2003
Wood, Gary J.; Bughi, Stefan; Morrison, John; Tanavoli, Sara; Tanavoli, Sohrab; Zadeh, Homayoun H. (2003). Hypnosis, differential expression of cytokines by T-cell subsets, and the hypothalamo-pituitary-adrenal axis. American Journal of Clinical Hypnosis, 45 (3), 179-196.
Tested the hypothesis that hypnosis can differentially modulate T-cell subsets, and that this effect is mediated by changes in hypothalamo-pituitary-adrenal (HPA) mediators. Seven healthy, highly hypnotizable volunteers (aged 24-42 yrs) participated in 3 1-day sessions, a baseline and 2 intervention sessions. Hypnosis intervention entailed a standardized induction, suggestions for ego strengthening and optimally balanced functioning of the immune and neuroendocrine systems, and post-hypnotic suggestions for stress management and continued optimal balance of bodily systems. Blood samples were analyzed for T-cell activation and intracellular cytokine expression (Interferon [IFN]-gamma, Interleukin-2 [IL-2], Interleukin-4,) and HPA axis mediators (ACTH, cortisol, and beta-endorphin). The proportion of T-cells expressing IFN-gamma and IL-2 were lower after hypnosis. T-cell activation response to polyclonal stimulation was positively correlated with ACTH and beta-endorphin, while IFN-gamma expression was correlated with levels of cortisol. Further controlled studies utilizing hypnosis with patients in treatment are warranted in order to examine whether an altered T-cell response can be replicated in the presence of disease. (PsycINFO Database Record (c) 2003 APA, all rights reserved)
2002
Hammond, D. C. (2002). Treatment of chronic fatigue with neurofeedback and self-hypnosis.. NeuroRehabilitation, 16, 1-6..
A 21 year old patient reported a relatively rapid onset of serious chronic fatigue syndrome (CFS), with her worst symptoms being cognitive impairments. Congruent with research on rapid onset CFS, she had no psychiatric history and specialized testing did not suggest that somatization was likely. Neuroimaging and EEG research has documented brain dysfunction in cases of CFS. Therefore, a quantitative EEG was done, comparing her to a normative data base. This revealed excessive left frontal theta brainwave activity in an area previously implicated in SPECT research. Therefore, a novel treatment approach was utilized consisting of a combination of EEG neurofeedback and self-hypnosis training, both of which seemed very beneficial. She experienced considerable improvement in fatigue, vigor, and confusion as measured pre-post with the Profile of Mood States and through collaborative interviews with both parents. Most of the changes were maintained at 5, 7, and 9 month follow-up testing.
2001
Kiecolt-Glaser, Janice K.; Marucha, Phillip T.; Atkinson, Cathie; Glaser, Ronald (2001). Hypnosis as a modulator of cellular immune dysregulation during acute stress. Journal of Consulting and Clinical Psychology, 69 (4), 674-682.
To assess the influence of a hypnotic intervention on cellular immune function during a commonplace stressful event, the authors selected 33 medical and dental students on the basis of hypnotic susceptibility. Initial blood samples were obtained during a lower stress period, and a second sample was drawn 3 days before the first major exam of the term. Half of the participants were randomly assigned to hypnotic-relaxation training in the interval between samples. Participants in the hypnotic group were, on average, protected from the stress-related decrements that were observed in control participants”” proliferative responses to 2 mitogens, percentages of CD3-super(+ ) and CD4-super(+ ) T-lymphocytes, and interleukin 1 production by peripheral blood leukocytes. More frequent hypnotic-relaxation practice was associated with higher percentages of CD3-super(+ ) and CD4-super(+ ) T-lymphocytes. These data provide encouraging evidence that interventions may reduce the immunological dysregulation associated with acute stressors. (PsycINFO Database Record (c) 2002 APA, all rights reserved) (journal abstract)
2000
Rossi, Ernest L. (2000). In search of a deep psychobiology of hypnosis: Visionary hypotheses for a new millennium. American Journal of Clinical Hypnosis, 42 (3/4), 178-207.
