In their Discussion, the authors note that animal experimental literature suggests that stimulation of the cortico-medial amygdala facilitates arousal functions, of the baso- lateral amygdala diminishes arousal and produces sleep, and lesions of the amygdala lead to ‘amygdala hangover’ (Weiskrantz, 1956). “The animal with amygdala destruction appears tame and placid, with reduced social reactivity, insensitive to environmental changes and reluctant to initiate new behavior, unless highly motivated (Isaacson, 1976)” (p. 101-102).
In contrast, the animal research on hippocampus suggests it is involved in inhibitory functions (Isaacson, 1976), and may be the ‘internal inhibitor’ theorized by Pavlov (1955) to be responsible for animal hypnosis. With lesions, animals are more willing to undertake new behaviors, less inactive, less distractible during goal-oriented behavior (Isaacson, 1976). “Moreover, normal hippocampograms show typical, slow (theta) synchronous activity opposed to the arousal desynchronized activity of the electroencephalogram. During hypnosis, desynchronization of the normal, slow activity of the hippocampal Ammon’s horn has been registered as compared with the waking hippocampogram, opposite to the slow synchronous activity of the amygdala” (p. 102).
The authors note that their results are at variance with the finding by Crasilneck et al. (1956) that their patient, during brain surgery for an epileptogenic focus, aroused from hypnosis each time they stimulated the hippocampus. They explain the discrepancy as due to the fact that the hippocampus was not simply stimulated, but in fact there was ‘coagulation’ of a hippocampal vessel each time. Quoting from Crasilneck et al. “‘The patient did not complain of pain during this [brain] excision [in hypnosis] except on one noteworthy occasion, when a blood vessel of the hippocampal region was being coagulated. The patient suddenly awoke from the hypnotic trance … She was immediately rehypnotized. … The surgeon then purposefully ‘restimulated’ the same region of the hippocampus. Once again, the patient abruptly awakened from trance… [p. 1607].’To the present authors, the description appears misleading and responsible for subsequent misinterpretation of the observation. Because on the first occasion the hypnotic arousal effect followed ‘coagulation’ of the hippocampal region, it may be assumed that ‘restimulation’ is a misnomer for repeated coagulation. From this it may be inferred that the arousal effect observed by Crasilneck et al. (1956) could probably be ascribed to a hippocampal microlesion rather than to hippocampal stimulation. This could explain the apparent discrepancy” (p. 104).
1974
Bloom, Richard F. (1974). Validation of suggestion-induced stress.
NOTES
Technical Memorandum 23-74 (October 1974), US Army Human Engineering Laboratory, Aberdeen Proving Ground, Maryland 21005, AMCMS Code 5910.21.68629, Contract No. DAAD05-73-C-0243, Dunlap and Associates, Inc. (now Stamford, CT), AD002557.
Sixty college men, divided into three equal groups, each attended two induced stress sessions in which their physiological, psychological and performance reactions were measured. Their responses were compared to determine if valid stress reactions could be induced through suggestion in an altered state (in this case, hypnosis), and also to determine the validity of such reactions if the subject had never before experienced that stress situation. It was demonstrated that valid stress reactions can be induced in an individual with the aid of suggestions, especially if the real stress situation has been experienced before. If no previous experience with that real situation exists, the subject still exhibits stressful reactions; however, the closest resemblance to real stress is found in the subjective or psychological measures, less similarity is found in the physiological measures, and the least similarity is found in the performance measures.
1961
McCartney, James L. (1961). A half century of personal experience with hypnosis. International Journal of Clinical and Experimental Hypnosis, 9, 23-33.
NOTES
(Author”s Summary and Conclusions). “After fifty years of experience with hypnosis, it is evident that it is not a superficial and careless technic but should be utilized only by capable, trained physicians, as are the other complex and difficult medical technics. … In order to induce hypnosis, the patient must be perfectly willing to be hypnotized, he must have confidence in the practitioner, and he must concentrate on doing exactly as he is told. In selected cases, drugs or electrical impulses may be used for the initial induction of hypnotic sleep, but if hypnotherapy is to be continued, the physician must keep in contact with the patient by repeated suggestions. The technic used should fit the individual patient, but in most cases, verbal suggestions are all that is necessary to bring about dissociation. Hypnosis may be used to facilitate the beginning of mental catharsis, the establishment of transference, and may be easily instituted following narcosynthesis, electroshock therapy, minimum stimulus, or Sedac. Suggested activity under hypnosis may be carried out at a designated time, place, and manner after awakening. This is a result of autosuggestion and may be mistaken for psychopathic behavior. Such suggestions may be instituted by television, movies, radio, telephone, or recorded or written instruction. Hypnosis may be used to plant suggestions; if misused, it may create an obsessive-compulsive neurosis, while when properly used, it may overcome many functional symptoms and may be used to supplement other forms of psychotherapy” (p. 32).
19954
Thaheld, Feri Herndon (1954). Nonconclusive electrostimulation under narcotic hypnosis. Journal of Clinical and Experimental Hypnosis, 2, 175-177.
NOTES
Hypnosis was used in an attempt to reduce the side effects of nonconvulsive electrostimulation in a single subject. Subject was given 2 gr of nembutal, followed by hypnotic induction, then repeated suggestions that the “subject could feel no pain and that therefore as a result of this there could not be any physical response at all to this very harmless and quite painless treatment which was being administered” (p. 176).
Subject had 42 treatments (unidirectional, modulated, spiked current averaging 5-9 ma, through electrodes placed above the ears, for usually 3 minutes but sometimes 5-8 minutes) over 3 wk period. Ordinarily in such a situation pain would be experienced, with physiological changes (dilation of pupils, increase in pulse rate, flushing of skin, perspiration, some contraction of muscles) and emotional outbursts observed. In this subject, “none of the usual side reactions were found to be present and the further use of posthypnotic suggestions eliminated any after-effects or complications which might have arisen” (p. 176).
