No differences were found in outcome measures of length of time in ICU, time on respirator, length of stay, and cumulative index of recovery. Didn’t publish our data on pain medications because learned it was poorly charted.
Only difference found was: the relaxation imagery group got more wound drainage. It was degree of hypnotizability, independent of group, that made a difference in total number of hours on Nipride – highs were on it almost twice as long. On cumulative stability (having need of medications or respirator) the mid-range people did better. Not statistically significant but nevertheless clinically important, the lows were in the hospital 5 days longer.
This was counter-intuitive though it supports Herbert Spiegel’s theory. We, as experimenters, were independent of the treatment team. We didn’t have DRGs then and now we may have hit a ceiling effect in the amount of time people stayed in the hospital, because they had excellent pre-surgery education.
We had difficulty continuing the study because the intervention seemed to other staff to be so useful: after 6 months the surgeons began requesting hypnosis for their anxious patients; the chief anesthesiologist had started using it routinely.
Sample size is problematic. They were patients who were actively recruited, not people who sought hypnosis.
High hypnotizables in the hospital intensive care unit (ICU) demonstrate sensitivity to external stimuli without critical ability to screen; we see this reversed in the postoperative period. Mid range hypnotizables can decide which external cues to pay attention to. Lows are less able to incorporate new suggestions. They are bound by pre-existing views and also vigilance.
Hypnosis = Dissociation + Absorption + Suggestibility (Spiegel’s theory)
We must focus more on the state-trait phenomena, the context, and then select the treatment.

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

Morgan, William P. (1993, October). Use of hypnosis in exercise and sport psychology. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.

Performance of exercise is rated as equal effort with hypnosis and waking conditions; but with hypnotic suggestion they will perceive it as more or less effortful (uphill exercise vs going down the hill). When they think they are going up hill both cardiac and respiratory response increase physiologically, with catecholamine differences.
Mitchell (1981) suggests that respiration changes with exercise do not result from muscle feedback, but that central motor brain signals go to both the cardiovascular centers and to exercising muscle. Actually, it appears that both muscle and cortex give signals, and their synergy governs whether ventilation or heart rate increase.
Wang & Morgan, Psychophysiological responses to imagined exercise, Sport Psychology Lab, University of Wisconsin-Madison. Reported that both external (watching someone else) and internal (imagining oneself) visualizing give responses similar to actual exercise.
We have done research on the prediction of respiratory distress (dyspnea) – work we have done with fire fighters. The best predictor of this on treadmill with air supply is trait anxiety. Sometimes the firefighters who took off face mask even though they had air did not know why they did. It is an opportunity to use hypnotic age regression. SCUBA divers described in Lynn & Rhue also were age regressed to obtain information that was repressed. They have demonstrated stress responses like panic in a 12 foot tank also.
For active people and athletes there is an “iceberg” profile on the POMS, below average on tension, depression, anger, fatigue, and confusion, but higher on vigor. But the divers who panic have a flat profile, around the 50th percentile on all POMS scales.
Middleman et al used Navy divers in 25 degree C. water and used hypnosis to increase and decrease their body temperature–one of the best papers on the topic. Ss who were best able to use imagery, to think of a beach, had the poorest responses; the ones who could relax did poorest, because shivering produces heat and keeps you warm. It is opposite of what is needed.
In our work, we took 5 highest and 5 lowest anxiety Ss; the latter had higher rates of respiration than the former.
All Ss are similar in oxygen use whether volunteers or not. When people volunteer for research before they know hypnosis will be used, the males are lower than females [on hypnotizability?] when they finally volunteer. [He presents a lot of different tests on which volunteers do not differ from nonvolunteers personality wise.]
Ikai & Steinhaus is a classic study of Disinhibition of Inhibitory Mechanisms. Taking Ss up to their maximum (in weight training) to a plateau, Ikai & Steinhaus said this is a pseudomaximum. They showed that strength increases if – you fire a starter pistol behind them – you ask them to shout just as they do it – they have alcohol – they have amphetamine sulfate – they have hypnosis It is disinhibition of the inhibitory mechanisms.
[He referred to the book Mind of the Marathoner.]
In Tibet an anthropologist was amazed to see a man running into their camp, and he ran straight through–a monk carrying messages. He created a non-cultic form of meditation in the laboratory (trained to visually “fix” on mountaintop, to have respiration in synchrony with locomotion, and to use a pseudo mantra “down” each time they put their foot down). Placebo condition was used also. Ss were tested by blinded lab assistants. Endurance time increased from 16 minutes to 20, while controls decreased a minute.
Now we can predict who will win a race. Elite runners do not dissociate; they use association strategy. They pay close attention to race strategy, they monitor themselves constantly (they slow down when they feel bad), and attempt informally to stay loose, not get tight, and relax. Dissociation has, however, been used for the last 300 meters of a marathon (New Zealander Dixon).

