AUTOMATIC NERVOUS SYSTEM
1999
Rainville, P.; Carrier, B.; Hofbauer, R. K.; Bushnell, M. C.; Duncan, G. H. (1999). Dissociation of sensory and affective dimensions of pain using hypnotic modulation. Pain, 82 (2), 159-171.
Understanding the complex nature of pain perception requires the ability to separately analyze its psychological dimensions and their interaction, and relate them to specific variables and responses. The present study, therefore, attempted to selectively modulate the sensory and affective dimensions of pain, using a cognitive intervention, and to assess the possible relationship between these psychological dimensions of pain and changes in physiological responses to the noxious stimuli. In three experiments, normal subjects trained in hypnosis rated pain intensity and pain unpleasantness produced by a tonic heat-pain stimulus (1-min immersion of the hand in 45.0-47.5 degrees C water). Two experiments were designed to test hypnotic suggestions to decrease (Experiment one (Section 2.5.1)), or increase and decrease (Experiment two (Section 2.5.2)) pain affect. Suggestions in Experiment three (Section 2.5.3) were directed towards an increase or decrease in pain sensation. In Experiments one and two (Sections 2.5.1 and 2.5.2), the significant modulation in pain unpleasantness ratings was largely independent of variations in perceived pain intensity. Moreover, in Experiment two (Section 2.5.2), there was a significant correlation between the stimulus-evoked heart-rate increase and ratings of pain unpleasantness, but not of pain intensity, suggesting a direct functional interaction between pain affect and autonomic activation. In Experiment three (Section 2.5.3), suggestions to modulate the sensory aspect of pain produced significant modulation of pain intensity ratings, with secondary changes in pain unpleasantness ratings. Hypnotic susceptibility (Stanford Hypnotic Susceptibility Scale form A) was specifically correlated to pain unpleasantness modulation in Experiment two (Section 2.5.2) and to pain intensity modulation in Experiment three (Section 2.5.3), suggesting that this factor relates to the primary process toward which hypnotic suggestions are directed. The specific pain dimension on which hypnotic suggestions act depends on the content of the instructions and is not a characteristic of hypnosis itself. Results are consistent with a successive-stage model of pain perception (e.g. Wade JB, Dougherty LM, Archer CR, Price DD. Assessing the stages of pain processing: a multivariate analytical approach. Pain 1996;68:157-167) which provides a conceptual framework necessary to study the cerebral representation of pain perception.
Abstract from National Library of Medicine, PubMed
1998
Danziger, N.; Fournier, E.; Bouhassira, D.; Michaud, D.; De Broucker, T.; Santarcangelo, E.; Carli, G.; Chertock, L.; Willer, J. C. (1998). Different strategies of modulation can be operative during hypnotic analgesia: A neurophysiological study. Pain, 75 (1), 85-92.
Nociceptive electrical stimuli were applied to the sural nerve during hypnotically-suggested analgesia in the left lower limb of 18 highly susceptible subjects. During this procedure, the verbally reported pain threshold, the nociceptive flexion (RIII) reflex and late somatosensory evoked potentials were investigated in parallel with autonomic responses and the spontaneous electroencephalogram (EEG). The hypnotic suggestion of analgesia induced a significant increase in pain threshold in all the selected subjects. All the subjects showed large changes (i.e., by 20% or more) in the amplitudes of their RIII reflexes during hypnotic analgesia by comparison with control conditions. Although the extent of the increase in pain threshold was similar in all the subjects, two distinct patterns of modulation of the RIII reflex were observed during the hypnotic analgesia: in 11 subjects (subgroup 1), a strong inhibition of the reflex was observed whereas in the other seven subjects (subgroup 2) there was a strong facilitation of the reflex. All the subjects in both subgroups displayed similar decreases in the amplitude of late somatosensory evoked cerebral potentials during the hypnotic analgesia. No modification in the autonomic parameters or the EEG was observed. These data suggest that different strategies of modulation can be operative during effective hypnotic analgesia and that these are subject-dependent. Although all subjects may shift their attention away from the painful stimulus (which could explain the decrease of the late somatosensory evoked potentials), some of them inhibit their motor reaction to the stimulus at the spinal level, while in others, in contrast, this reaction is facilitated.
Abstract from National Library of Medicine, PubMed
Wickramasekera, Ian E.; Kolm, Paul; Pope, Alan; Turner, Marsha (1998). Observation of a paradoxical temperature increase during cognitive stress in some chronic pain patients. Applied Psychophysiology and Biofeedback, 23 (4), 233-241.
A total of 224 chronic pain somatoform disorder patients without obvious pathophysiology or psychopathology were found to have colder hands than nonpatients. A paradoxical temperature increase (PTI) in response to a cognitive stressor (mental arithmetic) was noted in a subset of these chronic pain patients. Patients were defined as “PTI” responders if, during cognitive stress, an increase in digital temperature occurred over a prior eyes closed resting condition. It was found that 49.4% of males and 42.6% of females in a total sample of 224 patients demonstrated PTI. The PTI patients had significantly colder hands than non-PTI patients prior to stress. A concurrent SCL measure of sympathetic activation found no difference between the PTI and non-PTI groups either at baseline or during cognitive stress. It appears from this data that PTI is specific to the peripheral vascular system of these patients and may be a marker of psychophysiological dissociation or trauma blocked from consciousness.
1995
Enqvist, Bjorn; von Konow, L.; Bystedt, H. (1995). Pre- and perioperative suggestion in maxillofacial surgery: Effects on blood loss and recovery. International Journal of Clinical and Experimental Hypnosis, 43 (3), 284-294.
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 were administered a hypnosis tape containing preoperative therapeutic suggestions, 18 patients were administered hypnosis tapes containing pre- and perioperative suggestions, and 24 patients were administered a hypnosis tape containing perioperative suggestions only. The patients who received taped suggestions were compared to a group of matched control patients. The patients who received preoperative 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. Lower blood pressure was found in the groups that received pre- and perioperative and perioperative suggestions only. Rehabilitation was facilitated in the group of patients receiving perioperative suggestions only.