The author discussed the possibility that trance depth was facilitated by the pyramiding action of layering one set of suggestions on top of another, something like Vot’s fractionation technique (in which subject is repeatedly hypnotized and de-hypnotized with suggestions of increasing depth).
ELECTROMYOGRAM (EMG)
1997
Jasiukaitis, Paul; Nouriani, Bita; Hugdahl, Kenneth; Spiegel, David (1997). Relateralizing hypnosis: Or, have we been barking up the wrong hemisphere?. International Journal of Clinical and Experimental Hypnosis, 45 (2), 158-177.
Research and theory over the past couple decades have suggested that the right cerebral hemisphere might be the focus of brain activity during hypnosis. Recent evidence from electrodermal responding, visual event-related potentials, and Stroop interference, however, can make a case for a role of the left hemisphere in some hypnotic phenomena. Although hemispheric activation on hypnotic challenge may depend in large part on the kind of task the challenge might involve, several general aspects of hypnosis might be more appropriately seen as left-rather than right-hemisphere brain functions. Among these are concentrated attentional focus and the role of language in the establishment of hypnotic reality. A left-hemisphere theory of hypnosis is discussed in light of recent findings and theories about a left-hemisphere basis for synthetic or generational capabilities (Corballis, 1991) and a neuro-evolutionary model of a left-hemisphere dopaminergic activation system for the implementation of predetermined motor programs (Tucker & Williamson, 1984). — Journal Abstract
1996
DeBenedittis, Giuseppe De (1996). Hypnosis and spasmodic torticollis — report of four cases: A brief communication. International Journal of Clinical and Experimental Hypnosis, 44 (4), 292-306.
Dystonia and particularly spasmodic torticollis are neuromuscular disorders that are extremely resistant to most therapies (physical, medical, or surgical). Torticollis is a unilateral spasm of the neck muscles, particularly of the sternocleidomastoid, that produces violent, tonic turning of the head to one side. The etiology remains uncertain, although the role of psychogenic factors has been emphasized. This article reviews the literature and reports four cases of spasmodic torticollis treated successfully with hypnosis. In all four cases, psychogenic causes were involved. Postural hypnosis (i.e., hypnosis in the standing position) was employed to counteract and minimize muscle spasms due to postural reflexes. A hypnobehavioral approach was adopted along with hypnotic strategies that included hierarchical desensitization, sensory-imaging conditioning, ego-boosting suggestions, and hypnosis-facilitated differential muscle retraining. In two cases, a combined hypnosis and electromyographic-biofeedback approach was used to equilibrate and retrain affected neck muscles. Although the hypnotherapeutic process took several months to induce and stabilize significant changes, outcome results were good to excellent in all cases, with marked reduction of the torticollis and the hypertrophy of the neck muscles as well as a reduced interference of symptoms in daily living. — Journal Abstract
1992
Zitman, Frans G.; Van Dyck, Richard; Spinhoven, Philip; Linssen, A. Corrie G. (1992). Hypnosis and autogenic training in the treatment of tension headaches: A two-phase constructive design study with follow-up. Journal of Psychosomatic Research, 36, 219-228.
Tension headaches can form a chronic (very long duration) condition. EMG biofeedback, relaxation training and analgesia by hypnotic suggestion can reduce the pain. So far, no differences have been demonstrated between the effects of various psychological treatments. In a constructively designed study, we firstly compared an abbreviated form of autogenic training to a form of hypnotherapy (future oriented hypnotic imagery) which was not presented as hypnosis and secondly we compared both treatments to the same future oriented hypnotic imagery, but this time explicitly presented as hypnosis. The three treatments were equally effective at post-treatment, but after a 6- month follow-up period, the future oriented hypnotic imagery which had been explicitly presented as hypnosis was superior to autogenic training. Contrary to common belief, it could be demonstrated that the therapists were as effective with the treatment modality they preferred as with the treatment modality they felt to be less remedial.
NOTES
An earlier review by these authors found that EMG biofeedback and relaxation training were equally effective with headache [Zitman, 1983, Biofeedback and chronic pain, In Advances in Pain Research and Therapy (Edit by Bonica, Lindblom, Iggo) V. 5, pp 794-809. N. Y.: Raven Press]. Other authors also found that hypnotic suggestion, EMG biofeedback and EMG biofeedback plus progressive relaxation training were equally effective [Schlutter, Golden, Blume, 1980, A comparison of treatments for prefrontal muscle contraction headache. Br J. Med Psychol, 53, 47-52.]. The authors raise the question whether any treatment element or perhaps combination of elements can enhance a basic relaxation training procedure, with respect to chronic headache.
The first phase of this research compared autogenic training (AT) and future oriented hypnotic imagery (FI) which was not labeled as hypnosis. Results were the same for both groups, and were reported earlier [van Dyck, Zitman, Linssen et al. International Journal of Clinical and Experimental Hypnosis, 1991, 39, 6-23]. The current study added a third group which received future oriented hypnotic imagery but also was told that they were getting hypnosis (FI-H). Thus the AT and FI groups were ‘historical’ comparison groups for the FI-H group in this study.
Patients were described as having headache complaints of at least 6 months (76% had been suffering for >2 years), were over 18 years old, had no drug dependence and no psychiatric disorder, and no previous therapy with autogenic training or hypnosis; no other treatment during the project; fluent in Dutch.
The autogenic training consisted of six exercises learned in a fixed order. The FI method, in which the hypnotized patient imagines himself in a future, pain-free, situation, had been described by Milton Erickson [1954, Pseudo-orientation in time as a hypnotherapeutic procedure. JCEH, 2, 261-283]. For that future situation the investigators used descriptions that the patients provided. Both kinds of intervention taught patients muscular and mental relaxation. Both methods required home practice of the technique, using audio cassettes.