Kostka, Marion (1992). Personal experience with ‘Use of Hypnosis Before and During Angioplasty’ [Letter]. American Journal of Clinical Hypnosis, 34, 281-282.

Author read the article referred to after his/her heart attack and before angioplasty. Goal was to control preprocedure anxiety and assist by being relaxed and cooperative; also to be able to tolerate inflations of the balloon for as long as needed. Used self-hypnosis “and by the time I entered the laboratory my anxiety was under control. … None of the physiological responses that can occur (i.e., nausea, pain, etc.) did occur and, for the most part, my postprocedure recovery was uneventful. … Had two procedures because the artery again occluded. … My cardiologist commented later that the time of inflation was longer than he had even attempted with any of his patients and he attributed this to my lack of symptoms. I felt this was due in part to the use of self- hypnosis. …. my subjective feeling was that both my discomfort and anxiety were minimal” (Pp. 281-82). No blood was sampled to measure catecholamine levels.

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.

Tosi, D. J.; Rudy, D. R.; Lewis, J.; Murphy, M. A. (1992). The psychobiological effects of cognitive experiential therapy, hypnosis, cognitive restructuring, and attention placebo control in the treatment of essential hypertension. Psychotherapy, 29, 274-284.

Evaluated the effects of cognitive experiential hypnotherapy (CEH), which includes hypnosis, cognitive restructuring, and developmental staging, on essential hypertension. CEH, Hypnosis alone, cognitive restructuring, and attention-placebo control conditions were randomly assigned to 39 subjects. There was a significant interaction effect with the nine psychobiological outcome measures. Discriminant analysis found a stronger overall effect over time for CEH when compared with its components.

Grossarth-Maticek, R.; Eysenck, H. J. (1991). Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: Part II – Effects of treatment. Behaviour Research and Therapy, 29, 17-31.

Reports on what they call creative novation behavior therapy or “autonomy training” to prevent cancer and coronary heart disease in prone individuals. This individually tailored cognitive-behavioral program includes the use of hypnosis and of imagery. When administered individually (20-30 hours) in a group (6-15 sessions of up to several hours) or via bibliotherapy with 4-6 hours of individual therapy, the outcome was better than that of control subjects. After 13 years, 45 of 50 cancer-prone subjects in individual treatment were still alive (and none of the 5 deaths were from cancer), while among 50 control subjects, 31 died, 16 from cancer. This study along with Spiegel et al. (1989) article in Lancet have important implications for health care.

Hopkins, Mildred B.; Jordan, Jeanette M.; Lundy, Richard M. (1991). The effects of hypnosis and of imagery on bleeding time: A brief communication. International Journal of Clinical and Experimental Hypnosis, 39, 134-139.

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.

McCue, Peter A. (1991). Key Paper Review: Prophylactic therapy for cancer and coronary heart disease. [Comment/Discussion] .

This is a commentary on two papers by Grossarth-Maticek and Eysenck, in which they report on ‘creative novation behaviour therapy’ to prevent cancer and heart disease in people with prsonalities associated with the development of those diseases. Therapy may involve hypnosis and/or relaxation, with suggestions that facilitate modification of unhealthy expectancies. The papers are:
Grossarth-Maticek, R. & Eysenck, H.J. (1991). Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: Part I – Description of treatment. Behaviour Research and Therapy 29, 1-16.
Eysenck, H.J. & Grossarth-Maticek, R. (1991). Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: Part II – Effects of treatment. Behaviour Research and Thearpy 29, 1, 17-31.

Weinstein, Edwin J.; Au, Phillip K. (1991). Use of hypnosis before and during angioplasty. American Journal of Clinical Hypnosis, 34, 29-37.

