2 studies are reported, one using hypnotized Ss selected on hypnotizability and one using Ss selected on imagery vividness, whose purpose is to examine whether non-patient Ss can control their bleeding in a laboratory setting. All Ss were cut on both arms with the “Surgicutt” device, an instrument that automatically makes a cut that will bleed from 2 to 10 minutes. Results suggest that Ss, who are instructed to reduce the bleeding time in one arm and to let the other arm bleed normally, are not able to control bleeding time.

Madrid, Antonio D.; Barnes, Susan v.d.H. (1991). A hypnotic protocol for eliciting physical changes through suggestions of biochemical responses. American Journal of Clinical Hypnosis, 122-128.

We employed brief hypnotherapy to effect physical changes in patients suffering from medical disorders including allergies, rectal bleeding, systemic lupus, hyperemesis, headache, asthma, and chronic pain. We present, in language appropriate to the individual patient, considerations and suggestions to effect the release of healing biochemicals. Ideomotor signals indicated the patient’s awareness of the healing. We hypothesize that the technique triggered novel state-dependent memory, learning, and behavior.

They hypothesize that the technique they use triggers novel state-dependent memory, learning, and behavior (See for example Rossi, 1987, and Rossi & Cheek, 1988).
Hypnotic Protocol: “1. Tell the patient that he can heal himself by allowing his body to supply its own biochemicals needed to make him well. If a specific biochemical is known, such as cortisone or endorphins, name it. “2. Hypnotize the patient. Resistant or hard to hypnotize patients need not be deeply hypnotized because the patients, using this protocol, will automatically go into trance while accomplishing the next task of accessing and using ideomotor signals (Erickson, 1980; Rossi & Cheek, 1988). “3. Tell the patient that his index finger will automatically and involuntarily twitch and float when his body releases the biochemicals he needs. This ideomotor response (Rossi & Cheek, 1988) is the sole physical response required of the patient. Rossi hypothesizes that the ideomotor response correlates with biochemical changes (Rossi & Cheek, 1988). “4. Next, ask the patient to consider some things (as described below). Present the considerations one after another until one of them triggers the ideomotor response. “5. In some instances, ask the patient to practice on his own. Many patients who have dramatic emotional reactions during or at the completion of the task may not need to practice on their own” (p. 123).
They present several ‘considerations’ to the patient, one after the other, tailored to the patient’s specific case, until his finger twitches or floats, indicating a biochemical response. For example, the following ‘considerations’ have been used: “1. Psychodynamic: ‘Consider that you are not blamed for anything; that you are in fact perfect just the way you are; that you are loved by those you care about.’ ‘Consider that you can forgive whoever needs forgiving for hurting you.’ ‘Consider that there are no longer any threats; everything is better; everything is as it used to be.’ “2. Autosuggestion: ‘Tell your body to heal. It knows what to do; so ask it to do it.’ ‘Tell your adrenal glands to produce the steroids that your body needs.’ ‘Allow a glowing light to permeate that injured back, filling it with healing energy.’ “3. Incompatible responses: ‘Cover yourself with a cool breeze, cooling the injured leg.’ ‘Imagine your back getting slack and limp and relaxed.’ ‘Imagine your stomach lining becoming smooth and moving with easy, ocean-like waves.’ “4. Emotion calling: ‘Consider yourself feeling very happy with everything, for no reason at all.’ ‘Consider yourself getting angry at someone–your mother, your wife (husband), your boss, your lawyer.’ “5. Bargaining: ‘Tell yourself that you will heal if you agree to stay away from that job.’ ‘Tell yourself you will heal by allowing your right arm to begin to hurt when you are over- exerting yourself.’ ‘Tell yourself that you will heal in exchange for something else, not so serious, to replace this disease and to serve the same function'” (pp. 123-124).
They present seven cases involving, respectively, allergies, rectal bleeding, systemic lupus, hyperemesis of pregnancy, adult onset asthma, chronic pain, and cluster headaches. Two cases were particularly interesting because they represented patients who did not respond initially.
Their procedure involves reframing the state or emotion originally associated with the onset of disease using considerations, and then giving a suggestion that it is within the power of the person, rather than factors outside, to heal the body. First they instruct the patient that the body can heal itself; then they give the list of suggestions for the patient to consider, persisting with different considerations until they get an ideomotor response. Incorporation of the patient’s psychodynamic issues appears to be very important.
The authors regard it as unimportant if the patient cannot by hypnotized; “As Cheek (Cheek & LeCron, 1968; Rossi & Cheek, 1988) points out, the patient’s inability to be hypnotized may be synonymous with his disease. It is actually beneficial if the patient cannot achieve ideomotor responses at first because both he and the therapist then trust the validity of the response when it does occur after the appropriate consideration” (p. 127).
Palan, Bhupendra M.; Lakhani, Jitendra D. (1991). Converting a ‘threat’ into a ‘challenge’: A case of stress-related hemoptysis managed with hypnosis. American Journal of Clinical Hypnosis, 33 (4), 241-247.

A 24-year-old patient was treated using hypnosis for chronic repeated episodes of hemoptysis. The symptom episodes were related to academic examinations (perceived as a threat by the patient). Clinical examinations and laboratory investigations failed to indicate an organic cause for hemoptysis. He did not respond to empirical treatment trials. These negative findings suggested the psychosomatic nature of the illness. We used hypnotherapeutic ego-strengthening and guided-imagery approaches. This reduced his acute anxiety but failed to check hymoptysis. Use of explorative hypnotic dreaming revealed an emotional trauma as the possible cause of origin of the symptoms. We restructured the trauma experience during hypnotic regression. We advised him to skip the upcoming examination and conducted a total of six therapeutic sessions. The patient continued using self-hypnosis throughout the follow-up period of 3 years during which he remained symptom free and achieved remarkable academic progress. He now perceives an examination as a challenge.

