volume 63, Issue 1, pages 31-44, January/February 2013
By: Guy H. Montgomery Ph.D., Director, Integrative Behavioral Medicine Program, Associate Professor, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY

Julie B. Schnur Ph.D., Co-Director, Integrative Behavioral Medicine Program, Assistant Professor, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY

Kate Kravits MA, RN, HNB-BC, LPC, NCC, ATR-BC, Senior Research Specialist, Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA

Study 2: Hypnosis for Cancer: Another Overview and Suggestions for Future Use and Research Hypnosis in Cancer Care.
http://bscw.rediris.es/pub/bscw.cgi/d4501369/Liossi-Hypnosis_cancer_care.pdf

Notes: Despite conclusive evidence for the efficacy of clinical hypnosis in the management of many cancer related symptoms and particularly acute and chronic pain, hypnosis is currently under-utilized in these applications. This paper gives a brief overview of the contemporary uses of hypnosis in pediatric and adult oncology and shows how hypnosis can be integrated into a total therapeutic process based on the needs and goals of the patient and the health care team treating them. The first section describes studies that have evaluated hypnosis in adult oncology. The second half consists of a review of the hypnosis literature in pediatric oncology. The paper concludes with suggestions for future research, and implications for clinical practice.

Contemp. Hypnosis 23(1): 47-57 (2006)
By: Christina Liossi, University of Southampton, UK

Study 3: Self-Hypnosis for Pain and Anxiety During Biopsy Outpatient Procedures
Adjunctive self-hypnotic relaxation for outpatient medical procedures: A prospective randomized trial with women undergoing large core breast biopsy
http://www.painjournalonline.com/article/S0304-3959(06)00393-9/abstract

Results: Women’s anxiety increased significantly in the standard group (logit slope=0.18, p<0.001), did not change in the empathy group (slope=-0.04, p=0.45), and decreased significantly in the hypnosis group (slope=-0.27, p<0.001). Pain increased significantly in all three groups (logit slopes: standard care=0.53, empathy=0.37, hypnosis=0.34; all p<0.001) though less steeply with hypnosis and empathy than standard care (p=0.024 and p=0.018, respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46min/$161 for standard care, 43min/$163 for empathy, and 39min/$152 for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management.

Notes: Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n=82), or self-hypnotic relaxation (n=78) during their procedures. Patients’ self-ratings at 10min-intervals of pain and anxiety on 0-10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model.

PAIN, Volume 126, Issue 1, Pages 155-164, 15 December 2006
By: Elvira V. Lang, Beth Israel Deaconess Medical Center/Harvard Medical School, Department of Radiology
Kevin S. Berbaum, Salomao Faintuch, Olga Hatsiopoulou, Noami Halsey, Xinyu Li, Michael L. Berbaum, Eleanor Laser, Janet Baum

Study 4: Pre-Surgery Hypnosis for Breast Biopsies – Post-Surgery Pain and Anxiety
Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients
http://www.tandfonline.com/doi/abs/10.1080/00207140208410088#preview

Results: Hypnosis reduced postsurgery pain and distress.

Notes: Each year, hundreds of thousands of women undergo excisional breast biopsies for definitive diagnosis. Not only do these patients experience pain associated with the procedure, but they also endure distress associated with the threat of cancer. To determine the impact of brief presurgical hypnosis on these patients’ postsurgery pain and distress and to explore possible mediating mechanisms of these effects, 20 excisional breast biopsy patients were randomly assigned to a hypnosis or control group (standard care).

Hypnosis reduced postsurgery pain and distress.
International Journal of Clinical and Experimental Hypnosis, Volume 50, Issue 1, 2002, pages 17-32
By: Guy H. Montgomerya, Christina R. Weltza, Megan Seltza, Dana H. Bovbjerga, Mount Sinai School of Medicine, New York

Study 5: Hypnosis to Reduce Presurgical Distress Regarding Breast Biopsies
Hypnosis decreases presurgical distress in excisional breast biopsy patients.
http://www.ncbi.nlm.nih.gov/pubmed/18227298

Results: Post intervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS emotional upset (16.5 vs 38.2, P < 0.0001, d = .85), VAS depressed mood (6.6 vs 19.9, P < 0.02, d = .67), and SV-POMS anxiety (10.0 vs 5.0, P < 0.0001, d = 0.85); and significantly higher levels for VAS relaxation (75.7 vs 54.2, P < 0.001, d = -0.76) than attention controls. The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical distress in women awaiting diagnostic breast cancer surgery.

