The Power of the Mind-Body Connection



I work with clients for all sorts of reasons to help them overcome and move beyond what they once believed held them back. These can be physical as well as psychological obstacles and they are always interconnected because of the mind-body link and frequently, many of these health problems occur because of a disconnect between the mind and the body due to all manner of external and internal influences. 

It never ceases to amaze me what people can achieve when they reconnect mind and body, dissolving limiting beliefs and replacing them with new empowering versions that support their new mindset and propel them into an exciting future full of possibilities.

I have been working with one particular client this year who has kindly sent me this testimonial and allowed me to share it with you. Mandy has worked incredibly hard on adapting her new found skills and beliefs in order to change her self perception, this has enabled her to challenge her old way of thinking and push way beyond those old boundaries and extend them creating a new field of opportunities and experiences. It’s been a pleasure and a privilege to see happening over the last few months. I do want to add that this has been in conjunction with Mandy discussing things with her GP, which is something I strongly recommend when any form of medication and existing treatment is involved.

I hope this provides some of you with the inspiration and motivation to do something similar for yourselves. 

Take it away Mandy:
Life Design / Brain2Body – Amanda Phillipson 

When I first started working with Simon I was suffering from CFS / ME. Having taken a year off I’d made it back to work with a combination of pacing and Graded Exercise Therapy but my quality of life was still poor as I didn’t have the energy to do anything else. Now, 5 months afternoon beginning Simon’s programme, I am free of CFS / ME and enjoying rebuilding my life, living my life the way I want to and being able to explore new possibilities. I’ve never said this about anything I’ve ever done before, but this programme has quite literally turned my life around and enabled me to enjoy life again.

So if you’re feeling stuck, feel that the way you are is just how it is always going to be, think again. Challenge yourself, challenge the medical system to do more for you than the bare minimum to get you going. Do not accept the status quo when it comes to your health and well being, your life. Your life is there to be lived so get out there and find what you need that enables you to live it to its fullest because we only get one shot at it. Make it count.

Have a great week.

Simon

Hypnosis and Control of Bleeding and Haemophilia


There are numerous accounts of the human ability to affect blood flow using mind-body techniques. Stories such as Milton Erickson, MDʼs well known account of using hypnosis to control severe bleeding in his hemophiliac son after an accident, to Martin Rossman, MDʼs less well known but equally dramatic story of using hypnosis in the Emergency Room with a woman to stop her haemorrhaging. However, the widespread use of techniques such as Guided Imagery and Hypnosis for blood control will not be embraced by the medical community without hard science to back up the contentions.

Fortunately, several published studies present corroborating evidence. Biofeedback training, of course, has a long and well-documented history of being able to affect perfusion.

A recent study showed that biofeedback-assisted relaxation training was 87.5% effective in increasing peripheral perfusion (and, thereby, healing) in patients with foot ulcers. The field of hypnosis also has many studies related to pain management in surgery, and studies showing hypnosisʼ ability to affect blood flow are beginning to show up in the literature. Studies with burn patients have shown that hypnosis can significantly improve wound healing by increasing blood flow to the affected area. Subjects were able to achieve significant increases in hand warming using hypnotically-induced vasodilation. Haemo-dynamic measurements of systolic blood pressure, arterial blood flow, and resistance all changed appropriately when hypnotised subjects believed they were donating blood.

As an indication that these so-called autonomic functions can be patient controlled during surgery, one matched, controlled study of maxillofacial surgery patients receiving pre-, post- and/or peri-operative hypnotic suggestion had up to a 30% reduction in blood loss. The health benefits to the patient and savings to hospitals with these kinds of blood loss reductions are considerable. A further study showed that intra-operative and post-op capillary bleeding can be reduced using hypnosis, even in haemophiliac dental patients.

A most impressive study is one in which 121 patients used hypnosedation during endocrine surgical procedures. It has become an expectation from patients who use mind-body modalities for these patients needed significantly less pain medication. Of even greater implication, however, is the fact that all surgeons in these 121 procedures reported better operating conditions (estimated by the visual analog scale), and the researchers attributed this to reduced bleeding in the operative field. Furthermore, no patients were required to convert to general anesthesia during any of the procedures.

These and other factors — high patient satisfaction, better surgical convalescence, turn beds faster, lower use of resources, fewer demands on personnel, fewer follow-up visits by physicians — reduce the socio-economic impact of patient treatment, especially in the area of in- patient surgery.

References

Rice B, Kalker AJ, Schindler JV, Dixon RM. “Effect of biofeedback-assisted relaxation training on foot ulcer healing.” J Am Podiatr Med Assoc 2001 Mar;91(3):132-41.
Moore L and Kaplan J. Hypnotically Accelerated Burn Wound Healing. Am J Clin Hypn 1983 Jul;26(1):16-9.

Moore LE, Wiesner SL. Hypnotically-induced vasodilation in the treatment of repetitive strain injuries. Am J Clin Hypn 1996 Oct;39(2):97-104. Casiglia E, Mazza A, Ginocchio G, Onesto C, Pessina AC, Rossi A, Cavatton G, Marotti A. “Hemodynamics following real and hypnosis- simulated phlebotomy.” Am J Clin Hypn 1997 Jul;40(1):368-75.

Enqvist B, von Konow L, Bystedt H. “Pre- and perioperative suggestion in maxillofacial surgery: effects on blood loss and recovery.” Int J Clin Exp Hypn 1995 Jul;43(3):284-94.
Lucas ON. “The use of hypnosis in hemophilia dental care.” Ann N Y Acad Sci 1975 Jan 20;240:263-6.
Meurisse M. Faymonville ME, Joris J, Nguyen Dang D, Defechereux T, Hamoir E. “Service de Chirurgie des Glandes Endocrines et Transplantation, Centre

Hospitalier Universitaire de Liege, Belgique.” Ann Endocrinol (Paris) 1996;57(6):494-501.