Azuma, Nagato; Stevenson, Ian (1988). ‘Psychic surgery’ in the Philippines as a form of group hypnosis. American Journal of Clinical Hypnosis, 31, 61-67.

Psychic surgeons and their patients were observed in the Philippines during a variety of procedures of ‘minor surgery.’ In six cases, subcutaneous tissues (cysts and benign tumors) were removed. Histological examination confirmed the gross diagnoses and left no doubt that the skin had been penetrated. Although the psychic surgeons used no analgesics or anesthetics, the patients appeared to experience little or no pain and only slight bleeding. The authors believe that a supportive group ‘atmosphere’ enables the patients to enter a quasi-hypnotic state that reduces pain and facilitates healing.

Swirsky-Sacchetti, Thomas; Margolis, Clorinda G. (1986). The effects of a comprehensive self-hypnosis training program on the use of factor VIII in severe hemophilia. International Journal of Clinical and Experimental Hypnosis, 34, 71-83.

Hemophilia, the bleeder’s disease, is characterized by internal bleeding episodes which have been associated anecdotally with psychological stress. The focus of the present investigation was to study the potential utility of a comprehensive self- hypnosis training program to decrease stress and to assess the amount of clotting factor used for bleeding by those individuals trained in self-hypnosis compared to a control group. 30 severe hemophiliacs on home therapy were randomly assigned to a treatment or to a waiting list control group. The treatment group received a comprehensive 6-week training program including support, education, deep relaxation, and self-hypnosis. Over the 18-week follow-up, the treatment group significantly reduced the amount of factor concentrate used to control bleeding in comparison to controls. The treatment group also significantly reduced general distress level as measured by a symptom checklist. The training was extremely cost effective, and the results support the efficacy of this comprehensive training program to augment the medical management of severe hemophiliacs on a home therapy regimen.

The authors begin with a discussion of the importance of being able to reduce the amount of blood factor concentrate required by hemophiliacs, including the problems of obtaining uncontaminated blood in an era of HTLV-III and LAV contamination and the fact that some patients with Hemophilia A have developed antibodies to Factor VIII (so- called inhibitor patients). When an inhibitor patient hemorrhages, it is potentially life- threatening. Earlier controlled clinical research by LaBaw (1975) indicated that hypnosis might be useful for decreasing blood usage. The current study builds upon that research and adds further control procedures.
The hypotheses of this study were: “(a) hemophiliacs who received the comprehensive training program including self- hypnosis along with education, support, and relaxation for stress management would significantly reduce the amount of factor concentrate used to control spontaneous bleeding in comparison to randomly assigned waiting list controls; (b) the general distress level, as measured by the SCL-90 (Derogatis, 1977), would significantly decrease for the treatment group from pretraining to follow-up; and (c) hypnotizability as measured by the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. C. Orne (1962) would show a positive correlation with the treatment effect” (p. 74).
The Subjects were patients of a hematologically severe status (less than 1% clotting factor present in the blood); ages 11-50, mean age 30; normally distributed on socioeconomic variables; and prescreened to rule out serious psychological dysfunction. The treatment and control groups did not differ in SES or pretest bleeding severity. Control Ss were informed that they would receive the same training after the initial follow- up period. Three Ss were lost from the treatment group because they did not complete the 6 weekly self-hypnosis training sessions, and three from the control group due to geographic move or decision to obtain treatment elsewhere.
Patients recorded their factor usage on log sheets, and their reports were checked with distribution records kept at the clinic. (Factor received during hospital stays was not included. Also 3 “inhibitor” patients–2 treatment, 1 control–were removed from some analyses because they must infuse Factor IX at a level that far exceeds the amount appropriate for body were an inhibitor not present.)
The Ss, in groups of 3-4 people, were educated about the effects of stress on bleeding, physiological signals of overstress, and then trained as a group in self hypnosis. Each training session began with a group hypnosis induction followed by various suggestions and imagery. They were given a cassette tape with suggestions for decreased bleeding, ego-strengthening, relaxation, and sensations of floating. In addition to listening to the tape at least once each day, they were taught rapid (1-2 minute) inductions to combat stress, and were to develop their own self-hypnosis procedure.