Notes: Excisional breast biopsy is associated with presurgical psychological distress. Such distress is emotionally taxing, and may have negative implications for postsurgical side effects and satisfaction with anesthesia. We investigated the ability of a brief hypnosis session to reduce presurgical psychological distress in excisional breast biopsy patients. Ninety patients presenting for excisional breast biopsy were randomly assigned to receive either a 15-minute presurgery hypnosis session (n = 49, mean age: 46.4 (95% CI: 42.3-50.4)) or a 15-minute presurgery attention control session (n = 41, mean age: 45.0 (95% CI: 40.8-49.2)). The hypnosis session involved suggestions for increased relaxation and decreased distress. The attention control session involved nondirective empathic listening. Presurgery distress was measured using visual analog scales (VAS) and the short version of the Profile of Mood States (SV-POMS). Data were analyzed using analysis of variance and chi2 procedures.

Anesth Analg. 2008 Feb;106(2):440-4
By: J. B. Schnur, D. H. Bovbjerg, D. David, K. Tatrow, A. B. Goldfarb, J. H. Silverstein, C. R. Weltz, G. H. Montgomery, Department of Oncological Sciences, Box 1130, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York City, NY 10029-6574, USA

Study 6: Hypnosis to Alleviate Anxiety Related to Bone Marrow Aspirates and Biopsies
A Randomized Trial of Hypnosis for Relief of Pain and Anxiety in Adult Cancer Patients Undergoing Bone Marrow Procedures
http://www.tandfonline.com/doi/abs/10.1080/07347332.2012.664261#preview

Results: The hypnosis intervention reduced the anxiety associated with this procedure, but the difference in pain scores between the two groups was not statistically significant. The authors conclude that brief hypnosis concurrently administered reduces patient anxiety during bone marrow aspirates and biopsies but may not adequately control pain.

Notes: Pain and anxiety are closely associated with bone marrow aspirates and biopsies. To determine whether hypnosis administered concurrently with the procedure can ameliorate these morbidities, the authors randomly assigned 80 cancer patients undergoing bone marrow aspirates and biopsies to either hypnosis or standard of care.

Journal of Psychosocial Oncology, Volume 30, Issue 3, 2012, pages 281-293
By: Alison Snow LCSW-Ra, David Dorfman PhDb, Rachel Warbet LCSWa, Meredith Cammarata LCSWa, Stephanie Eisenman LCSWa, Felice Zilberfein PhDa, Luis Isola MDc & Shyamala Navada MDc

Author Affiliations:
a:  Department of Social Work Services, Mount Sinai Medical Center, New York, NY, USA
b:  Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
c:  Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA)

Study 7: Hypnosis Versus Analgesic Cream (Local Anesthetic) to Relieve Lumbar Puncture Induced Pain and Anxiety in Cancer Patients Aged 6 to 16
Randomized clinical trial of local anesthetic versus a combination of local anesthetic with self-hypnosis in the management of pediatric procedure-related pain.
http://www.ncbi.nlm.nih.gov/pubmed/16719602

Results: Confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety and less procedure-related pain and anxiety and that they were rated as demonstrating less behavioral distress during the procedure. The level of hypnotizability was significantly associated with the magnitude of treatment benefit, and this benefit was maintained when patients used hypnosis independently.

Notes: A prospective controlled trial was conducted to compare the efficacy of an analgesic cream (eutectic mixture of local anesthetics, or EMLA) with a combination of EMLA with hypnosis in the relief of lumbar puncture-induced pain and anxiety in 45 pediatric cancer patients (age 6-16 years). The study also explored whether young patients can be taught and can use hypnosis independently as well as whether the therapeutic benefit depends on hypnotizability. Patients were randomized to 1 of 3 groups: local anesthetic, local anesthetic plus hypnosis, and local anesthetic plus attention.