In order to substantiate the labeling of the hypnotic procedure as hypnotic future oriented imagery (FI-H) “hand levitation induction was employed during session two with the purpose of inducing positive expectancies concerning hypnosis as a procedure capable of changing ordinary experiences in an unexpected way [17]. This hand levitation procedure, however, was not presented on tape. Except for the labeling as hypnosis and the hand levitation induction, the hypnotic future oriented imagery procedure was identical to the future oriented imagery procedure in the first phase” (p. 221).
Treatment lasted for 8 weeks and provided 2 12 hours of therapist and 24 1/2 hours of home training with taped instructions. The outcome measures included: 1. Budzinsky-type headache index (mean daily sum of intensity rating for each hour of headache activity recorded during 3 separate days of the week of an assessment session) 2. State Anxiety 3. Zung-type Self-rating Depression Scale 4. Perceived credibility of treatment (4 Question’s developed by Borkovec & Nau using a visual analogue scale) 5. Neuroticism from the CPI
RESULTS
Of 96 patients who agreed to participate, 17 dropped out before the post-treatment assessment. Of the remaining 79, 28 completed AT treatment, 27 FI, and 24 FI-H. Sixty-six attended the follow-up assessment; there were no dropouts from the FI-H, and the drop-outs were equally divided between the AT and FI condition. The headache index scores were logarithmetically transformed because the distribution was positively skewed.
Using ANOVA, in terms of post-treatment scores, there were no significant main effects for therapist or treatment, nor were there any significant interaction effects when analyzing headache index, state anxiety, and depression. There was a significant main effect for Time for three outcome measures: headache index score, state anxiety, and depression.
Post-treatment, neither amount of medication used nor subjective estimates of headaches differed by treatment or by therapist. However, over time there were beneficial results for both treatment groups. “Patients rated their headaches as significantly reduced compared to pre-treatment (a mean pain reduction of 40%). …they had significantly reduced their use of analgesic medication (a mean decrease of 14%)” (p. 224).
Using ANOVA, in terms of follow-up scores, again there were no significant main effects for Treatment or Therapist on the outcome measures of headache index, state anxiety, or depression. There now were three time periods (pre-, post-, and follow-up), and once again there was significant main effect for Time for headache index (though not for state anxiety). That is, people benefitted over the time of the treatment and follow-up. Moreover, there was a significant interaction effect between Therapy and Time on the headache index measure. “A posteriori contrasts revealed that the patients from the FI-H condition showed a greater reduction in their headaches between pre-treatment and follow-up than patients from the AT condition” (p. 225).
The authors write in their Discussion, “Our data indicate that at least in tension headache patients, defining a procedure explicitly as hypnotherapy may not lead to greater effects at post-treatment, but does lead to longer lasting effects” (p. 226).
“The paucity of differences between the three conditions may be a consequence of the study design: the small number of patients and the large SD may have prevented the detection of more differences in effect between the three conditions” (p. 226).
“Other critical remarks are related to the difference in headache reduction at follow-up between AT and FI-H. Firstly, the differences at follow-up were found only with respect to the headache index and not with respect to the subjective estimate of the pain. Secondly, in defining future oriented hypnotic imagery explicitly as hypnosis, we hoped to enhance the efficacy via increased credibility. We found increased efficacy, but we did not find enhanced credibility. Therefore, the differences in effect at follow-up must have another cause. The different effects at follow-up could be linked to the fact that the FI-H condition was the only one without drop-outs. This absence of drop-outs was due to a new research assistant who tried extraordinarily hard to make the patients return for follow-up. By doing so, she may have prevented the patients who gained much from the treatment from dropping out as well as those who gained little” (p. 226-227).
“In this study, despite the differences in therapists’ preferences, both therapists were equally effective with all three treatments. This is an intriguing finding which goes against the belief commonly held by clinicians that therapists are more effective with the type of therapy they prefer” (p. 227).
“The effects were modest, but it must be kept in mind that most of our patients referred by a neurologist were chronic headache sufferers (76% had been suffering for > 2 yr). In such a group of patients even small effects are important, especially when these effects are long-lasting” (p. 227).
1991
Mauer, D. R. (1991, October). A comparison of cognitive-behavioral and hypnotic techniques in the management of electromyography pain (Dissertation, University of Iowa). Dissertation Abstracts International, 53 (4), 1070-B. (Order No. DA 9217180)
Compared a cognitive behavioral technique that included providing specific sensory and procedural information combined with relaxation with a hypnotic technique (relaxation with guided imagery) and a control group for management of acute EMG pain and anxiety. Pain and anxiety ratings were gathered from 45 EMG patients and observers for both nerve conduction and needle electrode components of the EMG exam. It was found that only the hypnosis group significantly reduced pain and anxiety during the needle electrode portion of the procedure. Patients with unexplained or functional symptoms reported more EMG pain and anxiety than patients who had an organically based disease. Because having had a prior EMG seemed to have an effect on the efficacy of treatment, the data were reexamined. Results determined that inexperienced EMG patients who were treated had less pain and anxiety than patients who experienced EMG before, but inexperienced control patients had an increase in pain and anxiety over experienced patients” (p. 1070).
1990
Sturgis, Laura M.; Coe, William C. (1990). Physiological responsiveness during hypnosis. International Journal of Clinical and Experimental Hypnosis, 38, 196-207.