In terms of results, 9 of 11 (82%) treatment Ss and 4 of 10 (40%) control Ss decreased in blood factor usage (p<.05). There was a great deal of variability between Subjects. While the treatment group demonstrated an overall decrease in factor usage, the control group actually had an overall increase in usage. The authors speculate that possibly a change in season caused the increase, because several Ss reported that a change in season ordinarily caused an increase due to their arthritic joints. Also, a change to warmer weather might have led to increased physical activity. General distress, measured by General Severity Index of the SCL-90, was reduced significantly for the treatment group. (Results of SCL-90 aren't reported for control group.) The third hypothesis was not supported. In fact, the correlation between HGSHS:A and treatment effect was in the opposite direction from what was expected (- .25, n.s.). However, "there was a significant correlation (rho = .56, p<.025) between Ss' self-reported trance usage and change scores, indicating that those Ss who practiced self- hypnosis more were more likely to have decreased factor usage. There was also a trend (rho = .44, p<.10) between treatment Ss' change scores and their initial distress levels (GSI), suggesting that those Ss who were initially more distressed tended to profit more from treatment" (pp. 78-79). In their Discussion, the authors suggest that the fact that the treatment effect of decreased factor usage was consistent throughout the follow-up period suggests that reduced usage was not due to a placebo effect. They note that placebo responses are usually brief, and situation-specific (Frank, 1976). They see the need for further research to clarify which component(s) of the treatment program are effective (self-hypnosis, relaxation, education, social support), and to extend the length of follow-up period. Since hypnotizability did not correlate with outcome, the results might be due to some other component. Since outcome did correlate with amount of self hypnosis practice, motivation may be an important determiner of effect. Decreased stress was not only reported by Ss but also reflected in changes on the test scores (SCL-90). Also, several Ss spontaneously used the self hypnosis for school and occupational performance, and to relieve headaches. In terms of financial benefits, "the one patient who had the most significant decrease in factor usage noted an average monthly savings of $850. For the entire treatment group (including those few Ss whose factor usage increased), the training resulted in savings of $1240 per month over the follow-up period" (p. 81). 1985 Lichstein, Kenneth L.; Eakin, Terry L. (1985). Progressive versus self-control relaxation to reduce spontaneous bleeding in hemophiliacs. Journal of Behavioral Medicine, 8 (2), 149-162. Investigated the effects of progressive and self-control relaxation on spontaneous bleeding and collateral symptoms with 7 hemophiliacs (average age 32.6 years) in a combined multiple-baseline partial-crossover design. Following 6 or 12 weeks of training in either or both relaxation methods, there was no strong evidence that the treatment affected bleeding or perceived pain in these Ss. Results failed to replicate findings of W. L. LaBow (1975) or J. W. Varni (see PA, Vol 65:13289) (20 ref) 1984 Bishay, Emil; Stevens, Grant; Lee, Chingmuh (1984). Hypnotic control of upper gastrointestinal hemorrhage: A case report. American Journal of Clinical Hypnosis, 27, 22-25. The use of hypnosis for control of bleeding during and after surgical procedures is common practice. It has also been a useful tool for control of bleeding in hemophiliac children, especially during dental procedures, and in traffic accidents. 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. NOTES: The physician explained to the patient that nothing would hurt her and that nobody would do anything against her will, that if she could "relax," then her unconscious mind would help her control her bleeding. [Gives script used in the hypnosis.] Trance terminated after 20 minutes. "One hour later, endoscopy performed under local anesthesia revealed 'non-bleeding gastritis, no ulcers seen.' She had no bleeding following the hypnotherapy" (p. 23). LeBaron, Samuel; Zeltzer, Lonnie K. (1984). Research on hypnosis in hemophilia--preliminary success and problems: A brief communication. International Journal of Clinical and Experimental Hypnosis, 32, 290-295. Although little is known about physiological effects of hypnosis on hemophilia, hypnosis for reduction of pain and/or bleeding in hemophilia has attracted increasing attention. Literature on this topic is reviewed, and important problems in conducting clinical research on hypnosis for hemophilia are discussed. NOTES: Reviews literature on physiological effects of hypnosis on hemophilia (for reduction of pain and/or bleeding). Discusses problems in conducting clinical research on same. 1983 Fung, E. H.; Lazar, B. S. (1983). Hypnosis as an adjunct in the treatment of von Willebrand's disease. International Journal of Clinical and Experimental Hypnosis, 31 (4), 256-265. Hypnosis ahs been used to control bleeding, both in normals and hemophiliacs. Case material is presented to demonstrate how hypnosis was used as an adjunct to standard medical treatment of a boy and his mother with von Willebrand's disease, initially to reduce anxiety and improve self-esteem and the parent-child relationship, and later, to reduce bleeding. This use of hypnosis illustrates the relationship between hemostatic control and psychological adaptation. 1957 Crasilneck, Harold B.; Fogelman, Morris J. (1957). The effects of hypnosis on blood coagulation. Journal of Clinical and Experimental Hypnosis, 5 (3), 132-137. A series of hematologic methods designed to determine the coagulative function of the blood were performed on eight healthy individuals who had previously been conditioned to enter somnambulistic states of hypnotic sleep. Rigorous and quantitative experimental conditions and controls were followed throughout the four phases of the study. The results of the present study indicate that hypnosis and simple hypnotic suggestion are not correlated with any alterations of bleeding or blood clotting factors in normal man" (pp. 135-136). Solovey, Galina; Milechnin, Anatol (1957). Concerning the nature of hypnotic phenomena. Journal of Clinical and Experimental Hypnosis, 5 (2), 67-76. NOTES 1: The authors write about the place of the hypnotic state in general psychology: "the study of the _psychological mechanisms_ that make the appearance of the phenomenon _possible, which need not be different from the normal and current psychological