Health Psychol. 2006 May;25(3):307-15
By: C. Liossi, P. White, P. Hatira, School of Psychology, University of Southampton, Southampton, United Kingdom

Study 8: Hypnosis for Colonoscopies: Anxiety and Pain (as well as decreasing Colonoscopy Recovery Time)
Hypnosis to Manage Anxiety and Pain Associated with Colonoscopy for Colorectal Cancer Screening: Case Studies and Possible Benefits
http://www.tandfonline.com/doi/abs/10.1080/00207140600856780#preview

Results: Results suggest that hypnosis appears to be a feasible method to manage anxiety and pain associated with colonoscopy, reduces the need for sedation, and may have other benefits such as reduced vasovagal events and recovery time.

Notes: This study explored using hypnosis for pain and anxiety management in 6 colonoscopy patients (5 men, 1 woman), who received a hypnotic induction and instruction in self-hypnosis on the day of their colonoscopy. Patients’ levels of anxiety were obtained before and after the hypnotic induction using Visual Analogue Scales (VAS). Following colonoscopy, VASs were used to assess anxiety and pain during colonoscopy, perceived effectiveness of hypnosis, and patient satisfaction with medical care. Hypnotizability was assessed at a separate appointment. The authors also obtained data (time for procedure, number of vasovagal events, and recovery time) for 10 consecutive patients who received standard care.

International Journal of Clinical and Experimental Hypnosis, Volume 54, Issue 4, 2006.
By: Gary Elkins, Joseph White, Parita Patel, Joel Marcus, Michelle M. Perfect und Guy H. Montgomery

Author Affiliations:
a:  Baylor University, Waco, Texas, USA
b:  Scott and White Memorial Hospital, Temple, Texas, USA
c:  Texas A & M University College of Medicine, College Station, Texas, USA
d:  Mount Sinai School of Medicine, New York, New York, USA)

Study 9: Hypnosis for Biopsy or Lumpectomy for Breast Cancer – Effect on Amount of Analgesics/Sedatives Required, Pain, Nausea, Fatigue, Discomfort, and Upset (as well as Reduced Surgical Time)
A Randomized Clinical Trial of a Brief Hypnosis Intervention to Control Side Effects in Breast Surgery Patients
http://jnci.oxfordjournals.org/content/99/17/1304.full.pdf+html

Results: Patients in the hypnosis group required less propofol (means = 64.01 versus 96.64 µg; difference = 32.63; 95% confidence interval [CI] = 3.95 to 61.30) and lidocaine (means = 24.23 versus 31.09 mL; difference = 6.86; 95% CI = 3.05 to 10.68) than patients in the control group. Patients in the hypnosis group also reported less pain intensity (means = 22.43 versus 47.83; difference = 25.40; 95% CI = 17.56 to 33.25), pain unpleasantness (means = 21.19 versus 39.05; difference = 17.86; 95% CI = 9.92 to 25.80), nausea (means = 6.57 versus 25.49; difference = 18.92; 95% CI = 12.98 to 24.87), fatigue (means = 29.47 versus 54.20; difference = 24.73; 95% CI = 16.64 to 32.83), discomfort (means = 23.01 versus 43.20; difference = 20.19; 95% CI = 12.36 to 28.02), and emotional upset (means = 8.67 versus 33.46; difference = 24.79; 95% CI = 18.56 to 31.03). Institutional costs for surgical breast cancer procedures were $8561 per patient at Mount Sinai School of Medicine. Patients in the hypnosis group cost the institution $772.71 less per patient than those in the control group (95% CI = 75.10 to 1469.89), mainly due to reduced surgical time.
Conclusions: Hypnosis was superior to attention control regarding propofol and lidocaine use; pain, nausea, fatigue, discomfort, and emotional upset at discharge; and institutional cost. Overall, the present data support the use of hypnosis with breast cancer surgery patients.

Notes: Breast cancer surgery is associated with side effects, including postsurgical pain, nausea, and fatigue. We carried out a randomized clinical trial to test the hypotheses that a brief presurgery hypnosis intervention would decrease intraoperative anesthesia and analgesic use and side effects associated with breast cancer surgery and that it would be cost effective. We randomly assigned 200 patients who were scheduled to undergo excisional breast biopsy or lumpectomy (mean age 48.5 years) to a 15-minute presurgery hypnosis session conducted by a psychologist or nondirective empathic listening (attention control).. Intraoperative anesthesia use (i.e., of the analgesics lidocaine and fentanyl and the sedatives propofol and midazolam) was assessed. Patient-reported pain and other side effects as measured on a visual analog scale (0-100) were assessed at discharge, as was use of analgesics in the recovery room. Institutional costs and time in the operating room were assessed via chart review.