Four physiological measures – electromyogram, respiration rate, heart rate, and skin conductance – were recorded for 11 high and 11 low hypnotizability Ss. It was hypothesized (a) that physiological responsiveness during hypnosis would vary depending on the nature of the task instructions, and (b) that high hypnotizability Ss would show more physiological responsiveness than low hypnotizability Ss. The first hypothesis was substantiated across all 4 measures. Only heart rate levels supported the second hypothesis. The results are discussed as they relate to the 1 hypotheses and to future research.
1988
Pagano, Robert R.; Akots, Normund J.; Wall, Thomas W. (1988). Hypnosis, cerebral laterality and relaxation. International Journal of Clinical and Experimental Hypnosis, 36, 350-358.
This study attempted to determine if hypnosis produces a shift towards more dominant right hemisphere functioning and if this increased dominance can be adequately explained by general somatic relaxation rather than being due to some other aspect of the hypnotic process. 14 right-handed, medium to highly hypnotizability Ss performed a dichotic listening task while in a prehypnosis, hypnosis, and post-hypnosis repeated measures design. Throughout the experiment, somatic relaxation was monitored physiologically by recording heart rate, respiration rate, and frontalis EMG. The results showed a highly significant shift toward a greater left ear advantage during hypnosis. There was no change in EMG. Respiration rate increased during the hypnosis condition and remained at an increased rate during the posthypnosis condition. Heart rate decreased during the hypnosis condition and remained at a decreased rate or decreased further during the posthypnosis condition. These results replicate and extend those reported by Frumkin, Ripley, and Cox (1978) and do not support the view that changes in general somatic relaxation can adequately account for this hypnotic effect.
NOTES
Frumkin et al. (1978) presented syllables simultaneously to two ears of subjects, requiring them to state which syllable they heard most clearly (e.g. ‘Ka’ vs ‘Ga’). They found a right ear advantage (REA) during waking conditions, which shifted toward a left ear advantage (LEA) during hypnosis. Their interpretation was that hypnosis results in more right cerebral hemisphere involvement. Two recent investigations did not find the shift in ear with advantage (H. J. Crawford, K. Crawford, & Koperski, 1983; Levine, Kurtz, & Lauter, 1984) but they were not actual replications of the Frumkin et al. (1978) investigation. This study is a replication of Frumkin et al., and is designed to learn whether relaxation could account for the results.
Subjects were 14 volunteer students of medium to high hypnotizability (Stanford Hypnotic Clinical Scale: Adult scores of 3-5). The dichotic listening tape has been used in other research at Haskins Laboratories (Yale University), and was developed by Dr. Terry Halwes. “Each run of the tape consisted of 96 dichotic pairs presented in 4 groups of 24. Six syllables from the English stop consonants k, g, p, d, b, and t preceded and followed by the vowel a, composed the pairs” (p. 352). The experimenters also recorded heart rate (HR), respiration rate (RR), and EMG.
There were two sessions for each subject: (1) screening and measuring hypnotizability with SHCS: Adult, (2) dichotic listening task within three conditions: pre- hypnosis, hypnosis, and posthypnosis. Table 1 (not shown here) gives for each S the SHCS score and the Laterality Quotient for each of the three conditions.
RESULTS
Laterality quotients were computed for each S by the formula (R- L/R+L) X 100, where R = right ear score and L = left ear score. A positive score indicates a predominate REA, and a negative score indicates a predominate LEA” (p. 353).
The analysis by ANOVA for repeated measures indicated that there was a significant shift to LEA during hypnosis; the means were 11.34 prehypnosis, 3.17 hypnosis, 8.93 posthypnosis. All 14 subjects demonstrated this directional shift. Heart rate decreased between prehypnosis (70.4 beats/minute) and hypnosis (67.8) and remained lower (67.9) during posthypnosis. However respiration significantly increased during hypnosis, from 13.5 breaths/minute prehypnosis to 16.2 for hypnosis and 15.2 for posthypnosis. There were no significant changes for EMG.
Self-reported depth of hypnosis remained the same for the first and second sessions.
In their Discussion, the authors interpret the shift toward greater LEA during hypnosis (and return to greater REA posthypnosis) as greater right hemisphere involvement, confirming Frumkin et al. They noted that the changes were not due to increased error in the right ear, but to identification of more syllables in the left ear. Several experimental design differences could account for why this study and Frumkin obtained the shift and two other investigations did not. These investigators and Frumkin used a competing response paradigm (requiring that subjects identify which syllable is heard more clearly) and the other two studies did not.
“In evaluating the possible confound of general somatic relaxation with hypnosis per se, the physiological data provide salient information. Davidson & Schwartz (1976) have discussed the limitations in evaluating the relaxation response as a unitary concept and have recommended looking at patterns of multiple physiological measures. Failing this, the best single measure is HR (Davison & Schwartz, 1976)” (p. 356). In this case, HR decreased over the three conditions, remaining low in posthypnosis when laterality shifted back to REA. If the cerebral shift were due to relaxation, presumably there would not have been low HR during posthypnosis.
The authors note the lack of convergence in physiological measures (EMG showing no change, RR increasing during hypnosis and remaining high, HR decreasing during hypnosis and remaining low). Lack of convergence is typical in physiological studies of the relaxation response (Davidson & Schwartz, 1976). “However, whether the three physiological measures are considered as an overall pattern in determining level of somatic relaxation or whether HR is considered alone, increased somatic relaxation due to hypnosis cannot adequately account for both the shift toward more dominant right hemisphere activity in the hypnosis condition and the shift back to more dominant left hemisphere activity during the posthypnosis condition” (p. 356).
The authors acknowledge that the absence of either a low hypnotizable subject group or a relaxation control group suggests caution in interpretation of the results.
1987
De Pascalis, Vilfredo; Marucci, Francesco; Penna, Pietronilla M.; Pessa, Eliano (1987). Hemispheric activity of 40 Hz EEG during recall of emotional events: Differences between low and high hypnotizables. International Journal of Psychophysiology, 5, 167-180.