Haemophilia

Study 1: Suggestions Reduce Blood Loss in Surgery
Preoperative Instructions for Decreased Bleeding During Spine Surgery
http://journals.lww.com/anesthesiology/Citation/1986/09001/Preoperative_Instructions_for_Decreased_Bleeding.244.aspx

Results: Those who were given preoperative suggestions for the blood to move away during surgery – so the body could conserve blood – lost significantly less blood than those in both the control and relaxation groups.

Notes: Ninety-two patients who were scheduled for spinal surgery were randomly divided into three groups. One served as the control, the second were given suggestions for relaxation, while the third were given preoperative suggestions that the blood would leave the area where the surgery was to take place at the start of the operation and then remain away until it was complete. This third group was also given suggestions about the importance of blood conservation. The authors note that generally blood loss during surgical procedures can vary wildly between different patients and is unpredictable. For certain types of surgeries, this blood loss often requires transfusions. Giving preoperative suggestions about decreased bleeding could help with these issues.

Anaesthesiology, Sept. 1986, Vol.65 A246
By: H. L. Bennett, Ph.D., D. R. Benson, D. A. Kuiken, Dept. of Anesthesiology and Orthopedic Surgery, UC Davis Medical Center, Sacramento California

Study 2: Case Study – Hypnosis to Treat Gastrointestinal Bleeding
Hypnotic Control of Upper Gastrointestinal Hemorrhage: A Case Report
http://www.tandfonline.com/doi/abs/10.1080/00029157.1984.10402584?journalCode=ujhy20

Results: After treatment with hypnosis, the patient (who was suffering from upper gastrointestinal tract bleeding) was discharged from the hospital without the need for surgical intervention.

Notes: This paper presents the successful treatment with hypnosis of a patient with upper gastrointestinal tract bleeding. After treatment, the patient was discharged from the hospital without the need for surgical intervention.

American Journal of Clinical Hypnosis, Volume 27, Issue 1, 1984
By: Emil G. Bishay M.D.a, Grant Stevensa and Chingmuh Lee, UCLA School of Medicine

Hemophilia Disorder Disease Word in Blood Stream in Red Cells

Study 3: Hypnosis Helps Hemophiliacs Avoid Transfusions, Decreases Risk of Other Health Problems, and Increases Quality of Life
The Use of Hypnosis with Hemophilia
http://www.ncbi.nlm.nih.gov/pubmed/1289965

Results: The hemophiliacs using hypnosis realized a reduction in the need for transfusions, which results in a decrease in the development of inhibitors, less potential exposure to dangers such as the AIDS virus and a lower incidence of liver and kidney damage. A decrease in the frequency and severity of bleeding episodes results in less morbidity and better coping in the face of HIV infection. Self-hypnosis has provided many bleeders with increased feelings of control and confidence and improved the quality of their lives.

Notes: The Colorado Health Sciences Center’s program to treat hemophiliacs using hypnosis is described.

Psychiatr Med. 1992;10(4):89-98
By: W. LaBaw, University of Colorado Health Sciences Center, Denver

Study 4: Hypnosis for Hemophilia Dental Care to Decrease Bleeding
The Use of Hypnosis in Hemophilia Dental Care
http://onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.1975.tb53358.x/abstract

Results: This paper discusses how hypnosis can decrease bleeding during dental care and lower the anxiety of hemophiliacs about dental procedures.

Notes: The author describes the experiences of a dental clinic that uses hypnosis for hemophiliacs undergoing dental surgical procedures.

Ann N Y Acad Sci,1975 , 240;263-6, Volume 240
By: Oscar N. Lucas, University of Oregon Dental School

Hypnotic blood flow control

Study 5: Hypnosis to Reduce Blood Loss in Maxillofacial (Neck, Head, Jaw, etc.) Surgery
Pre and perioperative suggestion in maxillofacial surgery: Effects on blood loss and recovery
http://www.ncbi.nlm.nih.gov/pubmed/7635580

Results: The patients who received hypnotic suggestions were compared to a group of matched control patients. The patients who received preoperative hypnotic suggestions exhibited a 30% reduction in blood loss. A 26% reduction in blood loss was shown in the group of patients receiving pre- and perioperative suggestions, and the group of patients receiving perioperative suggestions only showed a 9% reduction in blood loss.

Notes: The basic assumption underlying the present study was that emotional factors may influence not only recovery but also blood loss and blood pressure in maxillofacial surgery patients, where the surgery was performed under general anesthesia. Eighteen patients (group 1) were administered a hypnosis tape containing preoperative therapeutic suggestions, 18 patients (group 2) were administered hypnosis tapes containing pre- and perioperative (note “perioperative” generally means the time of hospitalization until discharge) suggestions, and 24 patients (group 3) were administered a hypnosis tape containing perioperative suggestions only. Groups 1 and 2 listened to the audiotape 1-2 times daily for the two weeks before surgery. The audiotapes provided therapeutic suggestions for improved healing, less bleeding, lower blood pressure, and faster recovery. The audiotape was 17 minutes in length. During surgery, group 2 also heard an audiotape, which contained similar positive therapeutic suggestions.

Int J Clin Exp Hypn. 1995 Jul;43(3):284-94
By: B. Enqvist, L. von Konow, H. Bystedt, Eastman Institute, Stockholm, Sweden

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.

steeplechase-1033335__180cycling-840975__180

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 Burns


A number of studies have shown that hypnosis can reduce the pain experienced during a variety of medical conditions including burn-wound debridement, [1]. The International Journal of Clinical and Experimental Hypnosis found that hypnosis relieved the pain of 75% of 933 subjects participating in 27 different experiments.[2]

Hypnosis is effective in reducing pain from and coping with cancer and other chronic conditions. Nausea and other symptoms related to incurable diseases may also be managed with hypnosis.[3]

For some psychologists who uphold the altered state theory of hypnosis, pain relief in response to hypnosis is said to be the result of the brain’s dual-processing functionality. This effect is obtained either through the process of selective attention or dissociation, in which both theories involve the presence of activity in pain receptive regions of the brain, and a difference in the processing of the stimuli by the hypnotised subject.[4]

The American Psychological Association published a study comparing the effects of hypnosis, ordinary suggestion and placebo in reducing pain. The study found that highly suggestible individuals experienced a greater reduction in pain from hypnosis compared with placebo, whereas less suggestible subjects experienced no pain reduction from hypnosis when compared with placebo. Ordinary non-hypnotic suggestion also caused reduction in pain compared to placebo, but was able to reduce pain in a wider range of subjects (both high and low suggestible) than hypnosis. The results showed that it is primarily the subject’s responsiveness to suggestion, whether within the context of hypnosis or not, that is the main determinant of causing reduction in pain.[5]

Burns Table

Study 1: Hypnosis to Control Pain of Burn Patients
An Experimental Study of Hypnosis in Painful Burns
http://www.tandfonline.com/doi/abs/10.1080/00029157.1978.10403952#preview

Results: Both studies revealed significantly lower percentages of medication used (p < .01) by the hypnotic groups than control groups.