JNCI J Natl Cancer Inst Volume 99, Issue 17Pp. 1304-1312
By: Guy H. Montgomery, Dana H. Bovbjerg, Julie B. Schnur, Daniel David, Alisan Goldfarb, Christina R. Weltz, Clyde Schechter, Joshua Graff-Zivin, Kristin Tatrow, Donald D. Price and Jeffrey H. Silverstein

Author Affiliations:

  1. Department of Oncological Sciences (GHM, DHB, JBS)
  2. Department of Surgery (AG, CRW), and Department of Anesthesiology Sciences (JHS), Mount Sinai School of Medicine, New York, NY
  3. Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania (DD)
  4. Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY (CS)
  5. Department of Health Policy and Management, Columbia University, New York, NY (JGZ)
  6. Department of Psychology, Good Shepherd Rehabilitation Hospital, Allentown, PA (KT)
  7. Departments of Oral and Maxillofacial Surgery and Neuroscience, University of Florida, Gainesville, FL (DDP)

Study 10: Self-Hypnosis for Percutaneous Tumor Treatment – Pain and Anxiety
Beneficial Effects of Hypnosis and Adverse Effects of Empathic Attention during Percutaneous Tumor Treatment: When Being Nice Does Not Suffice
http://www.jvir.org/article/S1051-0443(08)00180-2/abstract

Results: Patients treated with hypnosis experienced significantly less pain and anxiety than those in the standard care and empathy groups at several time intervals and received significantly fewer median drug units (mean, 2.0; interquartile range [IQR], 1-4) than patients in the standard (mean, 3.0; IQR, 1.5-5.0; P = .0147) and empathy groups (mean, 3.50; IQR, 2.0-5.9; P = .0026). Thirty-one of 65 patients (48%) in the empathy group had adverse events, which was significantly more than in the hypnosis group (eight of 66; 12%; P = .0001) and standard care group (18 of 70; 26%; P = .0118).

Notes: For their tumor embolization or radiofrequency ablation, 201 patients were randomized to receive standard care, empathic attention with defined behaviors displayed by an additional provider, or self-hypnotic relaxation including the defined empathic attention behaviors. All had local anesthesia and access to intravenous medication. Main outcome measures were pain and anxiety assessed every 15 minutes by patient self-report, medication use (with 50 µg fentanyl or 1 mg midazolam counted as one unit), and adverse events, defined as occurrences requiring extra medical attention, including systolic blood pressure fluctuations (=50 mm Hg change to >180 mm Hg or <105 mm Hg), vasovagal episodes, cardiac events, and respiratory impairment.

Journal of Vascular and Interventional Radiology, Volume 19, Issue 6, Pages 897-905, June 2008
Elvira V. Lang, MD, Kevin S. Berbaum, PhD, Stephen G. Pauker, MD, Salomao Faintuch, MD, Gloria M. Salazar, MD, Susan Lutgendorf, PhD, Eleanor Laser, PhD, Henrietta Logan, PhD, David Spiegel, MD (Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts 02215, USA

Study 11: Hypnosis for Venipuncture for Blood Sampling of Cancer Patients Aged 6 to 16 – Pain, Anxiety (and also Anxiety of Parents)
A randomized clinical trial of a brief hypnosis intervention to control venipuncture-related pain of pediatric cancer patients
http://www.painjournalonline.com/article/S0304-3959(09)00046-3/abstract

Results: Confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety, and less procedure-related pain and anxiety, and were rated as demonstrating less behavioral distress during the procedure than patients in the other two groups. Parents whose children were randomized to the local anesthetic plus hypnosis condition experienced less anxiety during their child’s procedure than parents whose children had been randomized to the other two conditions. The therapeutic benefit of the brief hypnotic intervention was maintained in the follow-up.