mechanisms in everyday life_" (p. 67). They classify hypnotic phenomena into three groups: "I. Phenomena _which are a function of the state of psychological_ retrogression (hypnotic depth), appearing in spontaneously [sic] or when proposed by the operator. II. Phenomena which appear without any specific suggestion, as _a side issue of other suggestions,_ capable of originating emotional states in the subject. III. Phenomena _which are independent of all suggestion,_ being a constituent part of the hypnotic state itself, in its 'positive' or 'negative' forms" (p. 68). Using this framework, the authors describe several aspects of hypnosis: catalepsy, anesthesia, retrogression, the taking of a role, negativism and resistance, visceral changes, emotional stabilization, psychotherapeutic benefits (indirect). They observe that direct suggestions are often not necessary for therapeutic benefit, and give as an example the tendency for less bleeding when dentists suggest that patients will not feel less pain. "For the elucidation of this point, the authors carried out an experiment in a dental clinic, taking six easily hypnotizable subjects in whom dental extractions were to be performed. They were given only the suggestions that they would feel the doctor working, but not experience pain ... that they would pay no attention to it ... or even if they felt a little pain, this would not trouble them and they would bear it perfrectly ... Nothing was said about the loss of blood. As a result, in all the cases the loss of blood was slight, practically insignificant, though technically difficult extractions of roots were included" (p. 74). "The explanation of hypnotic phenomena as natural and normal consequences of the hypnotic emotional state, and of the state of psychological retrogression, eliminates the supposed mysterious powers of suggestion. _Suggestion is thus relegated to the modest role of a litmus paper which reveals the psychological functioning of the individual_ in an experimental environment. On the other hand, in everyday-life hypnosis, in the principal hypnotic relationships of parents with their children, of teachers with their pupils, etc. (11), suggestibility plays an important role in education or re-education" (p. 75). 1956 NOTES 1: The authors report on a demonstration of dental extractions with two patients (of five patients with whom hypnosis was attempted). They describe successful results despite 3-minute inductions in people not pre-trained, a terse and abrupt approach by the dentist (who uses only hypnosis and refers non-responding patients elsewhere). "While the hypnotist demonstrated effectively what could be done with hypnosis, his theoretical orientaton as to why this had occurred can only be described as unfortunate. In response to questioning he stated and quite flatly: that in hypnosis there are no dangers (1); that hypnosis is essentially cardiovascular in nature; that drugs had no place along with hypnosis--despite the advice of Moss (2) that dentists should use hypnosis along with drugs routinely unless the latter is contraindicated. He expressed his attitude toward the use of local anesthetics by indicating that the package he had had was thrown away because it had become spoiled from disuse. Hypnosis was presented in effect as an all or nothing technique" (p. 3). 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). 1953 Kroger, William S. (1953). Hypnotherapy in obstetrics and gynecology. Journal of Clinical and Experimental Hypnosis, 1 (2), 61-70. Author's Summary - "A high percentage of gynecologic complains [sic] are due to psychic factors. Therapeutic efforts, therefore, must be directed primarily toward the psychologic component. Until recently, the principal weapon of the dynamically oriented physician was orthodox psychoanalysis. However, the increased interest for a relatively rapid approach has demonstrated the diagnostic and therapeutic value of hypnoanalysis. This development has been concomitant with the psychoanalysist's [sic] interest in 'brief psychotherapy' and narcosynthesis. "In many functional gynecologic disorders, hypnoanalysis has supplanted the parent therapy even though this form of treatment utilizes the concepts of dynamic psychiatry. "The relevant literature on the use of hypnotherapy in functional obstetrical and gynecological disorders has been reviewed. "Significant areas for research have been pointed out. "This review emphasizes that hypnosis _per se_ is only of value in obtaining symptomatic relief. On the other hand, hypnoanalysis elicits the responsible dynamics behind the symptom, and is effective in reaching all aspects of the personality. "Hypnoanalysis will be more applicable in obstetrics and gynecology when there is a wider acceptance of its techniques" (p. 68). Blindness 1992 Spanos, Nicholas P.; Burgess, C. A.; Cross, P. A.; MacLeod, G. (1992). Hypnosis, reporting bias, and suggested negative hallucinations. Journal of Abnormal Psychology, 101, 192-199. Examined the role of reporting bias in hypnotic negative hallucinations by using a paradigm in which reporting bias was assessed independently of perceptual change. In Experiment 1, highly hypnotizable subjects reported significant loudness reductions when tested for hypnotic deafness. Later, however, these subjects biased their reported loudness reductions in the absence of perceptual change, and their reporting bias scores were almost as large as their hypnotic deafness reports. Subjects also biased their ratings of strategy use. In Experiment 2, ratings of blindness given in response to a hypnotic negative visual hallucination suggestion were significantly correlated with reporting bias scores obtained in this paradigm. Although hypnotic blindness and hypnotic deafness correlated significantly, the partial correlation between these variables was nonsignificant when reporting bias scores were statistically controlled. Results are used to support a skeptical view of hypnotic response as being based on compliance. 1989 Bryant, Richard A.; McConkey, Kevin M. (1989). Hypnotic blindness: A behavioral and experiential analysis. Journal of Abnormal Psychology, 98, 71-77. NOTES: "This research examined the influence of visual information on a decision task that subjects were administered during hypnotically suggested blindness. Real, hypnotizable subjects and simulating, unhypnotizable subjects were tested in two experiments. Experiment 1 focused on behavioral responses, and Exper. 