Notes: The present study examines the usefulness of hypnosis in the control of acute pain in thermal and electrically burned patients as an adjunctive analgesic during the routine care of burn wounds. It was hypothesized that the use of hypnosis would lead to significant reductions in the amount of drugs needed as compared to patients using medication only. Anxiety and discomfort associated with daily tanking, debridement, and dressing changes were expected to be reduced because of the introduction of hypnotic procedures. The experimental study also examined the variables of age and percent of burns. Two studies were conducted including patients with 0-30% total body burns and 31-60% burns. A variety of hypnotic techniques were used.

American Journal of Clinical Hypnosis. Vol 21(1), Jul 1978, 3-12
By: John R. Wakeman, Jerold Z. Kaplan, Department of Psychiatry, Brooke Army Medical Center, USA, U.S. Army Institute of Surgical Research, Brooke Army Medical Center, USA, Psychology Service, Department of Psychiatry, Brooke Army Medical Center, Fort Sam Houston, Texas, USA)

Study 2: Hypnosis to Control Pain During Burn Wound Debridement
Hypnosis for the treatment of burn pain
http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&uid=1993-06886-001

Results: Only hypnotized subjects reported significant pain reductions relative to pre-treatment baseline. This result was corroborated by nurse VAS ratings. Findings indicate that hypnosis is a viable adjunct treatment for burn pain.

Notes: Investigated the clinical utility of hypnosis for controlling pain during wound debridement (removal of unhealthy tissue from a wound to promote healing). Thirty hospitalized burn patients and their nurses submitted visual analog scales (VASs) for pain during 2 consecutive daily wound debridements. On the 1st day, patients and nurses submitted baseline VAS ratings. Before the next day’s wound debridement, subjects received hypnosis, attention and information, or no treatment.

Journal of Consulting and Clinical Psychology, Vol 60(5), Oct 1992, 713-717
By: David R. Patterson, John J. Everett, G. Leonard Burns, Janet A. Marvin, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA

burns

Study 3: Hypnosis to Reduce Anxiety Before and During Dressing Changes of Burn Patients
Psychological approaches during dressing changes of burned patients: a prospective randomised study comparing hypnosis against stress reducing strategy
http://www.sciencedirect.com/science/article/pii/S0305417901000353

Results: The comparison of the two treatment groups indicated that VAS anxiety scores were significantly decreased before and during dressing changes when the hypnotic technique was used instead of stress reducing strategies (SRS).

Notes: A prospective study was designed to compare two psychological support interventions in controlling peri-dressing change pain and anxiety in severely burned patients. Thirty patients with a total burned surface area of 10-25%, requiring a hospital stay of at least 14 days, were randomized to receive either hypnosis or stress reducing strategies (SRS) adjunctively to routine intramuscular pre-dressing change analgesia and anxiolytic drugs. Visual analogue scale (VAS) scores for anxiety, pain, pain control and satisfaction were recorded at 2-day intervals throughout the 14-day study period, before, during and after dressing changes.

Burns, Volume 27, Issue 8, December 2001, Pages 793-799
By: Marie-Christine Frenay, Marie-Elisabeth Faymonville, Sabine Devlieger, Adelin Albert, Alain Vanderkelen, Burn Centre, Military Hospital Queen Astrid, Rue Bruyn, 1, 1120 Brussels, Belgium, Department of Anesthesiology, University Hospital, Liège, Belgium, Department of Biostatistics, University Hospital, Liège, Belgium

Study 4: Hypnosis for Pain in Severe Burn Patients
Hypnosis and pain in patients with severe burns: a pilot study
http://europepmc.org/abstract/MED/3228699

Results: Results show a 50-64 percent decrease in reported pain level for three patients and a 52 percent increase of pain for one patient. The mean decrease for these four patients was 30 percent (for overall as well as worst pain during dressing changes). A 30 percent reduction of anxiety level and a modest reduction of medication use were achieved concurrently. It is concluded that hypnosis is of potential value during dressing changes of burn patients.

Notes: This report presents a pilot study on the effectiveness of hypnosis in the control of pain during dressing changes of burn patients. Eight patients were treated, and all evaluated the interventions as beneficial. The treatment of four patients was more closely analyzed by obtaining pain and anxiety ratings daily.

Burns, Including Thermal Injury, 1988, 14(5):399-404
By: A. J. Van der Does, R. Van Dyck, R. E. Spijker, Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands

180px-Burn_Degree_Diagram

Study 5: Hypnosis for Burn Pain – Review of Six Studies
Medical hypnosis for pain and psychological distress during burn wound debridement: a critical review
http://www.oapublishinglondon.com/article/540

Results: The results of these studies suggest that hypnosis may be more effective than structured attention for reducing patients’ pain and anxiety levels during wound debridement. The existing evidence suggests that hypnosis may be effective in managing pain and distress for burn victims who have difficulty coping during wound debridement.

Notes: This article offers a critical review of the literature currently available on the efficacy of medical hypnosis for managing pain and distress during burn wound debridement. Six studies involving a total of 217 participants met inclusion criteria and are discussed in detail.