Olness, Karen N.; Lee, Lai (1995, November). Effects of self-induced mental imagery on autonomic reactivity in children. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES 1:
NOTES: One study that shows an IgA increase with hypnotic suggestion has been replicated and is in press.
The present study emerges from work using hypnosis with biofeedback. Morgan’s work with athletes has suggested the relationship between imagery and physiological activation. This has been observed clinically but not heretofore documented.
We are not using formal hypnosis. Each child was asked to think about being in a quiet place, doing exciting activities, baseline, etc. The children exhibited no neurological disorders, cognitive dysfunction, nor were they on medications at time of the study.
We confirmed our clinical experience: there was an increase in pulse rate when imagery changed to activity. Skin temperature continued to go up during the period (despite imagery of being active like being on roller coaster). Skin conduction went down during baseline. EDA [electrodermal activities] was higher during active imagery.
How do average daily thinking processes impact on autonomic changes over long periods of time? Do these changes affect cardiovascular status?
Clinically we observed that some children are more labile in different modalities, and under stress they react more in that system.
1994
DeBenedittis, Giuseppe; Cigada, Mario; Bianchi, Anna; Signorini, Maria Gabriella; Cerutti, Sergio (1994). Autonomic changes during hypnosis: A heart rate variability power spectrum analysis as a marker of sympatho-vagal balance. International Journal of Clinical and Experimental Hypnosis, 42 (2), 140-152.
Spectral analysis of beat-to-beat variability in electrocardiography is a simple, noninvasive method to analyze sympatho-vagal interaction. The electrocardiogram is analyzed by means of an automatic, autoregressive modeling algorithm that provides a quantitative estimate of R-R interval variability by the computation of power spectral density. Two major peaks are recognizable in this specter: a low-frequency peak (LF, -0.2 Hz), related to the overall autonomic activity (ortho + parasympathetic) and a high-frequency peak (HF, -0.25 hz), representative of the vagal activity. The LF/HF ratio is an index of the sympatho-vagal interaction. This technique was applied, using a computer-assisted electrocardiograph, to 10 healthy volunteers (6 high and 4 low hypnotizable subjects as determined by the Stanford Hypnotic Susceptibility Scale, Form C) in randomized awake and neutral hypnosis conditions. Preliminary results indicated that hypnosis affects heart rate variability, shifting the balance of the sympatho-vagal interaction toward an enhanced parasympathetic activity, concomitant with a reduction of the sympathetic tone. A positive correlation between hypnotic susceptibility and autonomic responsiveness during hypnosis was also found, with high hypnotizable subjects showing a trend toward a greater increase of vagal efferent activity than did low hypnotizables
1993
Harris, Ruth M.; Porges, Stephen W.; Carpenter, Myrna E. Clemenson; Vincenz, Lilli M. (1993). Hypnotic susceptibility, mood state, and cardiovascular reactivity. American Journal of Clinical Hypnosis, 36 (1), 15-25.
In this study we explored the relationship between hypnotic susceptibility measured with the Harvard Group Scale of Hypnotic Susceptibility (HGSHS) and cardiovascular parameters. After assessing their degree of hypnotic susceptibility, we induced 21 female students into happy mood states and into sad mood states. During the mood state induction we monitored blood pressure, heart rate, and cardiac vagal tone continuously. The study demonstrated a strong relationship between hypnotic susceptibility and both cardiac vagal tone and heart rate reactivity. Subjects with lower heart rate and greater vagal tone during baseline and greater heart rate increases during mood induction were more susceptible to hypnosis. Multiple regression analyses indicated that approximately 40% of the individual difference variance of hypnotic susceptibility was accounted for by baseline cardiac vagal tone and heart rate reactivity during mood state. The data demonstrate that autonomic tone, assessed by cardiac vagal tone and heart rate reactivity, are related to hypnotic susceptibility as measured by the HGSHS. – Journal Abstract
1992
Gainer, Michael J. (1992). Hypnotherapy for reflex sympathetic dystrophy. American Journal of Clinical Hypnosis, 34, 227-232.
Reflex sympathetic dystrophy (RSD) is an unusual, debilitating, chronic pain syndrome thought to be the result of a continuous excessive discharge of regional sympathetic nerves. Supportive and stress-reduction psychotherapies are commonly recommended as adjunctive treatments. Biofeedback is a more direct symptomatic treatment. Although hypnotherapy is effective in altering sympathetic reflex and pain responses, there are no reports of its use for the treatment of RSD. This article reviews some promising results of hypnotherapy with three RSD sufferers. I discuss the role of hypnotherapy as a supportive adjunct to medical treatment. I also explore the possible role of hypnotherapy as a complementary treatment.
NOTES 1:
“Hypothetically, RSD represents a continuous excessive discharge of the regional sympathetic nerves. Such discharge normally occurs in response to an injury. In RSD this reflex response is unremitting despite the cessation or absence of an external stimulus” (p. 227).
The psychosomatic aspects of RSD are highly disputed. Some studies suggest a relationship between RSD and various psychopathological conditions. Also proposed is a predisposing character type, sometimes termed ‘Sudeck personality’ … patients who are generally anxious, inactive, and hypertensive. … Others cite chronic pain as the cause, not the result, of certain ‘typical’ behavior patterns and emotional responses (Abram, 1990; Ecker, 1984)” (p. 228).
“Reports of four cases described RSD treatment with temperature biofeedback. These studies suggest that the patients learned to warm the affected limb through increasing cutaneous circulation. The temperature change was associated with decreased regional sympathetic activity and decreased pain. Complete remission of symptoms is reported in three of these cases; significant improvement is reported in the fourth” (p. 228).
“Abram (1990) reported that in two independent studies the incidence of RSD was 6.3% and 10.7% of patients admitted to pain clinics” (p. 228).