This search for the deep psychobiological foundations of hypnosis begins with a review of some of the paradoxes of historical hypnosis and the impasse of current theory. It is proposed that further progress requires a deeper investigation of how psychosocial cues can modulate the mechanisms of healing at the CNS, autonomic, neuroendocrine and cellular-genetic levels. The dynamics of hypnotic communication and healing from the cognitive-behavior level to the cellular-genetic are outlined in 4 stages: (1) information transduction between the experiences of consciousness and the limbic-hypothalamic-pituitary system; (2) the psychosomatic network of messenger molecules and their receptors; (3) the immediate early gene protein cascade; and (4) state dependent memory, learning and behavior. Neuroscience research is outlined for its contributions to a mathematical model of how a psychobiological approach to the therapeutic applications of hypnosis and the placebo response could facilitate neurogenesis in the human hippocampus and healing at the cellular-genetic-protein level throughout the body. A series of 10 hypotheses is proposed as a guide for theory and research in therapeutic hypnosis. (PsycINFO Database Record (c) 2002 APA, all rights reserved)
1997
Schafer D. W. (1997). Hypnosis and the treatment of ulcerative colitis and Crohn’s disease. American Journal of Clinical Hypnosis, 40 (2), 111-117.
Ulcerative colitis and Crohn”s Disease can be cured if they are treated as autoimmune diseases with a special understanding of the personality conflicts in the patient. The author hypothesizes that all autoimmune diseases are characterized by a high normal amount of the aggressive instinctual drives and ambivalence about their realization. Each patient”s personality causes the ambivalence to be somaticized into specific autoimmune bodies that aggressively are overproduced and then attack specific tissues. Hypnosis helps in gaining insight, reinforcing interpretations, handling stress, visualizing normal intestinal areas, and controlling of the autoimmune antibodies to the normal level. This paper deals specifically with these 2 diseases.
Hall, Howard; Papas, Angela; Tosi, Michael; Olness, Karen N. (1996). Directional changes in neutrophil adherence following passive resting versus active imagery. International Journal of Neuroscience, 85, 185-194.
This study was designed to determine whether increases or decreases in neutrophil adherence could be achieved following a self-regulation (relaxation/imagery) intervention. Fifteen subjects were randomly assigned to one of three conditions. Two experimental groups employed imagery focused on either increasing or decreasing neutrophil adherence. Subjects had two weeks of self-regulation practice (4 total training sessions) prior to blood drawings. A third group of control subjects had the same number of resting sessions without imagery training. All subjects had blood samples collected before and after either 30 minutes of self-regulation or resting practice for two sessions. Pulse and peripheral finger temperature measures were taken before and after the blood samples. Both experimental groups demonstrated decreases in neutrophil adherence, and the control group showed a tendency toward increases in this measure. The psychophysiologic data for the control group was suggestive of a relaxation response. The experimental group that attempted to increase neutrophil adherence demonstrated psychophysiologic responses that were contrary to relaxation. We concluded that an active cognitive exercise or process is associated with decreases in neutrophil adherence irrespective of the intent of the exercise. In contrast, relaxation without an active imagery exercise was associated with increases in neutrophil adherence. The results of this study are discussed in terms of behavioral engineering of directional immune changes.
1995
Ruzyla-Smith, Patricia; Barabasz, Arreed; Barabasz, Marianne; Warner, Dennis (1995). Effects of hypnosis on the immune response: B-cells, T-cells, helper and suppressor cells. American Journal of Clinical Hypnosis, 38, 71-79.
This study tested the effects of hypnosis on the immune response. High and low hypnotizable Ss were exposed to hypnosis, relaxation or control conditions. Blood samples obtained before treatment and twice thereafter were subjected to flow cytometry analysis. Significant alteration of the immune response as measured by B-cells and helper T-cells was shown only for highly hypnotizable Ss exposed to hypnosis.
1994
Holroyd, Jean (1994, January 27). Hypnosis and the mind-body relationship. [Lecture]
NOTES 1:
Historically, hypnosis has been associated with mental healing (e.g. Mesmer’s salon), and clinical literature has been well reviewed by T. X. Barber (1984); Di Piano & Salzberg (1979); E. Hilgard & J. Hilgard (1975); Mott (1979); Paul (1963); and Perry, Gelfand, & Marcovitch (1979). Recently psychoneuroimmunology research has provided some support for the clinical evidence of healing. Research in this area should provide for determining whether the results are due to relaxation, to suggestion (waking or hypnotic), to personality (high hypnotizability), and should lead to an understanding of the basic physiological processes.
Clinical studies are sometimes given more credence by basic laboratory studies in a closely related area. For example, irritable bowel syndrome responded better to hypnosis with direct suggestions than to a combination of psychotherapy and a placebo pill (Whorwell, Prior, and Faragher, 1984). In the laboratory, Klein and Spiegel (1989) showed that secretion of stomach acid could be controlled by hypnosis and suggestion. Chapman, Goodell, & Wolff (1959) demonstrated that hypnotic suggestions could not only decrease but could increase the inflammatory response to burns, and that the response probably was mediated by a histamine-type substance.