OA Alternative Medicine 2013 Apr 01;1(1):10
By: J. Sliwinski, W. Fisher, A. Johnson, G. Elkins, Baylor University Mind-Body Medicine Research Lab, Waco, Texas, USA

Additional References:

  1. Patterson, David R.; Questad, Kent A.; De Lateur, Barbara J. (1989). “Hypnotherapy as an adjunct to narcotic analgesia for the treatment of pain for burn debridement”. American Journal of Clinical Hypnosis 31 (3): 156–163.
  2. Nash, Michael R. “The Truth and the Hype of Hypnosis”. Scientific American: July 2001
  3. Kwekkeboom, K.L.; Gretarsdottir, E. (2006). “Systematic review of relaxation interventions for pain”. Journal of Nursing Scholarship 38 (3): 269–277.
  4. Myers, David G. (2014). Psychology: Tenth Edition in Modules (10th ed.). Worth Publishers. pp. 112–13.
  5. “Hypnosis, suggestion, and placebo in the reduction of experimental pain” faqs.org

Hypnosis and Bruxism (Teeth Grinding)


Bruxism is very common, particularly in conjunction with stress and anxiety and is often not recognised by the individual for lengthy periods of time. Many times it is not until someone else tells them to stop grinding their teeth, that a person becomes aware of it.

This unconsciously driven habit, as they all are, is very amenable to treatment by hypnosis because of the unconscious nature and the ability for hypnosis to access the unconscious enabling patients/clients, with guidance, to resolve the reasons behind the Bruxism.

As always you are free to make up your own mind after reading the research below.

Bruxism

Study 1: Case Study – Hypnosis Helps Nocturnal Bruxism
Nocturnal Bruxism and Hypnotherapy: A Case Study
http://www.tandfonline.com/doi/abs/10.1080/00207144.2013.753832?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed#preview

Results: At the end of the 7 hypnotherapy sessions, the bruxism had disappeared. Follow-up 1 year later indicated that the bruxism had not returned, and the client had become more assertive in her relations with others and had more exploratory activities in her life directions. The latter had not been dealt with in therapy. Thus, there appeared to be a “ripple effect” of successful therapy from one part of her life into its other aspects.

Notes: This article describes a case study of a hypnotherapeutic treatment of nocturnal bruxism. The author saw the client for a total of 7 hypnotherapy sessions.
It seems that a third party obtained this full research article and provided more details at http://www.hypnotherapy-glasgow.net/index.php/glasgow-hypnotherapy-about-hypnotherapy/hypnotherapy-for-teeth-grinding-bruxism-in-glasgow/.

Some of those details are listed below.
The client had been bruxing for more than 20 years, only at night. The result had been a sore jaw most mornings and consistent sleep interruption. Hypnosis was focused around the following themes:

(a) Allowing herself to “let go” and to learn new things about herself. It was suggested that her “unconscious mind” (a metaphor, following Milton Erickson) would begin to learn new ways of acting in the world;

(b) Shedding old roles in life and old discomforts and pains. While she was in trance, it was suggested that her strategy in life so far had been conservational, in that she was protecting herself. She could now begin to adopt a strategy of being transformational. It was compared metaphorically to adding new rooms to an existing house; the central core of the house (herself) remains the same, while new rooms (representing new actions, new ways of looking at things, new ideas) undergo significant change. The same person grows and develops while remaining centrally the same. The phrase “growing and developing; developing and growing” was used;

(c) Making new connections among her thoughts, feelings, and actions as she grows and develops. It was suggested that these connections will go around, under, through, and over her walls, gradually crumbling them and making them more permeable and transparent. It was suggested that as she continues to grow and develop she will no longer need her old ways of coping and the discomfort to her mind and body (metaphorically the jaw pain) they have produced; and

(d) “Letting go” (multifaceted) – letting go of her fear and letting go of the pain in her jaw (phrased as discomfort). They were, it was suggested, elements of her past she has now outgrown.

About a year later after the hypnotherapy sessions, the client reported that the jaw pain had not returned. Furthermore, her relationship with her husband and especially her mother had continued to improve. She had even made plans to return to school for an advanced degree and said, “I don’t think I would have done that before.” The author noted that he usually avoids direct suggestions in hypnosis and instead uses metaphors and stories to avoid arousing resistance.
The International Journal of Clinical and Experimental Hypnosis. 2013

Apr;61:205-18
By: E. Thomas Dowd, Dept. of Psychology, Kent State University, Kent, Ohio

Study 2: Case Study – Hypnosis Helps Bruxism (Improvement Maintained Five Years After Hypnosis)
Understanding change: five-year follow-up of brief hypnotic treatment of chronic bruxism
http://www.ncbi.nlm.nih.gov/pubmed/8203355

Results: A woman with a 60-year history of bruxism became symptom-free using hypnosis. This case demonstrates how enduring change may occur. Follow-up assessments at 2, 3, and 5 years revealed that she continued to be symptom-free with her self-reports corroborated by her spouse and family dentist.

Notes: This paper describes the treatment of a 63-year-old woman with a 60-year history of nocturnal bruxism. Treatment included assessment, two psychotherapy sessions, including a paradoxical behavior prescription to reduce daytime worrying, hypnotic suggestions for control of nocturnal grinding, and reinforcement of the patient’s expectations for success.

Am J Clin Hypn. 1994 Apr;36(4):276-81
By: M. B. LaCrosse, Monroe Mental Health Center, Inc., Norfolk, NE

Study 3: Hypnosis Helps Nocturnal Bruxism and Related Facial Pain
Suggestive hypnotherapy for nocturnal bruxism: a pilot study
http://www.tandfonline.com/doi/abs/10.1080/00029157.1991.10402942#.UhqVYRavszI

Results: The bruxers showed a significant decrease in EMG activity; they also experienced less facial pain and their partners reported less bruxing noise immediately following treatment and after 4 to 36 months.

Notes: This study describes the use of suggestive hypnotherapy and looks at its effectiveness in treating bruxism. Eight subjects who reported bruxism with symptoms such as muscle pain and complaints of bruxing noise from sleep partners were accepted into the study. An objective baseline of the bruxing was established using a portable electromyogram (EMG) detector attached over the masseter muscle during sleep. Hypnotherapy was then employed. Both self-reports and posttreatment EMG recordings were used to evaluate the hypnotherapy. Long-term effects were evaluated by self-reports only.