2 focused on experiential reactions. In both experiments, the findings indicated that the behavioral responses of reals were influenced by visual info. despite their reported blindness. The behavioral responses of reals and simulators were essentially similar. The experiential data in Experiment 2 provided information about the phenomenal nature of subjects' reported blindness. The experiential reactions of reals and simulators were essentially different. The research is discussed in terms of the issues that need to be considered in the development of a model of hypnotic blindness" (p. 71). Bryant, Richard A.; McConkey, Kevin M. (1989). Visual conversion disorder: A case analysis of the influence of visual information. Journal of Abnormal Psychology, 98, 326-329. NOTES: "Examined the influence of visual information on a decision task that was administered to an individual with monocular visual conversion disorder. Findings indicated that his performance was influenced by the visual information and by motivation instructions. The findings are discussed in terms of a model of hysterical blindness that recognizes the interplay of cognitive and motivational processes" (p. 326). 1981 Blum, Gerald S.; Nash, John; Jansen, Robert D.; Barbour, John S. (1981, June). Posthypnotic attenuation of a visual illusion as reflected in perceptual reports and cortical event-related potentials. Academic Psychology Bulletin, 3, 251-271. Highly selected and trained hypnotic subjects, capable of ablating portions of visual stimuli from conscious awareness, showed varying degrees of ability to attenuate the Titchener-Ebbinghaus circles illusion post-hypnotically under a negative visual hallucination instruction. The presence or absence of such inhibitory skill, inferred from perceptual reports, was differentially reflected in changes in cortical event-related potentials not typically associated with shifts in selective attention. These findings point to the cognitive operation of a distinctive mechanism of selective inattention. NOTES: Blum et al. postulate an inhibitory mechanism of the central nervous system with stages of amplification and attenuation. They suggest that individual differences in inhibitory skill may be improved with practice even for very skilled Subjects. They studied this type of inhibition using a visual illusion (the Titchener-Ebbinghaus circles) because the neural locus of such illusions is thought to be more central in the nervous system rather than at the level of the retina. Experiment 1. Three Ss trained in using hypnosis viewed stimuli in waking and posthypnotic negative visual hallucination (NVH) conditions. All three had previously passed a negative hallucination item (not seeing a playing card of three such cards placed on a table). Training included practice sessions applying NVH to the experimental stimuli. S1 reported immediate success; S2 experienced some initial difficulty ("I have a feeling something's there") but then reported success; S3 required a couple of long practice sessions. The classic Titchener-Ebbinghaus illusion stimuli were used. Stimuli were ten slides with drawings of a standard 17-mm-diameter black circle on the left and a comparison black circle on the right. The black circle on the right was either 14, 15, 16, 17, or 18 mm in diameter, skewed intentionally around 17, to compensate for the proportion of smaller and larger judgments applied to the comparison figure in relation to the standard. One black comparison figure was surrounded by seven 15-mm diameter white circles; the other by seven 10 mm diameter white circles. The key drawings were both black circles of 17 mm. The second set of five drawings, used as a control, contained the same black circles but lacked outer rings of white circles. The Subject was to state whether the black circle on the right appeared larger, smaller, or the same as the standard black circle on the left. Slides were shown for 4 seconds each, with 6 seconds in between slides. Alternating blocks of trials were given under baseline (B) condition and a posthypnotically programmed negative hallucination condition (NVH). In the NVH condition, "the rings of white circles surrounding the standard and comparison black inner circles were 'ablated' from consciousness. The observers were amnesic in the waking state for their prior hypnotic instructions and were cued in advance of a block of trials simply by the phrases 'This will be a mixed series' (referring to B, in which the stimuli appeared as they really were, some with outer rings of white circles present and others not), or 'This will be a black only series' (referring to NVH, in which all stimuli appeared to the observer as black circles only, whether the outer rings were physically present or not)" (pp. 254- 255). Sessions were spread out over 8-12 months for each observer, interspersed with a variety of other experiments. In one session the Experimenters used a selective attention instruction, with Ss given posthypnotic suggestions to regulate their cognitive arousal to a peak of mental alertness and concentration (+AA) and focus on the inner black circles but not to negatively hallucinate the outer white circles. Although all three Ss showed the illusion effect, they varied in ability to attenuate the illusion when negative visual hallucination suggestions were given. "S1 showed a very greatly reduced frequency of reports in the illusory direction under the NVH condition, a less marked reduction under +AA concentration, and no reduction at all under a waking instruction to ignore the outer circles; S2 revealed a moderate but significant reduction under NVH but not under +AA; S3 gave no evidence of attenuation in either condition" (p. 258). The response times for the two more successful Ss (1 and 2) with the 17 mm stimuli under NVH conditions were not different when the outer circles were either present or absent. Experiment 2. The next year S1 and S2 returned but S3 was no longer available as a Subject; S4 and S5 were added and trained in hypnosis skills. EEG evoked response potentials (ERPs) were recorded while Ss made size judgments as in Experiment 1. Averaged ERPs for each block of 100 stimulus presentations were obtained for the first 500 milliseconds following stimulus onset. Judges blind to the experimental conditions evaluated the ERP records. All Subjects experienced the Titchener-Ebbinghaus illusion, but again there were individual differences in ability to attenuate the illusion: S1 was the most successful; S2 gave significantly fewer responses in the larger category under NVH than B conditions; and both S1 and S2 improved attenuation performance over the previous year. S4 fell between S1 and S2 in ability; S5 was unable to attenuate the illusion in the NVH condition. Results. "All three observers whose perceptual reports indicated some attenuation of the visual illusion during the NVH condition also showed a consistent reduction of the P2-N2 amplitude during NVH" (p. 262) at the Occipital sites. Median amplitude reduction was 36%, 40%, and 36% for S1, S2, and S4; only 7% for S5. There were no similar reductions for the other electrode sites, though "enhancement of P2-N2 amplitudes occurred in the lateral prefrontal and frontal areas in the two most successful individuals, S1 and S4" (p. 263). There was also a lag in N2 peak latencies for the three best subjects. The Experimenters noted that the N2 peak occurred 50 msec later in the frontal and prefrontal areas than in the occipital area. In their Discussion, the authors express the view that it is not likely that faking could have occurred, for several reasons: 1. The Subjects were trained to report honestly, and they often had reported failures to experience hypnotic phenomena suggested during training sessions. 