Warts have been removed not only by hypnotic suggestion but by waking suggestion (Spanos, Stenstrom, & Johnston, 1988; Spanos, Williams, & Gwynn, 1990), and the hypnosis was more effective than potent placebo comparison treatment conditions. The elimination of warts may be related to control of blood flow or to a change in the immunological response. Chaves, Whilden, & Roller, 1979 (and Chaves, 1980) showed that dental patients could reduce the blood loss associated with dental surgery, using hypnosis and imagery suggestions. Bennett, Benson, & Kuiken (1986) helped back surgery patients to reduce blood loss using waking suggestions. The immune response also can be modified using hypnotic suggestion (Zachariae, Bjerring, & Arendt-Nielsen, 1989).
In the research on mind-body healing, the following considerations also apply: 1. People’s psychosomatic reactivity may affect the results obtained with hypnosis. Research on the immune response has sometimes used patients with psychosomatic disorders as the research subjects, to assure reactive physiological systems. 2. Severity of the disease may affect outcome (e.g. in the Spanos studies, those with the most warts responded best to the hypnosis intervention). 3. Hypnotizability sometimes relates to outcome and sometimes does not, in these investigations. In general, among very highly hypnotizable people, some can perform one hypnotic task such as develop amnesia while others can perform other, different hypnotic tasks.
In summary, there is an extensive clinical literature on hypnosis and healing, and experimental laboratory studies can offer support and some understanding of hypnosis effects on blood flow, histamine release, acid release, immune cell function, etc. In order to establish the effect of hypnosis one needs to start with the best chances for finding an effect: use high hypnotizable subjects. But later you either need to see if results correlate with general hypnotizability or with some other ability or experience, and often waking suggestion is sufficient.
Zachariae, Robert; Locke, Steven E. (1994, October). Effects of hypnotic suggestions on immune and inflammatory processes–experimental studies 1962-1994. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
NOTES 1:
We reviewed studies of the effects of hypnotic suggestion to enhance or suppress immediate type hypersensitivity (ITH) or delayed type hypersensitivity (DTH) skin responses (investigations between 1960-1994). In the early 60’s most of the studies occurred in England with Black and colleagues. In Black’s studies there weren’t many subjects.
In most studies the stimulus was an allergen to the patient, or histamine injections that mimic immediate type hypersensitivity response. In one study we have used ultraviolet stimulation. Most studies involve decreasing the response, but a few studies used both increasing and decreasing the response.
Measures include the wheal response (local) and erythema (mediated by the nervous system). Most studies find a reduction in both types of response, but in some of our later studies and also the study by Beahrs, Harris, & Hilgard (1970) they didn’t find a wheal response but did find erythema reduction. In the ultraviolet response we didn’t get a reduction in erythema but did in blood flow.
Studies in delayed type hypersensitivity usually measure induration and erythema; 3 used tuberculin, 3 used varicella zoster, 1 used multiple antigens, 1 used mumps. Antigen in mumps is latent in the body so the immune response will be different. Most studies tried to increase and decrease the response; two tried just to increase, one just to depress it. Some tried to increase the response in one arm and suppress it in the other arm. In ours we separated the two conditions by a week.
RESULTS.
ITH in general can be suppressed, both the wheal and flare response. Erythema was altered in six studies, unchanged in three; wheal response was altered in [missed number] and unchanged in four. Some studies used allergic patients or those with a psychosomatic history; others screened them out.
DTH results are inconclusive for erythema and induration. All studies using PPD as the antigen were positive; one study using DCP and DNCB was positive. Negative results are found in three studies using Varicella Zoster; 1 study using the Multitest, and 1 study using mumps as antigen.
One could think the reasons for positive vs. negative results relate to the antigens used, and also the dosages given. Some studies use very small doses; one of ours uses such a large dose it is actually felt and sensed. Health status of Ss also could make a difference: a healthy immune response would resist modification if it’s not needed. Timing between stimulus and measurement also varies. Suggestions and rapport may affect results, and also the presentation of suggestions. (Some studies taped the suggestions, some use scripts, but using tapes or scripts may lessen rapport with the Subjects.) Measurements differ, e.g. from area tested, diameter of measurement, type of measurement (ultrasound to measure skin thickness, caliper measurement of skin thickness). In measuring hypnotizability and selecting only high hypnotizables, you may eliminate people who can modify their physiological processes. Ss differ with degree of prior training (those with training are more able to effect responses than on the first time). Operator differences between hypnotists may have some effect.