In this study, 16 patients matched with 16 controls were hypnotized prior to angioplasty. The hypnotized patients had a 25% increase in the time the cardiologist was able to keep the balloon inflated compared to the controls. Of the hypnotized patients, 13% required additional narcotic pain medication during the procedure as compared to 44% for the controls. Although we found no differences in rhythm, ischemia, blood pressure, or pulse between the two groups, the results of arterial catecholamine levels drawn at the start and at the end of the procedure were unexpected and seemed paradoxical. Norepinephrine levels were significantly higher in the hypnotized group (432 pg/ml, SE 51) than in the control group (281 pg/ml, SE 23) at the start of the procedure and fell more during the procedure than in control patients. Because catecholamines reportedly act as a barometer of neuroanxiety, further studies defining their role are needed.

While sedatives and tranquilizers may reduce anxiety on a coronary care unit, occasionally they result in confusion, agitation, and ataxia (Kornfeld, 1980). Hypnosis can be used in acute medical care settings (Deltito, 1984) and is beneficial in reducing pain, suffering, and anguish (Hilgard & Hilgard, 1975). There is some suggestion that hypnosis may help regulate heart rate and blood pressure (Hilgard & Morgan, 1975).
In this study, patients with even chart numbers were in the control group, while odd-numbered patients were in the hypnosis group. Patients who were deaf or senile were excluded. All patients received their usual medications before angioplasty, and both the hypnosis group and the control group received identical treatment other than the hypnosis intervention. However, only the hypnosis group was interviewed by the first author, on the night before angioplasty, and he was also present during the angiograph itself if necessary to help relax the hypnosis patients.
The hypnosis procedure was a modification of Barber’s (1977) Rapid Induction Analgesia, and lasted about 1/2 hour. Patients were given a posthypnotic suggestion that they could achieve the same sense of relaxation the next morning during the angioplasty.
“If the patient had severe angina or had an undue amount of discomfort during the procedure, additional pain medication was given as was felt necessary by the cardiologist.
Two of 16 hypnotized and 7 of 16 control patients received pain medication. The difference is significant at p = .05 (Chi Square)” (p. 34).
“In the hypnotized patients the total catecholamine levels (538 pg/ml, SE 60) and the levels of its major component, norepinephrine (432 pg/ml, SE 51), were significantly elevated above their corresponding control levels (361 pg/ml, SE 31 and 281 pg/ml, SE 23) at the start of the angioplasty procedure (p < .01). These were unexpected findings. The epinephrine level in the hypnotized group was also higher than the corresponding level in the control group but did not reach a level of significance. "At the end of the procedure, catecholamine levels had fallen in both groups, but the drop or [sic] total catecholamines in the hypnotized group of 124 pg/ml (SE 33) was greater than the corresponding drop of 37 pg/ml (SE 25) in the control group. This was significant at p < 0.025. Why the two groups handled catecholamines differently is not clear" (p. 33). Generally it is hoped that relaxation will permit the cardiologist to keep a balloon inflated longer, not needing to end the procedure because of pain or a complication. The total time required for the procedure was 79 minutes for hypnotized patients and 86 minutes for controls. The inflation time was 353 seconds for hypnotized and 283 minutes for control patients. These differences (which are in the positive direction) did not achieve significance with statistical testing. However, considering the total procedure time, the balloon was inflated 25% longer in the hypnosis than in the control group (p = .10). In their Discussion, the authors note that the reduction in pain medication required by the hypnosis patients is concordant with less pain medication being required by burn patients who are treated with hypnosis (Schafer, 1975; Wakeman & Kaplan, 1978). They do not have an explanation for finding elevated catecholamines in the hypnotized patients. "Catecholamines reportedly act as a barometer of neuroanxiety (Goldstein, 1981; Zaloga, 1988). Turton, Deegan, and Coulshed had already shown in 1977 that prior to catheterization catecholamine levels were elevated and returned to control levels 3 days later. .... One would expect that if hypnosis does cause relaxation, then those patients who were hypnotized would have a lower arterial catecholamine level than their controls. This was not the case. ... It is known that prolonged stress depletes catecholamine stores (Zaloga, 1988), but it is hard to believe that a brief hospitalized stay would cause a difference in depletion between the two groups. There is no literature dealing with the effect of hypnosis on catecholamine levels" (p. 35). 