2. The task elicited rapid responses, usually in less than 2 seconds, to 10 different slides in randomized blocks of 100 trials, which would make self monitoring of responses extremely difficult. 3. Subjects exhibited a consistency of responses over experimental sessions that were widely separated in time, making conscious or unconscious deception unlikely. 4. The finding of no difference in latency between 17 mm stimuli with and without outer rings of white circles supports an interpretation of reliable reporting. 5. Differences in ERP data between the B and NVH conditions were obtained only for those Ss who successfully attenuated the illusion. The authors also state, "In terms of our conceptual model of the mind, inhibitory skill is attributable to the capacity for invoking inhibitory action earlier in the sequence as signals are processed through stages of amplification and attenuation en route to consciousness (Blum & Barbour, 1979). In the NVH condition of the present task, first- stage attenuation ... [Subject 1] ... occurs in time to negate the illusion as well as preventing conscious awareness of the outer white circles, second-stage attenuation takes place too late to disrupt the illusion but still in time to keep the outer circles from consciousness" (p. 265). Note that the unsuccessful Subject 5 had the highest score on the screening hypnotizability tests. The variation among very high hypnotizables casts doubt on the practice of grouping Ss who score between 9 and 12 on the SHSS. "It is perhaps not surprising that many previous hypnotic studies involving alterations in such subtle phenomena as visual illusions have yielded negative results." p. 266. N.B. None of the Ss was able to eliminate the illusion under a strong waking instruction to ignore the outer circles while judging the inner black ones. "These different results for AA and NVH instructions pinpoint the contrast between selective attention (+AA) and selective inattention (NVH)" (p. 266). The ERP changes seen in occipital and frontal areas were in opposite directions. Thus "the data suggest an effect which seems to parallel both investment of attention (increases in late components over frontal cortex) and withdrawal of attention (relative decreases in late components over occipital cortex). This parallel leads us to speculate that our occipital decreases may have been due to active inhibition of information-processing in the occipital regions, and that the late component enhancement over frontal areas may have been due to the mobilization of resources in these areas necessary to accomplish the tonic inhibition of visual input. ... Activity in the frontal cortex apparently 'programs' inhibition on the specific sensory nuclei of the thalamus, in a modality specific and topographical way, accomplishing gating of sensory information to primary sensory cortex" (p. 268). 1965 Barber, Theodore Xenophon (1965). Physiological effects of 'hypnotic suggestions': A critical review of recent research (1960-64). Psychological Bulletin, 201-222. Recent studies are reviewed which were concerned with the effectiveness of suggestions given under "hypnosis" and "waking" experimental treatments in alleviating allergies, ichthyosis, myopia, and other conditions and in eliciting deafness, blindness, hallucinations, analgesia, cardiac acceleration and deceleration, emotional responses, urine secretion to sham water ingestion, narcotic-like drug effects, and other phenomena. The review indicates that a wide variety of physiological functions can be influenced by suggestions administered under either hypnosis or waking experimental treatments, and direct and indirect suggestions to show the particular physiological manifestations are crucial variables in producing the effects. 1960 Sukhakarn, Khun Vichit (1960/1962). Extra ocular vision [Letter]. British Journal of Medical Hypnotism, 14 (2), 41-47 NOTES: The article is in the original form of a letter to Herbert Spiegel, M.D. The author describes experiences training subjects, both blind and with normal vision, to 'see' through the skin of their cheeks. Training involved concentrative meditation (Buddhist) and hypnosis. Simple tests were performed, apparently independently, by two other scientists. "From information available from our subjects, the Extra Ocular Vision gained through the cheek-skin is different from those through the eyes as best explained here below:-- (1) The vision through the cheek-skin first takes a form of a series of spots somewhat like the image of coarse gain prints. Only after further training the spots are transformed into a clear object, so clear that needle threading is possible. (2) Objects seen through the cheek-skin are as clear as through the eyes. Distant objects can be magnified by the subject's wish, just like looking through an opera glass. (3) The vision gained through the cheek-skin is first 'seen' in black and white, and the 'colour picture' is achieved only after further training. But the colour 'seen' through the cheek is more intense than those through the eyes. (4) The field of vision 'seen' through each side of the cheek is more narrow than those seen through each eye. (5) There is a sign indicating that the vision through the cheek is only two-dimensional, the subjects find it difficult at first to stand the finger to another finger test" (p. 42). 