Notes: Venipuncture for blood sampling can be a distressing experience for a considerable number of children. A prospective controlled trial was conducted to compare the efficacy of a local anesthetic (EMLA) with a combination of EMLA with self-hypnosis in the relief of venipuncture-induced pain and anxiety in 45 pediatric cancer outpatients (age 6-16years). A secondary aim of the trial was to test whether the intervention will have a beneficial effect on parents’ anxiety levels during their child’s procedure. Patients were randomized to one of three groups: local anesthetic, local anesthetic plus hypnosis, and local anesthetic plus attention.

PAIN, Volume 142, Issue 3, Pages 255-263, April 2009
By: Christina Liossi, Paul White, Popi Hatira, School of Psychology, University of Southampton, Highfield, Southampton S017 1BJ, UK

Study 12: Hypnosis for Chemotherapy Related Nausea and Vomiting
Hypnosis for nausea and vomiting in cancer chemotherapy: a systematic review of the research evidence
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2354.2006.00736.x/abstract

Results: Studies report positive results including statistically significant reductions in anticipatory and “cancer chemotherapy-induced nausea and vomiting” (“CINV”). Meta-analysis revealed a large effect size of hypnotic treatment when compared with treatment as usual, and the effect was at least as large as that of cognitive-behavioral therapy. Meta-analysis has demonstrated that hypnosis could be a clinically valuable intervention for anticipatory and CINV in children with cancer.

Notes: To systematically review the research evidence on the effectiveness of hypnosis for cancer chemotherapy-induced nausea and vomiting (CINV). A comprehensive search of major biomedical databases including MEDLINE, EMBASE, ClNAHL, PsycINFO and the Cochrane Library was conducted. Specialist complementary and alternative medicine databases were searched and efforts were made to identify unpublished and ongoing research. Citations were included from the databases’ inception to March 2005. Randomized controlled trials (RCTs) were appraised and meta-analysis undertaken. Clinical commentaries were obtained. Six RCTs evaluating the effectiveness of hypnosis in CINV were found. In five of these studies the participants were children.

European Journal of Cancer Care, Volume 16, Issue 5, pages 402-412, September 2007
By: J. RICHARDSON bsc(hons), phd, rn, cpsychol, pgce, rnt, reader in nursing and health studies1,*, J.E. SMITH ba(hons), msc, former research assistant2, G. MCCALL dcr(t), msc, applied hypnosis, senior research radiographer & psychological support3, A. RICHARDSON bn(hons), msc, phd, rn, pgdiped, rnt, professor of cancer and palliative nursing care4, K. PILKINGTON bpharm(hons), dipinfsci, msc, pcme, mrpharms5, I. KIRSCH ba , ma , phd , professor of psychology 6

Author Information:

  1. Faculty of Health and Social Work, Portland Square, University of Plymouth, Drake Circus, Plymouth, Devon
  2. NHSP/CAMEO project, Research Council for Complementary Medicine, South-East London Cancer Centre, St Thomas’ Hospital, London
  3. The Florence Nightingale School of Nursing and Midwifery, King’s College London, Franklin Wilkins Building, London
  4. Project Manager/Senior Research Fellow, School of Integrated Health and Research Council for Complementary Medicine, University of Westminster, 115 New Cavendish Street, London
  5. School of Applied Psychosocial Studies, Portland Square, University of Plymouth, Drake Circus, Plymouth, Devon, UK

Study 13: Hypnosis and Survivorship (Life with Cancer Post Treatment) – Hot Flashes in Breast Cancer Survivors
Randomized Trial of a Hypnosis Intervention for Treatment of Hot Flashes Among Breast Cancer Survivors
http://jco.ascopubs.org/content/26/31/5022

Results: Fifty-one randomly assigned women completed the study. By the end of the treatment period, hot flash scores (frequency × average severity) decreased 68% from baseline to end point in the hypnosis arm (P < .001). Significant improvements in self-reported anxiety, depression, interference of hot flashes on daily activities, and sleep were observed for patients who received the hypnosis intervention (P < .005) in comparison to the no treatment control group.
Conclusion: Hypnosis appears to reduce perceived hot flashes in breast cancer survivors and may have additional benefits such as reduced anxiety and depression, and improved sleep.