This study evaluates individual differences in hypnotizability as reflected in waking-state hemispheric engagement during recollection of 3 positively and 3 negatively valenced personal life events. The State-Trait Anxiety Inventory, Maudsley Personality Inventory, Tellegen Absorption Scale and Harvard Group Scale of Hypnotic Susceptibility (Form A) were administered. Electromyogram (EMG) and bilateral electroencephalogram (EEG) activities within the 40-Hz band were recorded during rest and task conditions in 22 high and 21 low hypnotizable women. Self-report rating scores for vividness of visual imagery and emotional feeling of the material recalled were evaluated. The 40-Hz EMG amplitude and both hemisphere 40-Hz EEG densities were obtained. A 40-Hz EEG ratio, as a measure of hemispheric asymmetry, and a hemispheric specificity index were also computed. High hypnotizables showed significantly lower 40-Hz EEG density than low hypnotizables in all experimental conditions. The relationship between lateralization of 40-Hz EEG and emotional processing was moderated by hypnotizability. High hypnotizables, with respect to rest condition, showed an increase of density over both left and right hemispheres during two of the three positive emotional tasks, while they showed a depressed activity over the left and an increased activity over the right during negative emotional tasks. Low hypnotizables, on the other hand, did not exhibit differential hemispheric patterns that could be attributed to different emotional valences. The high group showed greater hemispheric specificity in the predicted direction than the low group. High subjects exhibited greater ratings of absorptive ability and emotional feeling than low subjects. Anxiety and EMG levels did not differ between groups. EMG was dependent on the type of emotion which showed greater activity in the negative emotion condition compared with the positive one.
1986
Sargent, Joseph; Solbach, Patricia; Coyne, Lolafaye; Spohn, Herbert; Segerson, John (1986). Results of a controlled, experimental, outcome study of nondrug treatments for the control of migraine headaches. Journal of Behavioral Medicine, 9, 291-323.
Headache variables were examined for 136 subjects who participated for 36 weeks in one of four groups: No Treatment, Autogenic Phrases, EMG Biofeedback, Thermal Biofeedback. All subjects kept daily records of headache activity and medication usage and participated in 22 laboratory sessions during which frontalis EMG and hand temperature measurements were taken; those in the 3 treatment groups practiced at home. There was a substantial reduction in headache variables in all groups. The No- Treatment Group differed significantly from the treatment groups combined, with the least reduction in headache variables. The thermal biofeedback group vs EMG biofeedback and autogenic phrases groups showed a suggestive trend toward improvement in the frequency and intensity of total headache.
]1985
Miller, Lorence S.; Cross, Herbert J. (1985). Hypnotic susceptibility, hypnosis, and EMG biofeedback in the reduction of frontalis muscle tension. International Journal of Clinical and Experimental Hypnosis, 33, 258-272.
Biofeedback and hypnosis have been used in the treatment of similar disorders. While each has been useful, it is unclear whether they involve similar or conflicting processes. Bowers & Kelly (1979) have hypothesized that high hypnotizable Ss are more likely to benefit from hypnosis and similar procedures, than moderate and low hypnotizable individuals. In contrast, Qualls & Sheehan (1979, 1981 a, b, c) have argued that hypnosis and biofeedback involve antithetical abilities. In the present study, high, moderate, and low hypnotizable individuals (N = 60) were randomly assigned to either EMG biofeedback or hypnosis conditions and instructed to relax. It was found that the mean percent reduction in frontalis muscle tension over the last 5 trials was significantly greater for the high hypnotizable Ss during hypnosis than the moderate and low hypnotizable Ss. The moderate and low hypnotizable Ss demonstrated greater reductions in frontalis muscle tension during EMG biofeedback than during hypnosis. These findings are partly supportive of the predictions of Qualls and Sheehan that hypnosis and biofeedback involve antithetical processes.
NOTES
Qualls and Sheehan (1979, 1981a) “have hypothesized that biofeedback and hypnosis abilities involve antithetical or antagonistic cognitive processes. Specifically, they argued that the biofeedback signal interferes with the natural ability of high absorption Ss to ‘direct their attention in an effortless manner toward subjective, imaginal experience [1981a, p. 33],’ by forcing them to attend to the external environment. In contrast, low absorption Ss, as well as moderate hypnotizable Ss, possess inadequate abilities to direct their attention in such an effortless and absorbing manner towards inner, subjective experiences, and therefore, the biofeedback signal better enables them to focus their attention. While the pattern of EMG results among the high, moderate, and low hypnotizable Ss … was somewhat consistent with these predictions, the self-report data did not reveal differences in Ss’ awareness of the biofeedback signal or hypnotic suggestions. In addition, there was only a trend for the high hypnotizable Subjects to report less effort in attempting to relax. It is, therefore, unclear whether the explanations postulated by Qualls and Sheehan (1979, 1981a) for the differences found in this study are valid” (p. 269).
Subjective relaxation response results were complex. Ss were asked how relaxed they were during the experimental session in comparison to the previous hypnosis sessions (screening tests). Biofeedback Ss rated the experimental session less favorably than hypnosis Ss. Ss were asked to what degree the feedback (or hypnotic suggestions) helped them to relax; there were significant main effects for treatment and trait, as well as a significant trait x sex interaction. Hypnosis Ss reported that this procedure was more helpful than was reported by the biofeedback Ss. Newman-Keuls comparison revealed that the main effect for trait was due to the high hypnotizable Ss reporting more help from the procedures than the low hypnotizable Ss, and moderate hypnotizable Ss. The Trait x Sex interaction was the result of the high hypnotizable female Ss indicating more help from either relaxation procedure, than was reported by the low hypnotizable male Ss and moderate hypnotizable female Ss and the high hypnotizable male Ss indicated that the procedures were significantly more helpful than was reported by the low hypnotizable male Ss.