“I hypothesized that hypnotic interventions could facilitate a decrease in local sympathetic nervous discharge. This would result in vasodilation and warming of the affected limb, decreased spasticity, and decreased pain. The following is a report of the effective treatment of three RSD cases with hypnotherapy” (p. 228).
Case #1. “The eventual resolution of her RSD symptoms was due, in part, to resolution of psychodynamic conflicts. … She had a grade-four profile on the Hypnotic Induction Profile (Spiegel & Spiegel, 1978). In later sessions she readily demonstrated superior hypnotic capacity, achieving such phenomena as spontaneous amnesia, negative hallucination, and somnambulism” (p. 229).
Case #2. … “She had a grade-three profile on the Hypnotic Induction Profile (Spiegel & Spiegel, 1978) Because of the success with the first patient, I used visualization techniques initially. … She responded more readily to kinesthetic and tactile suggestions. … These interventions produced dramatic improvement in the RSD symptoms” (p. 230).
Case #3. … “He had a grade-three profile on the Hypnotic Induction Profile (Spiegel & Spiegel, 1978). He was readily able to use visualization techniques. He was able to affect dramatic temperature changes (8-10 degrees F) by visualizing ‘warm’ vacation scenes and imagining the feeling of the ‘warm sun’ on the affected limb” (p. 231).
DISCUSSION mentioned, “The patients presented in this report were all highly motivated and demonstrated an above-average to superior hypnotic capacity. Despite the obvious limitations of such a selective sample, the actual treatment results support the initial hypothesis. The treatment results of these three cases indicate that hypnotherapy can be an adjunctive treatment to alleviate pain. Moreover, these results indicate that hypnotherapy can be a complementary treatment in RSD.
Morse, Donald R.; Martin, John; Moshonov, Joshua (1992). Stress induced sudden cardiac death: Can it be prevented?. Stress Medicine, 8, 35-46.
Previously, psychosomatically induced death relative to stress, hypnosis, mind control, and voodoo was discussed. In this article, emphasis is on one aspect of that – stress induced sudden cardiac death (SCD). A brief review is presented of the sympathetic aspects of the acute stress response and stress induced SCD. Findings from previous studies are presented to highlight sympathetic aspects of the acute stress response. This is followed by a presentation of various strategies to prevent of decrease the possibilities for stress induced SCD. These include long-term measures (e.g. diet control, smoking control, hypertension control, stress management strategies) and immediate measures (e.g. calm, controlled approach, elicitation of the relaxation response, selected use of drugs, and heart rate variability monitoring). Relative to prevention strategies, findings are presented both from previous studies and new investigations.
Spanos, Nicholas P.; Brice, Peter; Gabora, Natalie J. (1992). Suggested imagery and salivation in hypnotic and non-hypnotic subjects. Contemporary Hypnosis, 9, 105-111.
Salivation was measured in 100 subjects on both a baseline and post-test trial. Subjects in hypnotic, relaxation, and suggestion alone treatments were asked to imagine tasting a lemon during the post-test trial. Subjects in the suggestion alone and relaxation treatments exhibited significant baseline to post-test increments in salivation and, on the post-test trial suggestion alone subjects exhibited greater salivation than either hypnotic subjects or no treatment controls. Neither hypnotizability nor imagery vividness correlated significantly with suggestion-induced increments in salivation.
NOTES 1:
“Our findings, like those of numerous earlier studies (reviewed by White, 1978) indicate that instruction to imagine food substances enhance salivation. The fact that imagery-alone instructions were more effective in this regard than hypnotic imagery instructions was unexpected, but this finding is certainly consistent with the large body of evidence which indicates that hypnotic procedures are no more effective than non- hypnotic procedures at enhancing responsiveness to suggestions. Moreover, the present findings, along with those concerning wart regression (Spanos et al., 1988), contradict the hypothesis that hypnotic procedures are particularly effective at enhancing responsiveness to suggestion when the target response is not under direct voluntary control.
“The reasons for the superiority of the imagery-alone treatment to the hypnotic treatment at inducing saliva production remain unclear. Subjects in the three treated groups reported equivalent levels of suggested imagery vividness and, therefore, differences on that variable could not have mediated treatment differences in the amount salivated. On the post-test trial the two treatments that received relaxation instructions (hypnosis and relaxation groups) failed to differ significantly from controls in amount salivated, whereas imagery alone subjects did differ from controls in this respect. Perhaps high levels of relaxation produce a slight inhibition of salivation which at least partly offsets the enhancement produced by suggested imagery. This hypothesis is, of course, highly tentative, and the finding of somewhat less salivation in groups administered relaxation instructions requires replication before further speculation is warranted.
“The finding that controls exhibited a significant decrease in salivation was also unexpected, and the reason for this finding remains unclear.
“Neither the Betts QMI nor any of the hypnotizability indexes correlated significantly with the suggestion induced increments in salivation. On the one hand, these findings are consistent with those of previous studies, which reported no relationship between imagery and/or hypnotizability and suggestion-induced changes in target responses that were not under subjects ‘ direct control (e.g. Surman et al., 1973; Swirsky- Sacchetti & Margolis, 1986; Spanos et al., 1988). On the other hand, our results failed to replicate White’s (1978) finding of a significant correlation between suggestion-induced salivation and Betts QMI scores. Our study differed from that of White (1978) in several important respects. White asked subjects to imagine several foods which they preferred to differing degrees. Significant differences in salivation for subjects classified as high, medium or low on the QMI were found only when subjects imagined preferred foods. Furthermore, subjects classified as high and medium on the QMI tended to salivate to similar degrees when imagining preferred foods, but salivated more under these conditions than low QMI scorers. In the present study all subjects imagined the same food stimulus regardless of preference, and subjects were not selected for extreme scores on the QMI. These differences between our study and that of White (1978) may account for our failure to obtain a significant relationship between QMI scores and imagery-induced salivation” (p. 109).