Notes: Hot flashes are a significant problem for many breast cancer survivors. Hot flashes can cause discomfort, disrupted sleep, anxiety, and decreased quality of life. A well-tolerated and effective mind-body treatment for hot flashes would be of great value. On the basis of previous case studies, this study was developed to evaluate the effect of a hypnosis intervention for hot flashes. Sixty female breast cancer survivors with hot flashes were randomly assigned to receive hypnosis intervention (five weekly sessions) or no treatment. Eligible patients had to have a history of primary breast cancer without evidence of detectable disease and 14 or more weekly hot flashes for at least 1 month. The major outcome measure was a bivariate construct that represented hot flash frequency and hot flash score, which was analyzed by a classic sums and differences comparison. Secondary outcome measures were self-reports of interference of hot flashes on daily activities.

Journal of Clinical Oncology, JCO November 1, 2008 vol. 26 no. 31 5022-5026
By: Gary Elkins, Joel Marcus, Vered Stearns, Michelle Perfect, M. Hasan Rajab, Christopher Ruud, Lynne Palamara and Timothy Keith

Author Affiliations:

  1. From the Department of Psychology and Neuroscience, Baylor University, Waco
  2. Scott and White Memorial Hospital and Clinic, Department of Psychiatry and Behavioral Sciences, Temple
  3. Cancer Treatment and Research Center, San Antonio; and University of Texas at Austin, TX; University of Arizona, Tucson, AZ
  4. Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD

Study 14: Use of Hypnosis for Terminally Ill Hospice Cancer Patients – Insomnia, Itchiness, Bowel Issues, Pain, Chemotherapy Side Effects, Relaxation (and also suggests best time for Cancer Patients to start Hypnotherapy is right at time of diagnosis.)
Efficacy of Hypnotherapy as a supplement therapy in Cancer Intervention
http://bscw.rediris.es/pub/bscw.cgi/d4431493/Peynovska-Efficacy_hypnotherapy_supplement_therapy_cancer

Results: Of the 20 patients who completed the three sessions of hypnotherapy all reported varying degrees of anxiety. 5 patients wanted to have hypnotherapy for insomnia as a primary presenting complain, 1 for excessive itchiness during night time, 1 for excessively frequent bowel actions – 8 to 10 times a day for the last year, which invariably interfered with his social life and prevented him from going out, 8 wanted to have hypnotherapy for pain control, 3 patients opted for hypnotherapy to prevent the side effects of chemotherapy and 2 patients had it specifically for severe anxiety and panic attacks.
The 5 patients who had hypnotherapy for insomnia all reported improved sleeping patterns even after the first session. After the third session none of them complained of insomnia and this result was sustained till the followup, which was 3 to 4 months after the first session. They also reported increased energy levels, less tiredness and improved appetite. 2 of the patients with insomnia have been on Temazepam 10mg before bed, which they voluntarily stopped taking after the first session.

The patient with nighttime itchiness reported that their itchiness stopped after the first session and she continued with the remaining two hypnotherapy sessions working towards pain control.

The patient with frequent bowel action reported that he managed to half the number of times he went to the toilet after the second session.
Of the 8 patients who had hypnotherapy for pain control, all reported that the intensity of pain has significantly been reduced and as a result they have reduced heir dose of opiate analgesics taken daily.

The 3 patients, who took part in the study to prevent the side effects of chemotherapy, also reported very good results with no nausea, sickness and less loss of energy, which was in contrast with their previous experience with chemotherapy.

Most of the patients (19 out of 20) reported that after the first two hypnotherapy sessions they were able to relax for the first time in a very long period, felt less tired and more energetic, had more refreshing night sleep and as a result were able to cope better with their daily activities.

It appears that the best time for hypnotherapy to be offered to cancer patients is right at the time of diagnosis. In that way, patients will be able to develop better coping skills much earlier in the disease process, which will help them to possibly prevent severe anxiety, depression and panic attacks from developing. They will have better treatment compliance and generally will have a more positive psychological response to their illness, which has been suggested as a good prognostic factor with an influence on survival.