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. Twenty normotensive subjects participated in a study of the effects of specific suggestions on blood pressure (BP). After an induction, the experimental group received suggestions presumed to be relatively nonactivating, although capable of lowering or raising BP. A control group was used to record the BP changes over time. All subjects met for one session. Eight subjects from the experimental group met for a second session. Both adaptation and induction resulted in significant BP decreases. A specific suggestion to increase BP gave a significant result when compared to the induction point. There was no significant change from induction to the BP-decrease suggestion. Both systolic and diastolic BP behaved in the same way. A second experimental session resulted in no significant change compared with the first session. Also, no significant difference was found in suggestibility scores from the first to the second session. The results are in line with previously published studies. 1989 Abelson, James L.; Curtis, George C. (1989). Cardiac and neuroendocrine responses to exposure therapy in height phobics: Desynchrony within the 'physiological response system'. Behaviour Research and Therapy, 27 (5), 561-567. Monitored subjective, behavioral, cardiovascular and neuroendocrine responses in 2 men (aged 19 and 34 yrs) with height phobias over a full course of exposure therapy and at 6 and 8 month follow-up. Both Ss showed rising cortisol responses and stable, nonextinguishing norepinephrine responses to height exposure over the course of treatment, while improvement occurred in subjective and behavioral response systems. They had differing heart rate responses. Despite desynchrony among anxiety response systems and within the physiological system at treatment conclusion, Ss had successful outcomes with general measures of change (phobia rating scales, the Fear Survey Schedule, and the SCL-90) showing substantial improvement for both Ss. These outcomes were preserved at follow-up. Hall, H.; Minnes, L. (1989). Psychological modulation of auditory responses. International Journal of Psychosomatics, 36 (1-4), 59-63. Psychological modulation of auditory response, the effects of imagery and suggestion on auditory thresholds were examined in naive subjects. After a hypnosis-like induction, the subjects, who were not aware of the purpose of the study, were asked to generate and maintain a specific set of images before, during, and after which their auditory thresholds were tested. Following the imagery, which represented cooling and vasoconstriction in the cochlea, audiograms revealed a temporary auditory threshold shift (TTS) in the experimental group only. This TTS pattern was similar to that produced by exposure to loud noise. Information carried in the image is suggested as the basis for the observed auditory changes. Although a hypnosis-like induction was employed, the subjects' level of hypnotizability did not appear to be related to the findings. Meyer, H. K.; Diehl, B. J.; Ulrich, P. T.; Meinig, G. (1989). Changes in regional cortical blood flow in hypnosis. Zeitschrift fur Psychosomatische Medizin und Psychoanalyse, 35, 48-58. NOTES Regional cerebral blood flow (rCBF) was measured by means of the 133-Xenon inhalation method in 12 healthy male volunteers who had several months of experience in doing self-hypnosis (autogenic training). During hypnotically suggested right arm levitation, as compared to resting conditions, they found an increase in cortical blood flow and an activation of temporal areas; the latter finding was considered to reflect acoustical attention. In addition, a so-far-unexplained deactivation of inferior temporal areas was observed during successful self hypnosis and hypnosis. While there was a global absolute increase of cortical blood flow bilaterally, they could not observe a relative increase of the right as compared to the left hemisphere during hypnosis. Several subjects successfully performed the levitation of the right arm, despite a relative left hemispheric activation, provided the absolute right hemispheric activation remained dominant. 1987 Goldmann, Les; Shah, M. V.; Hebden, M. W. (1987). Memory of cardiac anesthesia: Psychological sequelae in cardiac patients of intra-operative suggestion and operating room conversation. Anesthesia, 42 (6), 596-603. Thirty elective cardiopulmonary by-pass surgery patients were interviewed pre- and postoperatively. A random selection of patients heard a prerecorded audio tape toward the end of surgery after they were rewarmed to 37 degrees C. The tape contained suggestions for patients to touch their chin during the postoperative interview, to remember three sentences, and to recover quickly. The interviewers were blind to the experimental conditions. The experimental group touched their chins significantly more often than the control group (p = .015). Sentence recognition did not reach significance, perhaps due to the small numbers and low salience of the stimuli. Seven patients (23%) recalled intraoperative events, five with the aid of hypnosis. Three reports (10%) were corroborated. Preoperative medication (p < .01) and postoperative anxiety (p < .05) were significant predictors of those patients who reported recall. 