1991
Van Der Kolk, Bessel; Van Der Hart, O. (1991). The intrusive past: The flexibility of memory and the engraving of trauma. American Imago, 48, 425-454.
Describes the work of Janet concerning narrative versus traumatic memory, dissociation, and subconscious fixed ideas. Janet (1904) believed PTSD patients suffer from a phobia for the traumatic memory. Repression and dissociation are distinguished. Contemporary concepts of memory processing and the concept of schemas are then reviewed. Finally, a model is presented about how the mind freezes some memories. Evidence for the involvement of autonomic hyperarousal, triggering, and state dependent learning in PTSD is reviewed. They conclude that helplessness and the inability of the PTSD victim to take action (psychological and physical immobilization) facilitates dissociation. Includes practical ideas for the working through of trauma.
NOTES 1:
p. 443 “Traumatic memories are triggered by autonomic arousal … and are thought to be mediated via hyper-potentiated noradrenergic pathways originating in the locus coeruleus of the brain… The locus coeruleus is the ‘alarm bell’ of the central nervous system, which properly goes off only under situations of threat, but which, in traumatized people, is liable to respond to any number of triggering conditions akin to the saliva in Pavlov’s dogs. When the locus coeruleus alarm gets activated, it secretes noradrenaline, and, if rung repeatedly, endogenous opioids. These, in turn, dampen perception of pain, physical as well as psychological (van der Kolk et al. 1989). These neurotransmitters which are activated by alarm affect the hippocampus, the amygdala and the frontal lobes, where stress-induced neurochemical alterations affect the interpretation of incoming stimuli further in the direction of ’emergency’ and fight/flight responses” (p. 443).
1990
Ader, Robert; Felton, David; Cohen, Nicholas (1990). Interactions between the brain and the immune system. In Cho, Arthur K.; George, Robert; Blaschke, Terrence (Ed.), null (30, pp. 561-602). Palo Alto, CA: Annual Reviews Inc..
NOTES:
“Without attempting to cover all the literature, we have used stress effects and conditioning phenomena as illustrations to point out that behavior can influence immune function. We have also described data indicating that the immune system can receive and respond to neural and endocrine signals. Conversely, behavioral, neural, and endocrine responses seem to be influenced by an activated immune system. Thus, a traditional view of immune function that is confined to cellular interactions occurring within lymphoid tissues is insufficient to account for changes in immunity observed in subhuman animals and man under real world conditions.
“These data question seriously the notion of an autonomous immune system. … The immune system is, indeed, capable of considerable self-regulation, and immune responses can be made to take place in vitro. The functions of that component of adaptive processes known as the immune system that are of ultimate concern, however, are those that take place in vivo. There are now compelling reasons to believe that in vivo immunoregulatory processes influence and are influenced by the neuroendocrine environment in which such processes actually take place … . The immune system appears to be modulated, not only by feedback mechanisms mediated through neural and endocrine processes, but by feedforward mechanisms as well. The immunologic effects of learning, an essential feedforward mechanism, suggest that, like direct neural and endocrine processes, behavior can, under appropriate circumstances, serve an immunoregulatory function in vivo. Conceptually, the capacity to suppress or enhance immune responses by conditioning has raised innumerable questions about the normal operation and modifiability of the immune system via neural and endocrine processes.
“We do not yet know the nature of all the channels of communication between the brain and the immune system or the functional significance of the neural and endocrine interrelationships that have been established….
“This integrated circuitry has extensive ascending and descending connections among the regions cited. These regions also share many similarities. They are sites intimately involved in visceral, autonomic, and neuroendocrine regulation. The cortical and limbic forebrain regions mediate both affective and cognitive processes and may be involved in the response to stressors, in affective states and disorders such as depression, in aversive conditioning, and in the emotional context of sensory inputs from the outside as well as the inside world. From an immunologic perspective, these regions are the sites in which lesions result in altered responses of cells of the immune system; they are the regions that respond to immunization or cytokines by altered neuronal activity or altered monoamine metabolism; and they are the regions that possess the highest concentration of glucocorticoid receptors and link some endocrine systems with neuronal outflow to the autonomic and neuroendocrine systems. Thus, this circuitry is the major system of the CNS suspected to play a key role in responding to immune signals and regulating CNS outflow to the immune system” (pp. 587-589).
1989
Kramer, Richard L. (1989). The treatment of childhood night terrors through the use of hypnosis – a case study: A brief communication. International Journal of Clinical and Experimental Hypnosis, 37 (4), 283-284.
Night terrors are nocturnal episodes of intense autonomic arousal which are manifested by loud shouting or screaming in terror. The sufferer is not awake and is generally completely amnestic for the episodes. Night terrors and other sleep disturbances, such as somnambulism, are disorders of arousal (Broughton, 1968; Fisher, Kahn, Edwards, & Davis, 1973; Guilleminault, 1987). A 10-year-old white male was treated for a 6-year-long bout of night terrors. The hypnotic induction consisted of the finger lowering technique where the middle 2 fingers were raised and the individual was asked to watch the fingers as they “go to sleep.” He was given suggestions for dropping off to sleep gradually and for rotating cycles of sleep. The regularity and continual movement of the cycles of sleep were emphasized. He was also given direct suggestions for not dropping too quickly into an extremely deep stage of sleep. He has not had a recurrence of night terrors since that time (approximately 2 years). Psychodynamic issues are discussed as is the need for further research.
1987
Meyer, von H. K.; Diehl, B. J. M.; Ulrich, P.; Meinig, G. (1987). Kurz- und langfristige Anderungen der kortikalen Durchblutung bei Autogenem Training[Short and long-term changes in cortical circulation caused by autogenic training]. Zeitschrift fur Psychosomatische Medizin und Psychoanalyse, 33 (1), 52-62.