Notes: All the patients who took part in the trial were day hospice patients of Ann Delhom Centre, Wisdom Hospice, Rochester, UK. Patients were offered three hypnotherapy sessions and were assessed before the first session and after the third one together with a follow up after 3/4 months after the last session. On the first session all the patients were taught ”progressive muscle relaxation” and self- hypnosis. Short ego boosting was also incorporated at the end of the session. The second and third sessions were different for every patient depending on the expressed symptoms and because of that were always individually tailored. Most of the sessions included guided imagery and direct therapeutic suggestions.

2 European Journal of Clinical Hypnosis: 2005 Volume 6 – Issue 1
By: Dr Rumi Peynovska, Dr Jackie Fisher, Dr David Oliver, Prof V.M. MathewStone House Hospital, Dartford, West Kent NHS and Social Care Trust, Wisdom Hospice, Rochester, Medway NHS Trust
Dr Rumi Peynovska MD, MSc, FBAMH – Research Fellow, Stone House Hospital, Dartford, West Kent NHS Trust
Dr Jackie Fisher BSc, MRCGP – Consultant in Palliative Medicine, Wisdom Hospice, Rochester, Medway NHS Trust
Dr David Oliver BSc, FRCGP – Consultant and Medical Director, Wisdom Hospice, Rochester, Medway NHS Trust
Prof. V.M. Mathew MBBS, MPhil, MRCPsych – Clinical Director, Stone House Hospital, Dartford, West Kent NHS Trust

Hypnosis and Blood Pressure


Cardiovascular Disease (CVD) kills over 160,000 individuals every year in the UK and is still the greatest cause of mortality in women. Furthermore, over 40,000 premature deaths, those in individuals under 75 years of age, are caused by CVD, with more than two thirds of these occurring in men.

Source: British Heart Foundation – Cardiovascular Disease Statistics 2014

CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause with an estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths. Of these deaths, an estimated 7.4 million were due to coronary heart disease and 6.7 million were due to stroke .

Source: World Health Organisation – Cardiovascular Disease

Blausen_0486_HighBloodPressure_01

Study 1: Hypnosis Reduces Blood Pressure Short-Term and Long-Term
Effectiveness of Hypnosis in Reducing Mild Essential Hypertension: A One-Year Follow-Up
http://www.tandfonline.com/doi/abs/10.1080/00207140600995893

Results: The present study investigates the effectiveness of hypnosis in reducing mild essential hypertension. Results show that hypnosis is effective in reducing blood pressure in the short term but also in the middle and long terms.

Notes: Thirty participants who were suffering from mild essential hypertension were randomly assigned to either a control group (which did not receive any treatment) or a hypnosis group (where each person received 8 individually tailored hypnosis sessions).

International Journal of Clinical and Experimental Hypnosis, Vol. 55, Issue 1, 2007
By: M. C. Gay, Univ. of Paris, France

average-blood-pressure-for-age

Study 2: Hypnosis Helps Lower Blood Pressure and Reduces Need for Blood Pressure Medicine Following Hospitalization
Pilot study of the effect of self-hypnosis on the medical management of essential hypertension.
http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1099-1700(199910)15:4%3C243::AID-SMI820%3E3.0.CO;2-O/abstract

Results: On follow-up, the hypnosis group showed greater downward change in diastolic blood pressure than the monitored group, with the attention-only group in between. Additionally, no subjects in the hypnosis group required upward titration of medications. The results suggest the value of adding self-hypnosis to the standard medical treatment for hypertension.

Notes: Medical patients diagnosed as hypertensive whose blood pressures were normalized while they were hospitalized were often found to require upward titration of medication upon follow-up as outpatients. Self-hypnosis was taught to one group of hospitalized patients; a second group received equal attention and time to relax without the specified procedure; and a third group was monitored with no intervention.

Stress Medicine, Volume 15, Issue 4, Pages 243-247, October 1999
By: Richard Raskin Ph.D., Charles Raps Ph.D., Frederic Luskin Ph.D., Pace University, New York, USA, Veteran’s Hospital, Northport, USA, Stanford Center for Research in Disease Prevention, Stanford, USA, Private Practice, Roslyn, New York, USA

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Study 3: Hypnosis and Biofeedback for Hypertension
The use of hypnosis and biofeedback procedures for essential hypertension.
http://www.tandfonline.com/doi/abs/10.1080/00207147708415989?journalCode=nhyp20#preview

Results: Hypnosis only and biofeedback only procedures were both capable of providing significant lowering of diastolic pressure. However, in intergroup comparisons, the hypnosis only procedure showed the most impressive effect. Unexpectedly, the procedure of combining hypnosis and biofeedback into one technique was as ineffective as the measurement only procedure.