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. 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. Ulrich, P.; Meyer, H. J.; Diehl, B.; Meinig, G. (1987). Cerebral blood flow in autogenic training and hypnosis. Neurosurgery Review, 10, 305-307. (Abstracted in American Journal of Clinical Hypnosis, 1989) In 12 healthy volunteers with at least an experience of 6 months in autogenic training (AT), the cerebral blood flow (CBF) was measured at rest, in AT, and in hypnosis (H). The results were correlated with individual test profiles. The cortical flow pattern at rest of our AT-trained volunteers did not show the hyperfrontality which is described in the literature. This may be interpreted as an effect of better and habitualized relaxation in long-trained AT practitioners. This flow pattern corresponds to the low grades of neuroticism and aggressivity found in the tests. Furthermore, an activation in central cortical areas and a deactivation in regions which are associated with acoustic and autonomous functions occur. Possible explanations for these phenomena as well as for the relatively low perfusion of the left hemisphere at rest and activation in AT are discussed. The global rise of CBF in Hypnosis may be an activation effect caused by resistance against the hypnotizer: the deeper the trance, the smaller the catalepsy of the right arm and in temporal cortical fields processing acoustic inputs. 1986 Suls, Jerry; Sanders, Glenn S.; Labrecque, Mark S. (1986). Attempting to control blood pressure without systematic instruction: When advice is counterproductive. Journal of Behavioral Medicine, 9 (6), 567-577. Hypothesized that, without assistance, Ss' attempts to keep their blood pressure low would produce increases in blood pressure, compared to Ss asked to respond naturally to an arousing stimulus. 50 male undergraduates watched a videotape containing a neutral (nonarousing) section and an erotic section while their blood pressure was recorded by an automated blood-pressure monitoring device. 22 Ss were asked to relax and keep their blood pressure low during the erotic parts of the videotape, and 28 Ss were asked to respond naturally. Results confirm the hypothesis, suggesting that urging people to relax can be counterproductive if they do not also receive systematic instruction on how to relax or control blood pressure. 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) Olness, Karen N.; Conroy, Mary Margaret (1985). A pilot study of voluntary control of transcutaneous PO 2 by children: A brief communication. International Journal of Clinical and Experimental Hypnosis, 33, 1-5. This pilot study took place to determine whether or not children could voluntarily change tissue oxygen as measured by a transcutaneous oxygen monitor. It tested 2 hypotheses: (a) children can voluntarily change tissue oxygen as reflected by a transcutaneous oxygen monitor and (b) children, experienced in use of self-hypnosis exercises, will be able to change tissue oxygen to a greater degree than children unfamiliar with such exercises. 11 children between the ages of 7 and 17 year were studied. 8 children were previously experienced in the use of self-hypnosis; 3 were not. A Novametrix transcutaneous O 2/CO 2 monitoring system provided a constant read-out of PO 1, PCO 1 and local perfusion. After stabilization, children were asked to attempt increases of oxygen. 9 children increased tissue oxygen significantly. Of those, 8 children had previous self-hypnosis training. 1 had not. Only 2 children with no previous self- hypnosis training were unable to change oxygen values. This pilot study upholds both hypotheses; however, it does not conclude that self-hypnosis mediated the changes noted or that self-hypnosis would be essential to success in voluntary control of tissue oxygen. 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 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). 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 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). 1984 Holmes, David S. (1984). Meditation and somatic arousal evidence. American Psychologist, 39 (1), 1-10. The conceptual and methodological issues associated with research on the effects of meditation are reviewed. A summary of the research in which the somatic arousal of meditating subjects was compared to the somatic arousal of resting subjects did not reveal any consistent differences between meditating and resting subjects on measures of heart rate, electrodermal activity, respiration rate, systolic blood pressure, diastolic blood pressure, skin temperature, oxygen consumption, EMG activity, blood flow, or various biochemical factors. Similarly, a review of the research on the effects of meditation in controlling arousal in threatening situations did not reveal any consistent differences between meditating and nonmeditating (no-treatment, antimeditation, or relaxation) subjects. The implications of these findings for research and practice are discussed. 