English Summary. The well-known hyperfrontal pattern of hemispheric blood flow measured with 133-Xenon is not found in 12 healthy resting men who have been practicing Autogenic Training at least six months. This might indicate a long-term decrease in the level of activation. Successfully practiced exercises of Autogenic Training lead to an increased blood flow in the Rolandic area representing the body scem (sic) and to a decreased blood flow in regions related to acoustical attention and to autonomic functions. Left hemispheric cerebral blood flow is lower in rest. The relative activation of the left hemisphere during Autogenic Training is discussed.
Minichiello, William E. (1987). Treatment of hyperhidrosis of amputation site with hypnosis and suggestions involving classical conditioning. International Journal of Psychosomatics, 7-8.
Hyperhidrosis of an amputation site utilizing hypnosis and/or behavioral strategies has not been reported in the literature. This case report is on the successful use of hypnosis utilizing principles of classical conditioning in the treatment of a patient with hyperhidrosis of an amputated limb with two previous unsuccessful sympathectomies. The patient possessing moderate hypnotic ability as measured by the Stanford Hypnotic Clinical Scale (SHCS), reported a pre-treatment score of 10 on a 0-10 severity and intensity of sweating scale, and a post-treatment score of 0. All gains were maintained at the two-year follow-up.
NOTES 1:
The patient was hypnotized while an electric fan was blowing on his stump and prosthesis. Direct suggestions were given according to procedures of thermal biofeedback. The suggestions were: 1. You will notice in days ahead that your stump feels increasingly cooler and drier. 2. You will feel throughout the day as if a cool breeze from a fan is blowing on your stump. 3. Whenever you pay attention to your leg during the day, particularly after the first few hours of the morning, you will associate that leg with a cool dry breeze from a fan blowing on it. 4. You will increasingly develop the power to cool and dry your stump.
The results were that 2 1/2 weeks later patient reported reduced frequency and intensity of sweating and significant healing of the stump ulcers; rating = 2. One month later, patient reported continued progress with almost normal skin color and stump condition; the patient discontinued disability, and returned to work. Patient returned one month later reporting, “It’s cured and my physician can’t believe it.” Rating = 0. Author concludes that hypnosis should be tried prior to more invasive traditional procedures. In this case two previous sympathectomies failed to correct the condition and a third sympathectomy was being contemplated.
1986
Olness, Karen N. (1986, March). Hypnotherapy in children: New approach to solving common pediatric problems. Postgraduate Medicine, 79 (4), 95-105.
Hypnotherapy, once thought of as magical and mysterious, is rapidly becoming accepted as an appropriate form of treatment for a wide range of disorders. Some primary care physicians are beginning to discover the value of hypnotherapy in controlling chronic disease and pain, in changing negative behavior, and in facilitating self- regulation of autonomic responses. Dr. Olness explores such use of hypnotherapy in children, the age-group that most readily acquires self-hypnosis skills and in which this technique has had dramatic results.
Omer, Haim; Friedlander, Dov; Palti, Zvi (1986). Hypnotic relaxation in the treatment of premature labor. Psychosomatic Medicine, 48, 351-361.
Hypnotic relaxation was used as an adjunct to pharmacologic treatment with 39 women hospitalized for premature contractions in pregnancy. The control group received medication alone and consisted of 70 women. Treatment was started at the time of hospitalization and lasted for 3 hr on the average. patients were also given cassettes with a hypnotic – relaxation exercise for daily practice. The rate of pregnancy prolongation was significantly higher for the hypnotic – relaxation than for the medication- alone group. Infant weight also showed the advantage of the hypnotic – relaxation treatment. Background variables of the two groups were compared and it was shown that they could not have explained the treatment effect obtained.
Wickramasakera, Ian (1986). A model of people at high risk to develop chronic stress-related somatic symptoms: Some predictions. Professional Psychology: Research and Practice, 17, 437-447.
Certain measurable high-risk factors that predispose people to develop functionally based somatic disorders are identified. These risk factors compose a multidimensional model that encompasses variables involved in the predisposition, the precipitation, and the buffering of stress-related symptoms. These high-risk factors are (a) high or low hypnotic ability, (b) habitual catastrophizing cognitions and pessimistic belief systems, (c) autonomic lability or neuroticism, (d) multiple major life changes or multiple minor hassles over a short period of time, and (e) a deficit in support systems or coping skills or both.
1985
Tranel, Daniel; Damasio, Antonio R. (1985, June). Knowledge without awareness: An autonomic index of facial recognition by prosopagnosics. Science, 208 (4706), 1453-1454.
Prosopagnosia, the inability to recognize visually the faces of familiar persons who continue to be normally recognized through other sensory channels, is caused by bilateral cerebral lesions involving the visual system. Two patients with prosopagnosia generated frequent and large electrodermal skin conductance responses to faces of persons they had previously known but were now unable to recognize. They did not generate such responses to unfamiliar faces. The results suggest that an early step of the physiological process of recognition is still taking place in these patients, without their awareness but with an autonomic index.
1984
Conn, Lois; Mott, Thurman, Jr. (1984). Plethysmographic demonstration of rapid vasodilation by direct suggestions: A case of Raynaud’s Disease treated by hypnosis. American Journal of Clinical Hypnosis, 26, 166-170.
Raynaud’s Disease is a painful vasospastic disorder of the fingers and toes precipitated by cold or emotional stimuli. Treatment has usually included protection from cold stimuli and vasodilators. Biofeedback, imagery, relaxation, and hypnosis have also been used. The relationship between response to treatment and hypnotizability has been inconclusive. A case of Raynaud’s Disease was treated using hypnosis. The patient was highly hypnotizable and responded rapidly to direct suggestion with a fourfold increase in her blood volume. The implications of this rapid response and its relationship to hypnotizability are discussed with suggestions for further studies.