American Journal of Clinical Hypnosis. 1991 Apr;33(4):248-53
By: J. H. Clarke, P. J. Reynolds

Study 4: Hypnosis for Temporomandibular Disorders (problems with the jaw, jaw joint and surrounding facial muscles)
Medical hypnosis for temporomandibular disorders: Treatment efficacy and medical utilization outcome
http://www.calmhorizon.co.uk/downloads/tmd-and-hypnosis.pdf

Results: Statistical analysis of this open trial suggests that medical hypnosis is a potentially valuable treatment modality for temporomandibular disorders (TMD). After hypnosis, patients reported a significant decrease in pain frequency (F [3, 87] = 14.79, P < .001), pain duration (F [3, 87] = 9.56, P < .001), and pain intensity (F [3, 87] = 15.08, P < .001), and an increase in daily functioning. Analysis suggests that their symptoms did not simply spontaneously improve, and that their treatment gains were maintained for 6 months after hypnosis treatment.

Notes: The aim of this study was to examine the effectiveness of medical hypnosis on reducing the pain symptoms of temporomandibular disorders (TMD).Twenty-eight patients who were recalcitrant to conservative treatment for TMD participated in a medical hypnosis treatment program and completed measures of their pain symptoms on 4 separate occasions: during wait list, before hypnotic treatment, after hypnotic treatment, and at a 6-month follow-up.

Hypnosis involved, typically with eye closure inductions, imagery to evoke relaxation, catalepsy of a limb, hypnotic-deepening techniques, metaphors to induce automatic or unconscious bodily responses, hypnotic analgesia and anesthesia, and suggestions that use muscle tension, pain, or both as a cue for automatic muscle relaxation. An example of this follows: “I will now give you a very powerful post-hypnotic suggestion… that should you ever feel any tension in your jaw… head… neck… or shoulders… that is related to your medical, dental condition… it will be an immediate signal and cue to you for your muscles to relax… you will immediately take 2 deep relaxing breaths… and envision the healing ball causing the muscles to immediately relax… let go… release the tension… numbing the entire area… and then absorbing… any remaining pain or discomfort in those areas… as those muscles relax some more… and that’s just fine… you may be consciously aware of carrying out this healing process… or maybe just simply aware of carrying this process out at an unconscious level… as those muscles let go of the tension immediately… and your healing continues… and you will be surprised to find that this process occurs even during your sleep… instructing you that your unconscious is protecting you whether you had realized it or not…” with the addition of posthypnotic suggestions for relapse prevention. At the end of each session, patients were instructed to practice daily self-hypnosis with audiotaped recordings of the hypnotic inductions.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:54-63
By: E. Simon, D. Lewis. Eric P. Simon, Ph.D., ABPP (Department of Psychology, Multi-Disciplinary Pain Clinic) and David M. Lewis, DDS, (Dept of Dentistry) Honolulu, Hawaii, Tripler Regional Medical Center and the University of Hawaii.

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

Hypnosis and Asthma


I hope that this review is useful for those in the medical profession that have not considered Hypnosis as a form of treatment for asthmatic patients as yet. It can be highly effective for some patients and the self hypnosis skills learned can be used to manage their emotional state in many other areas of their lives also.

As always I look forward to your feedback, comments, thoughts and opinions.

Asthma Full

Study 1: Hypnosis Superior to Breathing Exercises for Improving Asthma
Hypnosis for Asthma – A Controlled Trial
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1912142/pdf/brmedj02105-0025.pdf

Results: Results were judged by analyses based on the daily “score” of wheezing recorded in patients’ diaries, by the number of times bronchodilators were used, and by independent clinical assessors. The hypnosis group had improved by 59% compared to a 43% improvement among those who had only been taught the breathing exercises. The average number of times a bronchodilator was used diminished more in the hypnosis group than the control group.

Notes: Two hundred and fifty-two participants aged 10 to 60 (with paroxysmal attacks of wheezing or tight chest capable of relief by bronchodilators) were broken into two groups. One hundred and twenty-seven were given monthly hypnosis sessions for a year and taught to practice self-hypnosis every day and 125 (the control group) were taught a series of breathing exercises designed to bring on deep relaxation. When they were independently assessed at the end of the trial there was a statistically significant difference between the two groups. For the hypnosis group, an eye-thumb fixation induction was used. Suggestions were then given that, by daily self-hypnosis, a state of easing of tension would occur, and – as a result – breathing would become and remain free.

Br Med J 1968;4:71-76 (12 October), A Report to the Research Committee of the British Tuberculosis Association
By: Those participating in the field-work were Drs. Crocket, Davies, Kalnowski, MacDonald, Maher-Loughnan, McAllen, Morrison Smith, Bria Shaw, and Stewart. The investigation was coordinated by Dr. G. P. Maher-Loughnan at Colindale Hospital, London.

Study 2: Review of Studies Concludes that Hypnosis Helps Asthma Generally and Especially in Children
Hypnosis and Asthma: Critical Review
http://www.ncbi.nlm.nih.gov/pubmed/10724294

Results: This report concluded that studies conducted to date have consistently demonstrated an effect of hypnosis with asthma. Existing data suggest that hypnosis efficacy is enhanced in subjects who are susceptible to the treatment modality (hypnosis), with experienced investigators, when administered over several sessions, and when reinforced by patient self-hypnosis. Children in particular appear to respond well to hypnosis as a tool for improving asthma symptoms.

Notes: This report analyzed numerous studies that were conducted on the effect of hypnosis on asthmatic patients.
Journal of Asthma, Volume 37, Issue 1 February 2000, pages 1-15
By: R. M. Hackman, J. S. Stern, M. E. Gershwin, University of California

Study 3: Review of Studies – Hypnosis Can Help Asthma Symptoms and Helps Manage Emotional States the Exacerbate Airway ObstructionEvidence-Based Hypnotherapy for Asthma: A Critical Review
http://www.tandfonline.com/doi/abs/10.1080/00207140601177947?journalCode=nhyp20

Results: This review concludes that hypnosis is possibly efficacious for treatment of asthma symptom severity and illness-related behaviors and is efficacious for managing emotional states that exacerbate airway obstruction. Hypnosis is also possibly efficacious for decreasing airway obstruction and stabilizing airway hyper-responsiveness in some individuals.