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. Wain, Harold J.; Amen, Daniel G.; Oetgen, William J. (1984). Hypnotic intervention in cardiac arrhythmias: Advantages, disadvantages, precautions, and theoretical considerations. American Journal of Clinical Hypnosis, 27, 70-75. A patient with ventricular tachycardia, which could not be controlled by various drug regimens, was treated using an hypnotic strategy. Among the positive results were a lessening of ectopic beats, an increase in exercise tolerance, a possible break in the arrhythmic pattern, and an increase in the patient's sense of participation in his treatment. Of the disadvantages noted, the most notable was a blocking of the patient's awareness that an arrhythmia was present, which deviated from his previous pattern and may have been facilitated by the dissociative strategy used. Additional well-designed, prospective studies in this area are needed to determine the overall usefulness of hypnosis in cardiac patients. 1983 Borgeat, Francois; Goulet, Jean (1983). Psychophysiological changes following auditory subliminal suggestions for activation and deactivation. Perceptual and Motor Skills, 56, 759-766. This study was to measure eventual psychophysiological changes resulting from auditory subliminal activation or deactivation suggestions. 18 subjects were alternately exposed to a control situation and to 25-dB activating and deactivating suggestions masked by a 40-dB white noise. Physiological measures (EMG, heart rate, skin-conductance levels and responses, and skin temperature) were recorded while subjects listened passively to the suggestions, during a stressing task that followed and after that task. Multi-variate analysis of variance showed a significant effect of the activation subliminal suggestions during and following the stressing task. This result is discussed as indicating effects of consciously unrecognized perceptions on psycho- physiological responses. 1982 Friedman, Howard; Taub, Harvey A. (1982). Accessibility: A necessary control for studies of essential hypertension. International Journal of Clinical and Experimental Hypnosis, 30, 4-8. A study which was planned to compare the relative effects of relaxation and hypnosis upon essential hypertension also offered the opportunity to replicate some of the findings of a previous investigation. A failure in such replication led to consideration of the effect of accessibility to the laboratory, a variable not typically controlled. A significant differential effect of easy versus hard access was observed. Holroyd, Jean; Nuechterlein, Keith; Shapiro, David; Ward, Frederick (1982). Individual differences in hypnotizability and effectiveness of hypnosis or biofeedback. International Journal of Clinical and Experimental Hypnosis, 30 (4), 45-65. 8 high and 8 low hypnotizable Ss used biofeedback and hypnosis to lower blood pressure in one session and forehead EMG activity in another session. Results were analyzed by repeated measures analyses of covariance using baseline physiological level on the dependent variable as the covariate. Electromyographic level was reduced more immediately by biofeedback than by hypnosis. When the task was to lower blood pressure, blood pressure and skin conductance were more effectively reduced by hypnosis than by biofeedback, considering only the first half of each session to eliminate within- session transfer effects. Hypnotizability did not predict overall outcome. Factors which may have prevented demonstrating a clearer relationship between hypnotizability and success using biofeedback or hypnosis are discussed. State and trait anxiety, cognitive strategies used during the tasks, and self-reported hypnotic depth are examined for correlates of successful performance. 1981 Claghorn, James L.; Mathew, Roy J.; Largen, John W.; Meyer, John S. (1981). Directional effects of skin temperature self-regulation on regional cerebral blood flow in normal subjects and migraine patients. American Journal of Psychiatry, 138, 1182-1187. Vascular headache of the migraine type is associated with vasomotor changes in cerebral arteries. The authors studied whether skin temperature training (biofeedback) reduced the frequency, severity, and duration of these headaches by measuring the regional cerebral blood flow (CBF) in 11 female migraine patients (27-52 years) and 9 female volunteers (22-37 years), using the noninvasive 133 Xe inhalation technique. Half of each group was randomly assigned to a hand-warming or a hand- cooling group. CBF increased in several regions of the left hemisphere to a significant degree only for the migraineurs who were in the hand-warming group. The pattern of vasomotor regulation apparently