NOTES 1:
The authors review experimental literature on the usefulness of hypnosis in modifying peripheral circulation, finding both positive (Barabasz and McGeorge, 1978, Roberts, Kewman, and MacDonald, 1973) and negative (Peters, Lundy, and Stern, 1973; Black, Edholm, Fox, and Kidd, 1963) outcomes. Experiments relating outcome to hypnotizability also have positive (Block, Levitsky, Teitelbaum, and Valletta, 1977) and negative (Crosson, 1980; Roberts et al, 1973) results.
Clinical literature found that peripheral circulation could be influenced (Crasilneck & Hall, 1975; Norris & Huston, 1956; Jacobson et al., 1973) but none of those studies reported the hypnotizability of the patients. In the Crasilneck and Hall (1975) investigation, 60% of their 48 Raynaud’s patients experienced marked improvement in symptoms or remission.
Hypnotizability has been investigated with respect to biofeedback results, finding both no relationship (Holroyd et al., 1982) and a positive relationship (Andreychuk and Skriver, 1975).
In this investigation, the highly hypnotizable (Stanford Hypnotic Susceptibility Scale, Form A, score = 11) female patient was treated with hypnosis when the blood vessels in her hands were constricted. Either she had arrived at the office with poor circulation, or a Raynaud’s attack was induced with ice water. Hypnosis involved progressive relaxation followed by suggestions to visualize the blood vessels in her hand opening up, the blood warming and nourishing her hands. “With each beat of your pulse your hand becomes warmer as more blood reaches your fingers. It is as though you are lying in the warm sun. Try to visualize the blood vessels in your hand opening up….” (P. 168).
The patient was asked to use self hypnosis and a cassette of the office session twice a week between sessions, but in fact she either failed to practice or did the exercise once between weekly sessions.
With neutral hypnosis (no specific suggestions about circulation) there was little change in pulse volume; with suggestions to open up her blood vessels, there was an increase in blood volume that began within 20 seconds, reaching four times the baseline in 45 seconds. This increase was reproduced in later sessions, and a somewhat lesser degree of change could be produced with self hypnosis.
In their Discussion, the authors question whether the positive results depend on someone who is high in hypnotizability, and/or on someone with a labile vascular system. They refer to a model of biological information processing to explain how suggestions might have been incorporated by the patient. “Bowers (1977) has speculated that hypnotized patients process information in a way different from when they are not hypnotized. He presents a number of different studies which have shown a significant relationship between hypnotizability and treatment response in patients with illnesses with a clear cut physiological component, including asthma, warts, and icthyosis. He then speculates that ‘suggestions delivered to deeply hypnotized subjects can be transduced into information that is somatically encodable, thereby producing a selective and specific impact on body function and structure.’ This kind of processing of information could explain the very rapid response described in the patient presented here.
“In reviewing the cases in which blistering has been produced by hypnotic suggestion, Chertok (1981) states, ‘It therefore clearly emerges that these experiments have all been conducted with _highly hypnotizable_ subjects, including a very large proportion of true somnambulists. Inversely, there is not a single known case where a blister has been produced without the subject having been deeply hypnotized beforehand'” (p. 169).
1983
Braun, Bennett G. (1983). Psychophysiological phenomena in multiple personalities and hypnosis. American Journal of Clinical Hypnosis, 26 (2), 124-137.
NOTES 1:
“Conclusion. As can be seen from the above example, the final common pathway, physiologic expression, which is seen in multiple peronality is not bizarre when compared with physiologic changes achieved in non-multiples using hypnosis or, in certain cases, non-multiples without the use of hypnosis. A form of hypnosis/autohypnosis* may be a common denominator. The neurophysiologic changes shown by Putnam et. al. (1982), but not observed by Coons (1982), may well have a similar explanation. The question of the neurophysiologic effect of hypnotic suggestion has not as yet been studied with appropriate controls or safeguards.
“That multiples do show significant changes in their psychophysiologic response patterns cannot be denied. To consider that the psychophysiologic chages of multiple personality aer so rare or different as to make multiples ‘freaks’ is not only a disservice to them, but to medical science, since it blocks thinking. The study of multiple personality will further our understanding, theorizing, and treatment of mental and physical illness” (p. 134). “*These terms are being used here in the generic sense” (p. 134).
1980
Bauer, K. E.; McCanne, T. R. (1980). Autonomic and central nervous system responding during hypnosis and simulation of hypnosis. International Journal of Clinical and Experimental Hypnosis, 28 (2), 148-163.
Heart rate, electrodermal responding, respiratory rate, frontalis muscle tension, and occipital electroencephalographic activity were monitored while 6 female Ss were experiencing hypnosis and while 6 other female Ss simulated the experience of hypnosis. Physiological data were collected during 7 sessions on 7 consecutive days. The results indicated no differences in physiological responding between hypnotized and simulating Ss. Both groups of Ss exhibited significant decreases in heart rate and amount of electroencephalographic alpha activity during their experiences, relative to pre- and posthypnotic or simulating levels. In addition, both groups of Ss exhibited significant increases in electroencephalographic beta activity during their experiences. Both groups of Ss also displayed lowered levels of electrodermal activity, skin conductance, and respiratory rate during their experiences. The changes in these modalities, however, were significant for hypnotized Ss, but were generally not significant for simulating Ss. Both groups of Ss also manifested lowered levels of muscle responding during their experiences, but these changes in responding were not significant for either group of Ss. The results are discussed in terms of several current theories of the nature of the hypnotic experience.
1975
Cowings, Patricia S. (1975, September). Observed differences in learning ability of heart rate self-regulation as a function of hypnotic susceptibility. [Paper] Presented at the 3rd Congress of the International College of Psychosomatic Medicine, Rome.
Three groups of eight men and women were given personality tests and were taught to control their own heart rates. Experimental group I and the control group had low hypnotic susceptibility (Stanford Hypnotic Susceptibility Scale), and subjects in experimental group II had high hypnotic susceptibility. The experimental groups received autogenic therapy and biofeedback, while the control group was given biofeedback only. Subjects who received autogenic therapy and biofeedback performed better than the control group. Significant differences, however, were found in all psychological test scores between high and low hypnotic susceptibles.