1954 Erickson, Milton H. (1954). The development of an acute limited obsessional hysterical state in a normal hypnotic subject. Journal of Clinical and Experimental Hypnosis, 2, 27-41. NOTES 1: The 25 year old female graduate student in psychology had often been used in hypnosis experiments and as a demonstration subject, and had witnessed induction of hypnotic deafness, blindness, and color-blindness though she had not been given those suggestions herself. Scientific curiosity appeared to be the motivation for volunteering to experience hypnotic blindness, but she was skeptical about her ability to experience it. The author gave a series of "exceedingly tedious" suggestions to develop somnambulism (passively responsive and receptive) followed by suggestions leading gradually to development of "blindness" with the intention of concealing it from the hypnotist, with attendant strong and mixed emotions. The initial attempts failed because the subject ostensibly was deceiving herself into thinking she had developed hypnotic blindness, but the author also was of the opinion that she was seeking to meet unconscious personality needs. The author then covertly changed the goal of the experiment "to develop in the subject an acute hysterical obsessional compulsive mental state which would be accompanied by hypnotic blindness and which would parallel or resemble the obsessive compulsive hysterical mental disturbances encountered in psychiatric practice" (p. 32). The author developed a monologue of suggestions based in part on the utterances of hospitalized obsessive patients and in part on trauma relating to traumatic blindness in a kitten and a friend of the subject. In a slow but directed manner the author built up a double-bind situation which eventually led to the experience of hypnotic blindness as well as heightened emotional reactivity, crying etc. Blood Hematology 2003 Wood, Gary J.; Bughi, Stefan; Morrison, John; Tanavoli, Sara; Tanavoli, Sohrab; Zadeh, Homayoun H. (2003). Hypnosis, differential expression of cytokines by T-cell subsets, and the hypothalamo-pituitary-adrenal axis. American Journal of Clinical Hypnosis, 45 (3), 179-196. Tested the hypothesis that hypnosis can differentially modulate T-cell subsets, and that this effect is mediated by changes in hypothalamo-pituitary-adrenal (HPA) mediators. Seven healthy, highly hypnotizable volunteers (aged 24-42 yrs) participated in 3 1-day sessions, a baseline and 2 intervention sessions. Hypnosis intervention entailed a standardized induction, suggestions for ego strengthening and optimally balanced functioning of the immune and neuroendocrine systems, and post-hypnotic suggestions for stress management and continued optimal balance of bodily systems. Blood samples were analyzed for T-cell activation and intracellular cytokine expression (Interferon [IFN]-gamma, Interleukin-2 [IL-2], Interleukin-4,) and HPA axis mediators (ACTH, cortisol, and beta-endorphin). The proportion of T-cells expressing IFN-gamma and IL-2 were lower after hypnosis. T-cell activation response to polyclonal stimulation was positively correlated with ACTH and beta-endorphin, while IFN-gamma expression was correlated with levels of cortisol. Further controlled studies utilizing hypnosis with patients in treatment are warranted in order to examine whether an altered T-cell response can be replicated in the presence of disease. (PsycINFO Database Record (c) 2003 APA, all rights reserved) 1997 Dinges, David F.; Whitehouse, Wayne G.; Orne, Emily Carota; Bloom, Peter B.; Carlin, Michele M.; Bauer, Nancy K.; Gillen, Kelly A.; Shapiro, Barbara S.; Ohene-Frempong, Kwaku; Dampier, Carlton; Orne, Martin T. (1997). Self-hypnosis training as an adjunctive treatment in the management of pain associated with sickle cell disease. International Journal of Clinical and Experimental Hypnosis, 45 (4), 417-432. A cohort of patients with sickle cell disease, consisting of children, adolescents, and adults, who reported experiencing three or more episodes of vaso-occlusive pain the preceding year, were enrolled in a prospective two-period treatment protocol. Following a 4-month conventional treatment baseline phase, a supplemental cognitive-behavioral pain management program that centered on self-hypnosis was implemented over the next 18 months. Frequency of self-hypnosis group training sessions began at once per week for the first 6 months, became biweekly for the next 6 months, and finally occurred once every third week for the next 6 months, and finally occurred once every third week for the remaining 6 months. Results indicate that the self-hypnosis intervention was associated with a significant reduction in pain days. Both the proportion of "bad sleep" nights and the use of pain medications also decreased significantly during the self-hypnosis treatment phase. However, participants continued to report disturbed sleep and to require medications on those days during which they did experience pain. Findings further suggest that the overall reduction in pain frequency was due to the elimination of less severe episodes of pain. Non-specific factors may have contributed to the efficacy of treatment. Nevertheless, the program clearly demonstrates that an adjunctive behavioral treatment for sickle cell pain, involving patient self-management and regular contact with a medical self-hypnosis team, can be beneficial in reducing recurrent, unpredictable episodes of pain in a patient population for whom few safe, cost-effective medical alternatives exist. 1996 Hall, Howard; Papas, Angela; Tosi, Michael; Olness, Karen N. (1996). Directional changes in neutrophil adherence following passive resting versus active imagery. International Journal of Neuroscience, 85, 185-194. This study was designed to determine whether increases or decreases in neutrophil adherence could be achieved following a self-regulation (relaxation/imagery) intervention. Fifteen subjects were randomly assigned to one of three conditions. Two experimental groups employed imagery focused on either increasing or decreasing neutrophil adherence. Subjects had two weeks of self-regulation practice (4 total training sessions) prior to blood drawings. A third group of control subjects had the same number of resting sessions without imagery training. All subjects had blood samples collected before and after either 30 minutes of self-regulation or resting practice for two sessions. Pulse and peripheral finger temperature measures were taken before and after the blood samples. Both experimental groups demonstrated decreases in neutrophil adherence, and the control group showed a tendency toward increases in this measure. The psychophysiologic data for the control group was suggestive of a relaxation response. The experimental group that attempted to increase neutrophil adherence demonstrated psychophysiologic responses that were contrary to relaxation. We concluded that an active cognitive exercise or process is associated with decreases in neutrophil adherence irrespective of the intent of the exercise. In contrast, relaxation without an active imagery exercise was associated with increases in neutrophil adherence. The results of this study are discussed in terms of behavioral engineering of directional immune changes. 