differed between migraine and normal Ss. The migraineurs'' headache symptoms were affected by both warming and cooling, but warming produced more salutary effects. Case, David B.; Fogel, David H.; Pollack, Albert A. (1980). Intrahypnotic and long-term effects of self-hypnosis on blood pressure in mild hypertension. International Journal of Clinical and Experimental Hypnosis, 28, 27-38. Self-hypnosis using the method of Spiegel (1974) was evaluated in 15 patients with labile or mild essential hypertension who were equally hypnotizable and adhered to a regimen of 6-10 daily exercises for a 4-month period. During the hypnotic state, there were consistent rises in both systolic and diastolic pressures in hypnotizable patients, but not in non-hypnotizable controls. Similar but smaller changes were also observed in normotensive subjects. Pressure rose immediately with hypnosis and subsided gradually over 15 minutes. However, the long-term effects of the daily practice of self- hypnosis were variable: ambulatory diastolic pressure fell in 5 patients, was unchanged in 7 patients, and rose in 3 patients. The changes in blood pressure could not be specifically attributed to the daily practice of self-hypnosis; however, all patients experienced improvement in well-being, mood, and behavior patterns during the 4-month period. The study indicates that self-hypnosis can produce changes in behavior and mood which may be beneficial to cardiovascular health, although paradoxically, the act of hypnosis by this technique is pressor. Aside from its therapeutic potential, self- hypnosis may provide useful information about central mechanisms of blood pressure regulation. Hart, R. (1980). The influence of a taped hypnotic induction treatment procedure on the recovery of surgery patients. International Journal of Clinical and Experimental Hypnosis, 28, 324-331. A study of 40 open heart surgery patients assigned to 1 of 2 equal size treatment groups sought to evaluate the efficacy and utility of a tape-recorded hypnotic induction procedure that preoperatively prepared patients for surgery. The dependent variables included daily blood pressure measurements and postsurgical outcome data pertaining to postoperative units of blood required, state/trait anxiety, and locus of control dimensions. Results of the study tended to provide some support for the tape-recorded hypnotic induction procedure in lessening state anxiety and in promoting a more self- directed attitude toward surgical recovery. 1980 Puente, Antonio E.; Beiman, Irving (1980). The effects of behavior therapy, self-relaxation, and transcendental meditation on cardiovascular stress response. Journal of Clinical Psychology, 26 (1), 291-295. NOTES Compared Behavior Therapy (BT), self-relaxation (SR), transcendental meditation (TM), and a waiting-list control group (WL) on measures of cardiovascular and subjective stress response. Male and female respondents (N = 60) to an ad for therapy were evaluated in assessment sessions before and after treatment. The results indicate that BT and SR were more effective than either TM or WL in reducing cardiovascular stress response. These data were interpreted as resulting from therapeutic suggestion and positively reinforced client progress. 1978 Parker, Jerry C.; Gilbert, Gary S.; Thoreson, Richard W. (1978). Reduction of autonomic arousal in alcoholics: A comparison of relaxation and meditation techniques. Journal of Consulting and Clinical Psychology, 46 (5), 879-886. To investigate and compare the effects of progressive relaxation training and meditation training on autonomic arousal in alcoholics, 30 subjects were selected from a population of alcoholics in a Veterans Administration hospital substance-abuse program. The subjects were randomly assigned to one of the following three experimental conditions: (a) progressive relaxation training group, (b) meditation training group, or (c) quiet rest control group. All groups met for 3 weeks during which state anxiety, blood pressure, heart rate, and spontaneous galvanic skin responses were measured. The measures were designed to assess the treatment effects following the first training session and at the end of the total training period. The results indicate that both progressive relaxation training and meditation training are useful for reducing blood pressure in alcoholics. In addition, significant differences between the groups in the effectiveness of the relaxation procedures were found. Meditation training induced blood pressure decreases at an earlier point in the 3-week training period and affected decreases in systolic blood pressure that progressive relaxation training did not. These results support the idea of considerable specificity of response to relaxation techniques. Parwatikar, Sadashiv D.; Brown, Marjorie S.; Stern, John A.; Ulett, George A.; Sletten, Ivan S. (1978). Acupuncture, hypnosis and experimental pain - I. Study with volunteers. Acupuncture and Electro-Therapeutic Research: International Journal, 3, 161-190.