1974
Bloom, Richard F. (1974). Validation of suggestion-induced stress.
NOTES 1:
Technical Memorandum 23-74 (October 1974), US Army Human Engineering Laboratory, Aberdeen Proving Ground, Maryland 21005, AMCMS Code 5910.21.68629, Contract No. DAAD05-73-C-0243, Dunlap and Associates, Inc. (now Stamford, CT), AD002557.
Sixty college men, divided into three equal groups, each attended two induced stress sessions in which their physiological, psychological and performance reactions were measured. Their responses were compared to determine if valid stress reactions could be induced through suggestion in an altered state (in this case, hypnosis), and also to determine the validity of such reactions if the subject had never before experienced that stress situation. It was demonstrated that valid stress reactions can be induced in an individual with the aid of suggestions, especially if the real stress situation has been experienced before. If no previous experience with that real situation exists, the subject still exhibits stressful reactions; however, the closest resemblance to real stress is found in the subjective or psychological measures, less similarity is found in the physiological measures, and the least similarity is found in the performance measures.
1957
Schneck, Jerome M. (1957). Hypnoanalytic observations on the psychopathology of fainting. Journal of Clinical and Experimental Hypnosis, 5 (4), 167-171. (Abstracted in Psychological Abstracts 62: 3 II 67S)
NOTES 1:
“Summary
Varieties of fainting have been described as hysterical syncope, vasodepressor syncope, and carotid sinus reactions, among others. Fainting has been linked in general with personality problems, emotional instability, and immaturity. It has been called a mechanism for blocking of ego functions in its role of primitive defense against overwhelming stimuli. The present paper gives in greater detail the specific dynamics in a patient with fainting episodes. A crucial event incorporating major dynamic ingredients was an operative procedure in childhood. The psychological impact of this trauma was revivified during a spontaneous hypnotic regression. The personality matrix significant for this patient in relation to the fainting episodes consisted of passive, masochistic submission to a dominant, highly influential mother whose pressure was felt by the patient as pervasive and stifling. Circumstances associated psychologically with this feeling apparently triggered the fainting reactions. As he matured through the years and cast off increasingly this type of maternal influence, the tendency toward fainting reactions diminished” (p. 170).
1956
Bigelow, Newton; Cameron, G. H.; Koroljow, S. A. (1956). Two cases of deep hypnotic sleep investigated by the strain gauge plethysmograph. Journal of Clinical and Experimental Hypnosis, 4 (4), 160-164.
NOTES 1:
“Two subjects, studied by means of a strain gauge plethysmograph, have shown greater changes in the peripheral pulse and the finger volume during deep hypnosis than they did immediately before or after. In the absence of external stimuli, the presence and the degree of such changes reflect the activity of the autonomic nervous system. This result suggests that in hypnosis the inhibiting tendency of the cortex on the autonomic nervous system is reduced or nullified” (p. 164).
1955
Stolzenberg, Jacob (1955). Clinical application of hypnosis in producing hypno-anesthesia control of hemorrhage and salivation during surgery. A case report. Journal of Clinical and Experimental Hypnosis, 3 (1), 24-27.
NOTES 1:
The patient was a 14 year old male with an impacted mandibular left first molar. A series of surgical interventions were required to remove granulation tissue, overlying bone, and fibrotic tissue prior to orthodontic procedures. Hypnoanesthesia and suggestions to stop bleeding and salivating were successfully employed. In fact “It was noticeable with the last two procedures that spontaneous dryness occurred without any suggestion by the operator” (p. 26).
1952
West, Louis Jolyon; Niell, Karleen C.; Hardy, James D. (1952). Effects of hypnotic suggestion on pain perception and galvanic skin response. A. M. A. Archives of Neurology and Psychiatry, 68, 549-560.
A study is reported in which pain perception and galvanic skin responses of seven subjects were measured before and during hypnosis. The depths of hypnotic trance varied from light to deep. Stimuli of measured intensity were administered, and changes in pain threshold were measured. Quantitative estimates of pain intensity were made by the subjects. Alterations in ability to discriminate between pains of differing intensities were noted. Quantitative records of galvanic skin responses were utilized, permitting statistical analysis of data from matched pairs. Data were collected at 45 experimental sessions, during which a total of 478 painful stimuli were administered, the stimuli varying in intensity from threshold to blister- producing levels. At each session, the subject’s sensations from and responses to stimuli during a control period were compared with sensations from and responses to identical stimuli administered after hypnotic suggestions of anesthesia. The following observations were made: 1. Hypnotic suggestions of anesthesia influence pain perception by causing elevation of pain threshold, hypalgesia, and analgesia. 2. When hypnotic suggestions of anesthesia caused hypalgesia and elevation of pain threshold, ability to discriminate among stimuli of different intensities was impaired. 3. There was a general correlation between the depth of hypnotic trance and the degree to which pain perception was altered by hypnotic suggestion. 4. The galvanic skin response to noxious stimulation was diminished, and it sometimes disappeared, as a result of hypnotic suggestions of anesthesia. The galvanic skin response was affected even when there was no alteration in pain perception, according to subjective reports.
NOTES: The authors review literature on the effects of analgesia suggestions on the galvanic skin response and other autonomic nervous system responses. The present study differs from previous studies in the following ways: “1. The subjects were studied in various stages of hypnosis. 2. Quantitatively determined noxious stimuli were used instead of pinching or pinprick. 3. Changes in pain threshold were measured. 4. Quantitative estimates of pain intensity were made by the subject in the hypnotized and the unhypnotized state. 5. Changes in ability to discriminate between pains of differing intensity were noted. 6. Quantitative records of galvanic skin responses in the control and in the hypnotized state were utilized” (p. 552).
Analgesia was defined as “that state in which none of the noxious stimuli administered were reported as painful;” hypalgesia was defined as “a state in which noxious stimuli were reported as less painful than would be expected on the basis of reports of the same subject regarding the same stimuli in control situations” (p. 554).