Notes: This paper reviewed evidence primarily from controlled outcome studies on hypnosis for asthma.

International Journal of Clinical and Experimental Hypnosis 2007 April.55(2)220-49
By: Daniel Brown, Ph.D., Harvard Medical School

Study 4: Hypnosis Reduces Asthmatics’ Hospital Stays, Drug Side Effects and Need for Drugs; also Improves Condition Generally
Chronic Asthma and Improvement with Relaxation Induced by Hypnotherapy
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1291881/pdf/jrsocmed00155-0023.pdf

Results: Sixteen chronic asthmatic patients inadequately controlled by drugs had, after one year of hypnotherapy, a drop – as a group – in hospital admissions from 44 in the year before starting hypnotherapy to 13 in the year after. Duration of hospital stay was reduced for 13 of the patients by hundreds of days; prednisolone was able to be withdrawn in 6 patients, reduced in 8 patients and increased in none. Adverse side effects of drugs were reduced. 62% of the patients reported improvement in their condition.

Notes: This study followed 16 asthmatics whose condition was not properly controlled by drugs. They were given hypnosis sessions at Southport General Infirmary in England. Instruction in self-hypnosis was given to induce relaxation daily for 5 to 15 minutes; if this was difficult for the participant, a tape recording was made to induce hypnosis. The asthmatics were told to use self-hypnosis/hypnosis at times of mild to moderate wheezing either alone or after use of an inhaler – but never in the event of a severe asthmatic attack.

J R Soc Med. 1988 Dec; 81(12) 701-4
By: J. B. Morrison, MD BSc Southport General Infirmary, Southport, Merseyside

Study 5: Hypnosis Helps Exercise-Induced Asthma
Hypnosis for Exercise-Induced Asthma
http://www.ncbi.nlm.nih.gov/pubmed/6803633

Results: Exercising after hypnosis resulted in only a 15.9% decrease in forced expiratory volume (FEV1 – volume of air that can be forced out taking a deep breath for one second, an important measure of pulmonary function) compared with a larger 31.8% decrease on the control days when hypnosis was not used prior to exercise (p less than 0.001). Pretreatment with cromolyn along with hypnosis resulted in a 7.6% decrease in FEV1. The study concludes that hypnosis can alter the magnitude of a pathophysiologic process, namely, the bronchospasm after exercise in patients with asthma.

Notes: This study assessed the efficacy of hypnosis in helping exercise-induced asthma (EIA) in 10 stable asthmatics. The subjects ran on a treadmill while mouth breathing for 6 min on 5 different days. Pulmonary mechanics were measured before and after each challenge. Two control exercise challenges resulted in a reproducible decrease in forced expiratory volume in one second (FEV1). On 2 other days, saline or cromolyn by nebulization was given in a double-blind manner with the suggestion that these agents would prevent EIA.

Am Rev Respir Dis. 1982 Apr;125(4):392-5
By: Z. Ben-Zvi, W. A. Spohn, S. H. Young, M. Kattan

Study 6: Hypnosis Can Help Mild to Moderate Asthma Symptoms
Improvement in Bronchial Hyper-Responsiveness in Patient with Moderate Asthma after Treatment with a Hypnotic Technique: A Randomised Controlled Trial
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1341848/

Results: The 12 participants with asthma who responded well to hypnosis improved their bronchial hyper-responsiveness (as measured by the methacholine challenge test) by 74.9%. In addition to this, symptoms improved by 41% and as a group they reduced their use of bronchodilators by 26%. In contrast the 17 patient who formed the control group and 10 who were not that hypnotizable had no change. This study concluded that hypnosis was a very effective technique for asthmatics who were moderately to highly hypnotizable. While this technique does not eliminate bronchial hyper-responsiveness, it does provide a clinically useful and nontoxic adjuvant to drug treatment that might benefit about half of the asthmatic population. In subjective terms, the perception of control over the degree of bronchospasm, accompanied by diminished anxiety, often results in an enhanced feeling of health and confidence.

Notes: 39 adults who had mild to moderate asthma were graded on their hypnotizability. 12 who were moderately to highly hypnotizable and 10 who were much less hypnotizable were then enrolled in a 6 week hypnotherapy program. The purpose of the inhaled bronchial challenge test using methacholine is to determine how responsive (or irritable) airways are and to determine the severity of any asthma; in the test, one inhales a mist that contains different concentrations of methacholine. The hypnotic technique used in this study started with an introductory discussion, which combined an outline of the treatment procedures, a general description of hypnosis, and a hypnotic induction. This was followed by suggestions of progressive relaxation, ego enhancement, and a method of self hypnosis. The remaining five sessions began with a similar but shortened induction, followed by a progression of guided imageries. By the final two sessions symptoms of asthma could be rapidly produced and immediately resolved under the subject’s own control. Although hypnotherapy is unlikely to have adverse effects, successful treatment might alter the patient’s appreciation of the severity of the airways obstruction, leading to a delay in seeking appropriate emergency treatment. In the treatment group, care was taken to minimize this possibility by suggestions given during hypnosis of increased awareness of symptoms of asthma, attention to the need for appropriate action, and the avoidance of symptom denial.

Br Med J (Clin Res Ed). 1986 Nov 1;293(6555): 1129-32
By: T. C. Ewer, D. E. Stewart, Dept. of Respiratory Medicine and Psychological Medicine, Princess Margaret Hospital, Christchurch, New Zealand

Study 7: Hypnosis Helps Children with Asthma
Hypnotherapy in the treatment of bronchial asthma
http://www.researchgate.net/publication/22018848_Hypnotherapy_in_the_treatment_of_bronchial_asthma

Results: The average improvement for all subjects using hypnosis was greater than 50% above the baseline measurement as documented by spirometry, monitored dyspnea, wheezing and subjective ratings by the subjects. It is suggested that hypnotherapy may be an important tool in ameliorating asthma, improving ventilatory capacity and promoting relaxation without recourse to pharmacologic agents. One explanation offered is that hypnosis affects an automic response, thereby diminishing bronchospasm.