Schlesinger, Jay Lawrence (1985). Hypnotizability in relation to success in learning biofeedback training: Attentional involvement (Dissertation, Adelphi University). Dissertation Abstracts International, 45 (n8-B), 2701. (Order No. DA 8424937)
NOTES
This study investigated the role of attentional focus in the relationship between hypnotizability and success in learning two types of biofeedback training. 40 female college students, aged 18-25, were measured for hypnotic responsiveness, and given one session of EMG biofeedback and one session of temperature biofeedback. For the biofeedback training, 20 Ss received written instructions designed to establish a passive, non-volitional attentional focus on the feedback signal, and 20 received written instructions intended to establish an active, volitional attentional focus on the feedback signal.
“It was hypothesized that level of hypnotizability would be positively related to success in learning EMG and temperature biofeedback training for the Ss given passive, non-volitional attentional instructions, while level of hypnotizability would be negatively related to success in learning biofeedback training for the Ss given active, volitional attentional instructions. It was also hypothesized that higher hypnotizables would perform better with temperature biofeedback than with EMG biofeedback, and that lower hypnotizables would perform better with EMG biofeedback than with temperature biofeedback.
“The hypotheses were not supported, nor was any overall relationship between level of hypnotizability and success in learning biofeedback demonstrated. There was support to suggest that an active, volitional attentional focus on the biofeedback signal was most adequately maintained by the 20 Ss given the active volitional instructions. Clinical implications of these findings and directions for future research were discussed” (p. 2701).
1983
Radtke, H. Lorraine.; Spanos, Nicholas P.; Armstrong, L. A.; Dillman, N.; Boisvenue, M. E. (1983). Effects of electromyographic feedback and progressive relaxation training on hypnotic susceptibility: Disconfirming results. International Journal of Clinical and Experimental Hypnosis, 31 (2), 98-106.
The efficacy of relaxation training in modifying hypnotic susceptibility was investigated. Following 2 pretests of hypnotic susceptibility, 24 Ss who scored 7 or below on both tests were randomly assigned to 1 of 2 relaxation training groups (EMG-biofeedback or progerssive relaxaton) or a no-treatment control group. Relaxation training was conducted over 10 20-minute sessions and was monitored by measurement of frontalis EMG. All Ss were then administered a posttest of hypnotic susceptibility. Hypnotic susceptibility did not increase significantly from pretest to posttest. Moreover, change in frontalis EMG was unrelated to change in susceptibility. These results fail to confirm earlier work conducted by Wickramasekera (1972, 1973, 1977).
1982
Credidio, Steven G. (1982). Comparative effectiveness of patterned biofeedback vs meditation training on EMG and skin temperature changes. Behaviour Research and Therapy, 20, 233-241.
Examined whether a low arousal, relaxation pattern of frontalis EMG decreases and peripheral skin temperature increases could be attained more effectively through biofeedback or meditation training. 30 21-59 yr old females were randomly assigned to 1 of 3 groups: patterned biofeedback, clinically standardized meditation, or control. Prior to training, Ss were administered the Eysenck Personality Inventory. Each S was seen weekly for 7 sessions. Subjective experiences and time spent practicing at home were also recorded. Results indicate that the meditation group showed significantly lower EMG levels at the end of treatment than did the control group. The biofeedback group had difficulty in patterning the 2 feedback signals simultaneously. Extraverts in the control group had the highest EMG levels. The most positive subjective reports came from Ss in the meditation group. It is suggested that meditation offers a viable alternative as a relaxation procedure, requiring little time to learn and devoid of any performance criteria levels.
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.
Schuyler, Bradley A. (1982). Further investigation of volitional and nonvolitional experience during posthypnotic amnesia (Dissertation, California School of Professional Psychology, Fresno). Dissertation Abstracts International, 44 (n6-B), 1977. (Order No. DA 8324472)
Electrodermal responses were compared between highly responsive hypnotic Ss who were classified as having control over remembering (voluntaries) or not having control over remembering (involuntaries) during posthypnotic amnesia. Three contextual conditions were employed: Two were meant to create pressure to breach posthypnotic amnesia (lie detector instructions alone or with feedback that Ss had been detected as not having told all they could remember); the other provided feedback, in addition to the lie detector instructions, that Ss had told all they could remember. The recall data confirmed earlier findings of Coe and Yashinski and showed that voluntary and involuntary Ss did not differ in response to the contextual conditions. However, lie detector instructions alone did not create pressure to breach as in previous studies. In addition, electrodermal results were insignificant. The results are discussed as they relate to (a) amnesia, (b) the physiological detection of deception and physiological activation, (c) the voluntary/involuntary classification of Ss, and (d) theories of hypnosis” (p. 1977).
1981
Cott, A.; et al. (1981). The long-term therapeutic significance of the addition of electromyographic biofeedback to relaxation training in the treatment of tension headaches. Behavior Therapy, 12, 556-559.
Eight tension headache sufferers seeking traditional medical treatment from a neurologist participated in either a therapist-delivered relaxation training (RT) condition or an RT plus EMG feedback condition. Mean hours of pain/day, headache severity, and medication ingestion were significantly lower in both groups following treatment. Results were maintained at a 1-year follow-up for hours of pain/day and medication ingestion. Findings thus indicate no benefit of adding EMG feedback to relaxation training.
Tellegen, Auke (1981). Practicing the two disciplines for relaxation and enlightenment: Comment on ‘Role of the feedback signal in electromyograph biofeedback: the relevance of attention’ by Qualls and Sheehan. Journal of Experimental Psychology: General, 110, 217-226.