In their Discussion, the authors state, “As a result of hypnotic suggestions of anesthesia, the following effects on sensation were observed: (1) no alteration in reports of pain intensity; (2) hypalgesia for higher-intensity stimuli without elevation of the pain threshold; (3) definite elevation of pain threshold with hypalgesia; (4) analgesia; (5) disturbances in pain discrimination.
” The third effect was observed in the majority of trials. The threshold elevation in light trances may be similar to that which can be produced by suggestion in the unhypnotized subject, but in deeper trances the effectiveness of hypnotic suggestion is much greater. The progression of effects 1 through 4 appears to be directly related to the depth of trance. The fifth effect was variable and was seen only in conjunction with the third effect. It is described as a separate phenomenon because the disturbance of ability to discriminate relatively between stimuli of differing intensities was only clearly observed when we were remeasuring pain thresholds. In actuality, it may merely represent a facet of altered pain perception, and the variability of its appearance may be related to the variable psychological state of the subject. It must be kept in mind that the hypnotic trance is not a static state” (p. 558). For one Subject, analgesia decreased in successive hypnotic sessions, while for four Subjects analgesia increased; a sixth Subject exhibited overall variability in hypnotic depth and analgesia from session to session.
The authors indicate that their review of the literature found no evidence that hypnosis, absent suggestions for analgesia, affects the galvanic skin response. In the present study, diminishment of the GSR is related to, though not dependent on, the effectiveness of the suggestion of anesthesia. “Thus, in Subject 2, with only moderate hypalgesia, the GSR to noxious stimuli was diminished by 64%; in S 6, with analgesia on nearly all trials, only 57%. It is particularly interesting that S 1 had a reduction in GSR of 26% after hypnotic suggestions which apparently had no effect upon his pain perception, and which seemed even to make him anxious. S 5 showed a direct correlation between depth of trance and decrease of GSR while Subjects 6 and 7 showed no such correlation” (p. 559).
“It is important to realize that on some occasions hypnotic anesthesia apparently led to complete disappearance of the GSR to all stimuli during a given session, such stimuli evoking pain of 6 or 7 dols in the control period. This phenomenon was seen twice with Subject 3, twice with Subject 5, and once with Subject 6. In several trials there was only a very slight GSR to the higher stimuli during hypnosis. In all the control periods there was only one occasion on which a stimulus evoking pain of 6 or 7 dols failed to produce a GSR, while equally intense stimulation failed to produce a GSR on 14 occasions after hypnotic suggestions of anesthesia. This observation is stressed because it suggests a need for caution in the clinical use of the GSR to distinguish organic from hysterical anesthesias” (pp. 559-560).
B RESEARCH
Body Image
1989
Van Denberg, Eric J.; Kurtz, Richard M. (1989). Changes in body attitude as a function of posthypnotic suggestions. International Journal of Clinical and Experimental Hypnosis, 37, 15-30.
Hypothesized that highly hypnotizable subjects who remained amnesic for posthypnotic suggestions to improve body attitude would show greater changes than subjects who were not amnesic. Subjects given simulating instructions were used as a comparison group to assess experimental demands. 48 females were screened with the Harvard and assigned to one of 4 conditions: (a) high hypnotizable with amnesia suggestions, (b) high hypnotizable without suggested amnesia, (c) low hypnotizable simulator with amnesia, and (d) low hypnotizable simulator without suggested amnesia. A fifth group was formed of those high hypnotizable subjects who remembered the suggestion despite instructions to the contrary. The Body Attitude Scale (Kurtz, 1966) was administered prior to and 3 days after the experimental suggestions. Results generally demonstrated that high hypnotizable amnesic subjects manifested the greatest attitudinal and phenomenological changes as a result of the posthypnotic suggestion, although conclusions were tempered by performance of simulating subjects. The implications for hypnosis research and clinical practice are discussed.
NOTES:
“The hypothesis that hypnotized subjects would report greater positive changes in affect, self-esteem, and social functioning than simulators was tested using a brief structured questionnaire. An analysis of Subjects responses to the questionnaire while with the ‘blind’ research assistant (simulators in role) revealed number significant differences between groups (N = 48) on six of the seven questions. … An analysis of Subjects’ responses to the questionnaire while being debriefed by the primary investigator (simulators out of role) revealed significant differences among groups (N = 48) on three of the seven questions. … High hypnotizable subjects with maintained amnesia demonstrated a strong tendency to be the most responsive of all groups of subjects on the first and second assessment. In contrast, the high hypnotizable Ss for whom amnesia ‘broke down’ reported the fewest phenomenological changes of any of the five groups during the first assessment, and comparatively few during the second assessment. Also of note is that once out of their role, simulators in both conditions dramatically reduced their reporting of positive change” (pp. 23-24).
“Moreover, a closer examination of the data demonstrated that phenomenological and behavioral differences in the groups did appear at several points during the experiment. For example, the 10 high hypnotizable subjects told to explicitly remember the suggestion did so, while 3 of the 10 simulators in this condition claimed to have forgotten it. On debriefing, these Subjects reported they did this because they believed ‘really hypnotized subjects wouldn’t be able to remember anything, even if they were told they could.’ Further, no simulator in the amnesia condition reported they could recall the suggestion, in contrast to the high hypnotizable subjects, 44% of whom said they did remember it. With regard to phenomenological differences, simulators stated during debriefing with the primary investigator that they intentionally faked changes on BAS, and that they experienced no true effects from the suggestion for positive body attitude change. In contrast, high hypnotizability amnesic subjects reported global, pervasive changes in their mood and self-esteem that went beyond specific alterations in attitudes toward their appearance. By comparison, high hypnotizable subjects told to remember the suggestion reported greatly increased self-absorption and acute awareness of the suggestion, ‘sort of like a broken record in my head'” (pp. 25-26).