Notes: In an attempt to evaluate a procedure combining 2 techniques, hypnosis and biofeedback, which might effect significant changes in diastolic blood pressure in essential hypertensives, subjects were placed in 1 of 4 groups: hypnosis only, biofeedback only, hypnosis and biofeedback combined, or measurement only. The first phase-training sessions and brief follow-ups (1 week and 1 month) of the long-term study with 6 monthly followup periods, was evaluated.

International Journal of Clinical and Experimental Hypnosis, Vol. 25, Issue 4, 1977
By: Howard Friedman and Harvey A. Taub, Syracuse Veterans Administration Hospital and State University of New York Upstate Medical Center, Syracuse, New York, USA

Hypnosis and Bedwetting


Key Causes

Study 1: Hypnosis and Self-Hypnosis for Bedwetting (Enuresis) – Children Aged 5 to 16
Hypnosis and self-hypnosis in the management of nocturnal enuresis: a comparative study with imipramine therapy.
http://www.ncbi.nlm.nih.gov/pubmed/8259762

Results: Of the patients treated with imipramine (a prescription antidepressant medication), 76% had a positive response (all dry beds); for patients treated with hypnotic strategies, 72% responded positively. At the 9-month follow-up, 68% of patients in the hypnosis group maintained a positive response, whereas only 24% of the imipramine group did.

Notes: Enuretic (bedwetting) children, ranging in age from 5 to 16 years, underwent 3 months of therapy with imipramine (N = 25) or hypnosis (N = 25). After termination of the active treatment, the hypnosis group continued practicing self-hypnosis daily during the follow-up period of another 6 months.

Am J Clin Hypn. 1993 Oct;36(2):113-9
By: S. Banerjee, A. Srivastav, B. M. Palan, Pramukhswami Medical College, India

Study 2: Hypnosis and Bedwetting – Boys Aged 8 to 13
Hypnotherapy as a Treatment for Enuresis.
http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.1985.tb01635.x/abstract

Results: Results indicated that hypnotherapy was significantly effective over 6 months in decreasing nocturnal enuresis, compared with both pretreatment baseline enuresis frequency and no-treatment controls.

Notes: The main objective of this study was to provide an adequately controlled experimental and clinical study to assess the efficacy of hypnotherapy in the treatment of nocturnal enuresis. Subjects were 48 nocturnal enuretic boys, aged 8-13 yr. Treatment consisted of six standardized sessions, one hourly session per subject per week.

Journal of Child Psychology and Psychiatry, Volume 26, Issue 1, pages 161-170, January 1985
By: S. D. Edwards, Department of Psychology, University of Zululand, South Africa
H. I. J. Vander Spuvy, Department of Psychiatry, McMaster University, Ontario, Canada

Study 3: Hypnotherapy and Refractory Nocturnal Enuresis – Boys Aged 8 to 16
Hypnotherapy in the treatment of refractory nocturnal enuresis.
http://www.ncbi.nlm.nih.gov/pubmed/14983195

Results: At follow-up after three months and one year, nine out of 12 patients had respectively 6-7/7, and 7/7 dry nights per week. Three patients had nocturnal enuresis at follow-up; two of them were referred to a pediatric surgeon for their overactive urine bladder and one was referred to his local psychiatric clinic because of ongoing family conflicts.

Notes: Twelve boys, median age 12 years (range 8-16), eight with primary nocturnal enuresis and four with primary nocturnal and diurnal enuresis, reported at referral a median of 0 (range 0-3) dry nights per week They underwent hypnotherapy with a median of six sessions (range 2-8), followed by median one month with self-hypnosis exercises. Hypnotherapy had lasting effects for boys with chronic and complex forms of nocturnal enuresis.

Tidsskr Nor Laegeforen. 2004 Feb 19;124(4):488-91. (Article in Norwegian)
By: T. H. Diseth, I. H. Vandvik, Barne-og ungdomspsykiatrisk seksjon, Barneavdelingen, Rikshospitalet, Oslo