High and Low Absorption Ss differ in set rather than in capability for attending to external or internal stimuli, as Qualls and Sheehan suggest. Trait x Treatment interaction for Absorption illustrates concept of personality dispositions being inherently interactive functional units. Provides a content analysis of Absorption scale (subscales) and relates absorption to other constructs in psychology. “It is not the internal versus external focus per se that play a decisive role but the subject’s experiential versus instrumental set. For example, with two treatment levels, one would expect to obtain an Absorption x Treatment interaction even if both treatment conditions required an external attentional focus, as long as they contrasted an experiential and an instrumental set” (pp 223-224).
1979
Quall, Penelope J.; Sheehan, Peter W. (1979). Capacity for absorption and relaxation during electromyograph biofeedback and no-feedback conditions. Journal of Abnormal Psychology, 88 (6), 652-662.
The present research examined the relation between absorption capacity and relaxation during electromyograph biofeedback and no-feedback (instructions only) conditions. Sixteen high absorption and 16 low absorption female subjects underwent a biofeedback and no-feedback session with the order of conditions counterbalanced. For high absorption subjects in the first session, EMG reductions were greater during no- feedback than during biofeedback, although the performance of biofeedback subjects improved in the second session. For low absorption subjects, no differences in EMG reductions were apparent across experimental conditions. Postexperimental self-report data demonstrated differences between absorption groups in subjects’ state of arousal and quality of consciousness. It was concluded that for subjects with high capacity for absorbed attention, experimental conditions that allow for a withdrawal from the external environment are most conducive to relaxation, whereas for subjects with limited capacity for absorbed attention, conditions such as biofeedback that place an attentional demand on subjects may be preferable.
1978
Acosta, Frank X.; Yamamoto, Joe; Wilcox, Stuart A. (1978). Application of electromyographic biofeedback to the relaxation training of schizophrenic, neurotic, and tension headache patients. Journal of Consulting and Clinical Psychology, 46 (2), 383-384.
This study examined the effects of electromyographic (EMG) biofeedback on tension reduction by schizophrenic, neurotic, and tension headache patients. Fourteen patients participated voluntarily in at least 10 weekly EMG biofeedback sessions at a public outpatient clinic. All had complained of chronic tension. Patients showed significant decreases in their muscle tension levels with successive biofeedback training sessions. No significant differences were found between the schizophrenic, neurotic, and tension headache groups. A further contribution was the finding that patients with diverse socioeconomic and educational levels benefitted similarly from EMG biofeedback training.
Counts, D. Kenneth; Hollandsworth, James G., Jr.; Alcorn, John D. (1978). Use of electromyographic biofeedback and cue-controlled relaxation in the treatment of test anxiety. Journal of Consulting and Clinical Psychology, 46 (5), 990-996.
The effect of using electromyographic (EMG) biofeedback to increase the efficacy of cue-controlled relaxation training in the treatment of test anxiety was studied. Forty college undergraduates scoring in the upper third on a self-report measure of test anxiety were randomly assigned to one of four treatment conditions – EMG-assisted cue- controlled relaxation, cue-controlled relaxation alone, attention-placebo relaxation, and no-treatment control. Pre-post self-report measures of test anxiety, state anxiety, and trait anxiety were obtained. In addition, a performance measure in the form of a mental abilities test was administered. Subjects from the three relaxation groups received six 45- minute individual sessions over a period of 2 weeks. All treatments were conducted using audiotape recordings. The results indicate that cue-controlled relaxation is effective in increasing test performance for test anxious subjects, that EMG biofeedback does not contribute to the effectiveness of this procedure, and that self-report measures of anxiety are susceptible to a placebo effect.
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.
An experiment was designed to evaluate the protective effects of different agents – acupuncture, hypnosis, Morphine, aspirin, Diazepam and placebo – upon experimentally-induced pain in humans. Twenty normal, healthy volunteers were subjected to cold water and tourniquet- induced pain and the protective effects of 35 minutes of hypnotic suggestion, electro- stimulation of both acupuncture points and non-acupuncture points, 10 mg/kg of Morphine, 5 grains of aspirin, 10 mg of Diazepam and a mild sugar placebo were evaluated. Data was collected on subjective evaluation of pain, EKG, EEG, respiration, skin temperature, peripheral vascular activity and EMG. A special study was also done to evaluate the effects of all the above agents on the somatosensory evoked potentials and EEG. The data were further analyzed on the basis of hypnotic susceptibility of the volunteers. The results indicated: 1) Hypnosis, acupuncture at specific sites with electrical stimulation and Morphine Sulphate had about the same reduction in experimental pain. 2) Hypnosis produced different effects from those resulting from acupuncture stimulation on EEG. 3) Acupuncture stimulation in specific loci resulted in a latency increase in the early secondary response on somatosensory evoked potential. 4) Cold water pain was remarkably reduced after true acupuncture point stimulation. 5) Tourniquet (ischemic) pain was reduced by both hypnosis and true acupuncture site stimulation. 6) Skin temperature was significantly reduced on the side of acupuncture points (true) stimulation.
1975
Alexander, A. Barney (1975). An experimental test of assumptions relating to the use of electromyographic biofeedback as a general relaxation technique. Psychophysiology, 656-662.
Twenty-eight normal adults participated in an experimental test of two assumptions underlying the use of electromyographic (EMG) biofeedback as a general relaxation training technique: 1) that trained EMG reduction in one muscle generalizes to untrained muscles; and 2) that subjective feelings of relaxation are related to EMG reduction. An experimental group received 5 sessions, during the middle 3 of which EMG biofeedback training was offered on the frontalis muscle. Throughout all sessions, EMG recordings were also taken from the forearm and lower leg, and rating of subjective relaxation feelings were obtained at regular intervals. A control group, matched with the experimental group on baseline frontalis EMG, received 5 similar sessions without feedback. Employing a maximum p of .05, the results revealed no evidence of generalization of EMG reduction from the frontalis to the untrained sites, nor any tendency for successful frontalis EMG reduction to result in increased feelings of relaxation beyond what was obtainable from relaxing without the benefit of training. The results were interpreted as suggesting the EMG biofeedback cannot yet be accepted as a viable general relaxation training technique.