Notes: The efficacy of hypnotherapy in aborting acute asthmatic attacks was studied in 17 children ranging in age from six to 17. All had as their primary diagnosis bronchial asthma. Prior to hypnotic induction pulmonary function was assessed, then monitored in the immediate post hypnotic period and at two intervals thereafter.

Annals of Allergy 07/1975; 34(6):356-62
By: G. M. Aronoff, S. Aronoff, L. W. Peck

Hypnosis and Agoraphobia


What is Agoraphobia?

Agoraphobia is a very complex phobia usually manifesting itself as a collection of inter-linked conditions.

For example many agoraphobics also fear being left alone (monophobia), dislike being in any situation where they feel trapped (exhibiting claustrophobia type tendencies) and fear travelling away from their ‘safe’ place, usually the home. Some agoraphobics find they can travel more easily if they have a trusted friend or family member accompanying them, however this can quickly lead to dependency on their carer.

The severity of agoraphobia varies enormously between sufferers from those who are housebound, even room-bound, to those who can travel specific distances within a defined boundary. It is not a fear of open spaces as many people think.

Agoraphobia image

See more at: AnxietyUK

As always I am very interested to hear other opinions and experiences around this subject.

Study 1: Case Study of Hypnotherapy for Agoraphobia
Agoraphobia: A case study in hypnotherapy
http://www.tandfonline.com/doi/abs/10.1080/00207147108407147

Results: Based on the described case study, the author advocates a psychodynamically oriented rather than technique-centered approach to hypnotherapy to successfully treat agoraphobia.

Notes: A 58-year-old woman with a 43-year history of agoraphobia was treated with ego-supportive direct suggestion and hypnoanalytic techniques. Literature pertaining to etiological factors and treatment problems is cited. Pertinent details of the patient’s recent and past history are presented. The treatment plan, course of therapy, and outcome are discussed in the context of limited therapeutic goals and anticipated successful results.

International Journal of Clinical and Experimental Hypnosis, Volume 19, Issue 1, 1971
By: Doris Gruenewald, Psychosomatic and Psychiatric Institute for Research and Training Michael Reese Hospital, Chicago

Study 2: Hypnotherapy for Irritable Bowel Syndrome Induced Agoraphobia
Cognitive-Behavioral Hypnotherapy in the Treatment of Irritable-Bowel-Syndrome-Induced Agoraphobia
http://www.tandfonline.com/doi/abs/10.1080/00207140601177889?journalCode=nhyp20

Results: This research paper describes the etiology and treatment of irritable-bowel-syndrome (IBS)-induced agoraphobia. Cognitive, behavioral, and hypnotherapeutic techniques are integrated to provide an effective cognitive-behavioral hypnotherapy (CBH) treatment for IBS-induced agoraphobia. This CBH approach for treating IBS-induced agoraphobia is described and clinical data are reported.

Notes: There are a number of clinical reports and a body of research on the effectiveness of hypnotherapy in the treatment of irritable bowel syndrome (IBS). Likewise, there exists research demonstrating the efficacy of cognitive-behavioral therapy (CBT) in the treatment of IBS. However, until this research paper, little had been written about the integration of CBT and hypnotherapy in the treatment of IBS, and there had been a lack of clinical information about IBS-induced agoraphobia.

International Journal of Clinical and Experimental Hypnosis, Vol. 55, Issue 2, 2007
By: William L. Golden, Private Practice, New York, New York, USA

Study 3: Review of Research on Hypnosis for Agoraphobia and Social Phobia
The Place of Hypnosis in Psychiatry Part 4: Its Application to the Treatment of Agoraphobia and Social Phobia
http://www.londonhypnotherapyuk.com/agoraphobia-social-phobia.asp

Results: This review of world-wide research and literature concludes that hypnosis is a powerful adjunct to therapy for agoraphobia and social phobia. The case studies presented here demonstrate that hypnosis has been highly effective in helping patients (1) to explore feared situations in a safe environment; (2) to reduce anxiety using desensitization; (3) to gain more control using anchoring, fantasy techniques and autogenic training; (4) to enhance coping strategies using ego strengthening and breathing techniques; and (5) to reduce affect using television screen imagery. Age regression (6) was also employed effectively to help a patient to address, and come to terms with, inner conflicts and traumatic events in early childhood. Finally, carefully-designed audio tapes were employed to encourage two patients to practice self hypnosis at home, and this had the effect of enhancing treatment outcome.

Notes: This paper is based on a world-wide search of the literature, and focuses on the use of hypnosis in the treatment of social phobia and agoraphobia. Hypnosis is employed as an adjunct to therapy: it is used to help patients to reduce cognitive and physical symptoms of anxiety, and provides them with more control in every day situations. The author reviews a range of treatment procedures that have been shown to be highly effective in the treatment of both social phobia and agoraphobia. An extensive search of the literature has uncovered seven studies which have used hypnosis in the treatment of agoraphobia: the first two studies (Gruenewald, 1971; Jackson & Elton, 1985) use a hypnoanalytic approach with age regression, the third and fourth studies (Schmidt, 1985; Hobbs, 1982) both use audio tapes, the fifth study (Mellinger, 1992) employs a hypnotically-augmented multidimensional approach, while the sixth study (Roddick, 1992) uses a fantasy technique to encourage cognitive re-structuring. Finally, the seventh paper (Milne, 1988), is useful in that the therapist employs a number of approaches in treatment including group therapy, ego strengthening and the gradual introduction of hypnosis from a process similar to meditation.