1993 Crawford, Helen J.; Gur, Ruben C.; Skolnick, Brett; Gur, Raquel E.; Benson, Deborah M. (1993). Effects of hypnosis on regional cerebral blood flow during ischemic pain with and without suggested hypnotic analgesia. International Journal of Psychophysiology, 15, 181-195. Using 133Xe regional cerebral blood flow (CBF) imaging, two male groups having high and low hypnotic susceptibility were compared in waking and after hypnotic induction, while at rest and while experiencing ischemic pain to both arms under two conditions: attend to pain and suggested analgesia. Differences between low and highly-hypnotizable persons were observed during all hypnosis conditions: only highly-hypnotizable persons showed a significant increase in overall CBF, suggesting that hypnosis requires cognitive effort. As anticipated, ischemic pain produced CBF increases in the somatosensory region. Of major theoretical interest is a highly-significant bilateral CBF activation of the orbito-frontal cortex in the highly-hypnotizable group only during hypnotic analgesia. During hypnotic analgesia, highly-hypnotizable persons showed CBF increase over the somatosensory cortex, while low-hypnotizable persons showed decreases. Research is supportive of a neuropsychophysiological model of hypnosis (Crawford, 1991; Crawford and Gruzelier, 1992) and suggests that hypnotic analgesia involves the supervisory, attentional control system of the far-frontal cortex in a topographically specific inhibitory feedback circuit that cooperates in the regulation of thalamocortical activities. Hall, Howard; Minnes, Luke; Olness, Karen (1993). The psychophysiology of voluntary immunomodulation. International Journal of Neuroscience, 69, 221-234. In twenty-two studies of intentional efforts of humans to change immune measures, only four monitored psychophysiologic parameters. One study reported physiologic alterations associated with immune changes. In this current study we examined changes in pulse rate and peripheral temperature associated with intentional changes in neutrophil adherence. Subjects had blood, pulse and temperature recordings collected before and after either a rest condition (Group A), or a self-regulation exercise (Groups B and C) for two sessions. Group C had four prior training sessions before participating in the experimental sessions. This study found no association between psychophysiologic alterations and neutrophil changes. the control group (A) demonstrated no significant neutrophil changes but showed physiologic alterations, whereas, the experimental group (C) that showed increases in neutrophil adherence demonstrated no significant physiologic changes. It was speculated that intentional changes on neutrophil adherence and the pattern of the psychophysiologic measures were associated with and reflective of cognitive activity. 1992 Hall, Howard; Minnes, Luke; Tosi, Michael; Olness, Karen (1992). Voluntary modulation of neutrophil adhesiveness using a cyberphysiologic strategy. International Journal of Neuroscience, 63, 287-297. In a study of voluntary immunomodulation, 45 subjects were assigned either to a control group or one of two experimental groups. All groups had blood and saliva samples collected before and after either a 30 minute rest condition (Control group) or a 30 minute cyberphysiologic strategy (Experimental groups) to increase neutrophil adherence. These samples were analyzed on a range of immunologic measurements including neutrophil adherence. The second experimental group practiced a cyberphysiologic strategy two weeks prior to the experimental session. Subjects in each group returned to repeat their exercise in a second session the following week. Analysis of all immune measurements revealed statistical significance for changes in neutrophil adherence. These studies suggest that such strategies may be used to effect changes in immune cell functions. Analysis further revealed that those subjects with prior cyberphysiologic training were able, by the second session, to induce a significant increase in neutrophil adherence. 1991 Rapkin, David A.; Straubing, Marsha; Holroyd, Jean (1991). Guided imagery, hypnosis and recovery from head and neck cancer surgery. International Journal of Clinical and Experimental Hypnosis, 39, 215-226. The value of a brief, preoperative hypnosis experience was explored with a sample of 36 head and neck cancer surgery patients. 15 patients volunteered for the experimental hypnosis intervention. 21 patients who received usual care (no hypnosis) were followed through their hospital charts and were used as a comparison group. Hypnotic intervention and usual care groups were comparable in terms of relevant demographic variables. Postoperative hospitalizations for the hypnotic intervention group were significantly shorter than for the usual care group. Within the hypnotic intervention group, hypnotizability was negatively correlated with surgical complications and there was a trend toward a negative correlation between hypnotizability and blood loss during surgery. Findings suggest that imagery-hypnosis may be prophylactic, benefitting patients by reducing the probability of postoperative complications and thereby keeping hospital stay within the expected range. Recommendations are presented for a controlled, randomized, clinical trial with a sufficiently large sample to provide the opportunity for statistical analysis with appropriate power. 1990 Gil, Karen M.; Williams, David A.; Keefe, Francis J.; Beckham, Jean C. (1990). The relationship of negative thoughts to pain and psychological distress. Behavior Therapy, 21 (3), 349-362. Examined the degree to which negative thoughts during flare-ups of pain are related to pain and psychological distress in 3 pain populations: sickle cell disease, rheumatoid arthritis, and chronic pain. 185 adults completed the Inventory of Negative Thoughts in Response to Pain (INTRP), a pain rating scale, the SCL-90 (revised), and a coping strategies questionnaire. Factor analysis of the INTRP revealed 3 factors: Negative Self-Statements, Negative Social Cognitions, and Self-Blame. High scorers on Negative Self-Statement and Negative Social Cognitions reported more severe pain and psychological distress. Ss with chronic daily pain had more frequent negative thoughts during flare-ups than those having intermittent pain secondary to sickle cell disease or rheumatoid arthritis. The INTRP appears to have adequate internal consistency and construct validity. Sletvold, H.; Jensen, G. M.; Gotestam, K. G. (1990). The effect of specific hypnotic suggestions on blood pressure in normotensive subjects. Pavlovian Journal of Biological Science, 26, 20-24.