Andrews, Reagan H., Jr. (1975). Placebo effects in EMG biofeedback (Dissertation). Dissertation Abstracts International, 36, 1424.
Differential instructions were employed in a negative placebo model to alter expectancies of success in achieving criterion frontalis EMG voltage levels in 30 female subjects. The negative placebo model dictated that all subjects receive true feedback during both of two 10-minute experimental trials. On one of the two trials they were informed that feedback would be accurate, and on the other trial, that feedback would be accurate only 50% of the trial period. Data was collected for 20 subjects in a 2 X 2 Latin Square design, while 10 subjects were designated control subjects and received high-success expectancy instructions on both experimental trials. Pre-trial measures included administration of a standard hypnotic susceptibility scale and a pre-test subjective questionnaire. Dependent variable was the time from onset of feedback to 70% reduction of resting EMG levels of the frontalis. Significant differences were found between high and low-expectancy trials for experimental subjects. Effects were strongest on the first experimental trial and tended to diminish on the following trial. Correlation of hypnotic susceptibility scores with response latencies was not significant, but subjects’ impression of their degree of relaxation during susceptibility scale administration was significantly correlated with criterion latencies. Importance of subject expectancies, instrumentation standards and implications for future studies in the biofeedback area were discussed” (p. 1424).
1973
Wickramasekera, Ian (1973). Effects of electromyograph feedback on hypnotic susceptibility: More preliminary data. Journal of Abnormal Psychology, 82 (1), 74-77.
The purpose of this double-blind study was to determine if taped verbal relaxation instructions and response-contingent electromyographic feedback training would increase suggestibility or hypnotic susceptibility over that obtained with instructions and false or noncontingent feedback, The present data appear to confirm the hypothesis
1954
Malmo, Robert B.; Boag, Thomas J.; Raginsky, Bernard B. (1954). Electromyographic study of hypnotic deafness. Journal of Clinical and Experimental Hypnosis, 2 (4), 305-317.
NOTES
Summary and Conclusions. The main purpose of the present study was to investigate the question of similarities and differences between hysterical deafness, previously studied, and hypnotically induced deafness. The study was designed to repeat the objective physiological tests previously carried out with a case of ‘total hysterical deafness.’ There was also the more general aim of securing objective data to enrich our general understanding of hypnosis.
“Similarities between hysteria and hypnosis which we observed may be listed as follows: (a) Significantly reduced motor reaction (exclusive of blink) to strong auditory stimulation in the deaf state. (b) Complete hearing loss in the hysteric and in one of the hypnotic subjects, even with strong auditory stimulation (i.e., denial of any auditory sensation). (c) With elicitation of strong startle reaction to the first stimulus in the deaf state, much smaller reaction to the next stimulus than would have been predicted on the basis of habituation. (d) Suggestion of substitution of somesthetic for auditory sensations in all subjects (although this was much less definite in the hypnotic subjects than the hysteric).
“The most outstanding dissimilarity lay in the absence of emotional reaction when ‘hypnotic defense against sound’ was broken through, in contrast to marked affective reaction in the hysterical subject under these conditions.
“The qustion of inhibitory mechanisms in hysteria and hypnosis was discussed” (pp. 316-317).
ELECTROSLEEP
1993
Lyskov, E.; Juutilainen, J.; Jousmaki, V.; Hanninen, O.; Medvedev, S.; Partanen, J. (1993). Influence of short-term exposure of magnetic field on the bioelectrical processes of the brain and performance. International Journal of Psychophysiology, 14, 227-231.
The influence of an extremely-low-frequency (ELF) magnetic field on the bioelectrical processes of brain and performance was studied by EEG spectral analysis, auditory-evoked potentials (AEP), reaction time (Roletaking) and target-deletion test (TDT). Fourteen volunteers were exposed for 15 min to an intermittent (1 s on/off) 45- Hz magnetic field at 1000 A/m (1.26 mT). Each person received one real and one sham exposure. Statistically significant increases in spectral power through alpha- and beta- bands, as well as in mean frequency of the EEG spectrum were observed after magnetic field exposure. Field-dependent changes of N1OO were also revealed. No changes in the amplitudes or latencies of the earlier peaks were observed. No direct effects on Roletaking, nor on TDT performance were seen. However, practice effects on Roletaking (decrease of Roletaking in the course of the test-sessions) seemed to be interrupted by exposure to the magnetic field.
EMERGENCY MEDICINE
1992
Frederick, Claire C.; Phillips, Maggie (1992). The use of hypnotic age progressions as interventions with acute psychosomatic conditions. American Journal of Clinical Hypnosis, 35 (2), 89-98.
Age progression as a hypnotherapeutic technique is mentioned infrequently in the literature when compared with its counterpart, age regression. In this paper we explore the use of progressions, or ‘views of the future,’ as prognostic indicators of therapeutic progress and as valuable tools for ego strengthening and for the integration of clinical material. Age progressions vary in the types of suggestions given and can be used to promote growth on multiple levels, facilitating treatment goals and deepening the working-through process. We present six cases in which we used different types of age progressions, and we discuss the significance of the progressions used in each case, within the context of relevant clinical material. We conclude from our observations that the use of hypnotic progressions can be a sustaining, valuable aspect of hypnotherapy, particularly in providing an index of the current direction and progression of the therapy process itself. – Journal abstract.
1990