The text cited here is a pre-publication version of a paper published in the Australian Journal of Clinical & Experimental Hypnosis.
By: David Kraft, Harley Street, London, UK (PhD) (trained in psychotherapy at the National College of Hypnosis and Psychotherapy, diploma in clinical psychology (Dip.Cl.Psy). In addition, he trained at the BST Foundation in London where he gained both the diploma in Clinical Hypnosis (DCHyp) and the Advanced Certificate in Clinical and Strategic Hypnosis (A.Cert.CSHyp). David is a member of the Hypnosis & Psychosomatic Medicine Section of the Royal Society of Medicine; he is also a member of the British Society of Clinical and Academic Hypnosis (BSCAH))

Study 4: Use of Hypnosis to Counteract Resistance by a Client with Agoraphobia
Counteracting Resistance In Agoraphobia Using Hypnosis
http://www.londonhypnotherapyuk.com/agoraphobia-using-hypnosis.asp

Results: This research paper focuses on the treatment of agoraphobia and, specifically, on how hypnosis is employed in order to counteract resistance, thus reducing negative transference and providing the patient with the coping skills to become independent in the outside world. The author describes one case study in 1992 in which hypnotherapy was gradually introduced and used in stages; after 8 sessions, the client was able to drive herself to sessions and continued to make further progress.

Notes: The author describes how clients are often resistant to treatment for agoraphobia. Resistance takes on many forms. One case study is discussed in detail in which successful treatment consisted of the stages as shown below (Roddick, 1992). Note that the client in this case study had a particular aversion to being driven in a car and that these principles can be adapted to suit the needs of the patient. Stages: 1. Relaxing in the presence of the therapist; case history (approx. 4 sessions); 2. (a) Hypnosis is introduced using progressive muscle relaxation induction; (b) Experiencing special place imagery like a desert island beach; (c) Addressing the unconscious mind focusing on (i) the importance of practicing relaxation, (ii) being able to travel in a car, (iii) being able to eat and drink ‘as well as ever’; 3. (a) Direct suggestions of bringing the three parts together; (b) Ideomotor signalling used to ascertain whether the strategy has worked and was acceptable; (c) Re-integration of unconscious mind and conscious mind on the desert island beach; 4 (a) ‘Throwing out’ of negative thoughts; (b) Direct suggestions that the skills that the patient has learned in the special place can be utilized at any time. After 8 sessions of using this technique, the patient was able to drive herself to sessions and continued to make further progress thereafter.
This is a pre-publication version of the original research paper.
By: David Kraft, Harley Street, London, UK (PhD) (trained in psychotherapy at the National College of Hypnosis and Psychotherapy, diploma in clinical psychology (Dip.Cl.Psy). In addition, trained at the BST Foundation in London where he gained both the diploma in Clinical Hypnosis (DCHyp) and the Advanced Certificate in Clinical and Strategic Hypnosis (A.Cert.CSHyp). Also a member of the Hypnosis & Psychosomatic Medicine Section of the Royal Society of Medicine; he is also a member of the British Society of Clinical and Academic Hypnosis (BSCAH))

Study 5: Hypnotherapy for Panic Attacks
Rational self-directed hypnotherapy: a treatment for panic attacks
http://www.ncbi.nlm.nih.gov/pubmed/2296917

Results: Results showed an increased sense of control, improved self-concept, elimination of pathological symptoms, and cessation of panic attacks.

Notes: A single-subject research design was employed to assess the efficacy of rational self-directed hypnotherapy in the treatment of panic attacks. Presenting symptoms were acute fear, dizziness, constricted throat, upset stomach, loss of appetite, loss of weight, insomnia, fear of doctors, and fear of returning to work. Treatment lasted 13 weeks plus a 2-week baseline and posttherapy period and a 6-month follow-up. Objective measurements (MMPI, TSCS, POMS) and self-report assessments (physiological symptoms and a subjective stress inventory) were implemented. Using hypnosis and guided imagery, the subject reviewed critical incidents identifying self-defeating components within a cognitive paradigm, revising and rehearsing these incidents.

Am J Clin Hypn. 1990 Jan;32(3):160-7
By: Der DF, Lewington P, Dept. of Counseling Psychology, University of British Columbia, USA

Study 6: Direct and Awake-Alert Hypnosis for Panic Disorders
Awake-Alert Hypnosis in the Treatment of Panic Disorder: A Case Study
http://www.asch.net/portals/0/journallibrary/articles/ajch-47/iglesias2.pdf

Results: A case study about an individual with a lifestyle-limiting panic disorder is discussed. At the start of therapy, the client was having panic attacks about three times a week – especially during outings for lunch engagements and dinner parties. Direct suggestions as well as a variant of awake-alert hypnosis were used. (Presumably, awake-alert hypnosis was encouraged to make it easier for the client to self-hypnotize with eyes open in the event she felt a panic attack starting.) After four weeks of three-times-a-week hypnosis, the intensity level of the panic attacks markedly decreased. Then, the client became able to thwart the development of episodes by applying the hypnotic procedure in the early phases of the panic process.

Notes: An eye-fixation induction was used and direct suggestions under hypnosis were first provided that the client would become immediately cognizant of any panic episodes at the earliest onset; it was emphasized in hypnosis that to the degree that she employed hypnosis at the earliest level of a panic episode, she would be successful in aborting the episode. After inducing hypnosis and eye-closure, the client was gradually conditioned to open her eyes while remaining in the hypnotic state. The client was conditioned to engender a disconnected and “woodsy” feeling all over her body. Suggestions were given that the client would feel as if an anesthetic agent had been injected yet it could be active and move about as necessary. The client was instructed that she would be able to induce awake-alert hypnosis over her entire body. The client was asked to imagine she was staring at fine glassware – and that at the slightest hint of discomfort she would immerse herself in the splendor of the glassware; the richness of the glass would offer the perfect sanctuary to feel protected—like an impenetrable fortress. The greater the discomfort, the deeper within the glass the client was told she would retreat. As a result, suggestions were given that her respirations would slow down, her stomach would unwind, etc. until she felt it was acceptable to disengage from the glass.

Am. Jrnl of Clinical Hypnosis, April 2005
By: Alex Iglesias (Palm Beach Gardens, Florida) and Adam Iglesias (Florida Atlantic University)