Mechanisms of the process being studied are at issue: Are we dealing with immune or non-immune processes. Changes in skin temperature and blood flow suggest the latter (vaso dilation and vaso constriction), because of lack of changes seen in lymphocytes etc, although two studies found some kind of changes.
Damage to cutaneous sensory nerves has produced clearing of psoriasis.
COMMENTS FROM THE AUDIENCE:
H. Bennett: How about hypnotizability of the Subjects? Also, T. X. Barber indicated in a long review article that local vascular response accounts for all of this.
Response: Just testing for hypnotizability isn’t enough. Local response may be important; immunologists say this isn’t immunology because you are affecting nonimmune responses.
1993
Covino, Nicholas A.; Frankel, F. M. (1993). Hypnosis and relaxation in the medically ill. Psychotherapy and Psychosomatics, 60, 75-90.
Interest in the application of hypnotic techniques for patients with medical disorders seems to rise and fall over the years. Enthusiasm for this work comes both from patients and from clinicians. Often, however, these techniques are offered without regard to the psychological theories that should inform their operation and the limits that clinical and experimental research suggest. This article offers a brief description of the elements of hypnosis and a review of the history of the use of hypnotic techniques with a variety of medical problems, including asthma, habits, pain, cardiology, surgical preparation, irritable bowel syndrome, persistent nausea and vomiting, trichotillomania, and infection and immunity. Special attention is placed on the psychological and physiological principles that help to establish the valid use of hypnotherapy.
Don, Norman S. (1993, October). Trance surgery in Brazil. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
NOTES 1:
Showed a videotape of a Brazilian trance surgeon, who cuts without analgesia or asepsis. Patients later report no pain, infections, etc. The healer/surgeon is believed by everyone to be in a trance state, and the body is believed to be taken over by a spiritual doctor. The people involved deny that the patient is in trance.
Hall, Howard; Minnes, Luke; Olness, Karen (1993). The psychophysiology of voluntary immunomodulation. International Journal of Neuroscience, 69, 221-234.
In twenty-two studies of intentional efforts of humans to change immune measures, only four monitored psychophysiologic parameters. One study reported physiologic alterations associated with immune changes. In this current study we examined changes in pulse rate and peripheral temperature associated with intentional changes in neutrophil adherence. Subjects had blood, pulse and temperature recordings collected before and after either a rest condition (Group A), or a self-regulation exercise (Groups B and C) for two sessions. Group C had four prior training sessions before participating in the experimental sessions. This study found no association between psychophysiologic alterations and neutrophil changes. the control group (A) demonstrated no significant neutrophil changes but showed physiologic alterations, whereas, the experimental group (C) that showed increases in neutrophil adherence demonstrated no significant physiologic changes. It was speculated that intentional changes on neutrophil adherence and the pattern of the psychophysiologic measures were associated with and reflective of cognitive activity.
Hall, Howard R.; Papas, Angela; Tosi, Michael; Olness, Karen (1993, October). Bi-directional changes in neutrophil adherence following hypnosis. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
NOTES 1:
At the last time that I presented a paper, I talked about the neutrophil. The neutrophil is a model of convenience because it responds quickly to psychological interventions, it is important in upper respiratory infections, and it can be measured reliably in vitro.
We had found that Ss with two weeks of relaxation/imagery training showed an increase in stickiness of neutrophils. We wanted to replicate and extend that study. We wanted one group to increase, another group to decrease, stickiness in neutrophils. There were a total of three groups, including a resting control group.
The model of investigation involves two weeks of training in self hypnosis or simply resting.
Session 1
1 week of practice
Session 2
Results. The Control group increased adherence in neutrophils. The imagery- increase group and imagery-decrease group both decreased adherence. (In the first study the controls had no previous experience in relaxation. Also, the experimental group that was tested showed a decrease in first week and increased in the second week.)
Imagery is work, and that may result in less adherence. Pulse rate increased for the group trying to increase stickiness, in Session 1–implying less relaxation for them.
Hypnotizability (measured with the Pennsylvania State University Scale) was not correlated with increase in neutrophil adherence.
Olness, Karen N. (1993, October). Hypnosis, research, and public affairs. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
NOTES
Bill Moyers’ TV show on public television, Healing and the Mind, was seen by 15 million when first shown, and the book became a Book of the Month selection. Consumer Reports published _Mind-Body Medicine_. A TV program, _Heart of Healing_, sponsored by Noetic Sciences, will be shown; their teaching guides refer to the Society for Clinical and Experimental Hypnosis (SCEH).
The federal government’s NIH Office of Alternative Medicine (OAM) now has grants providing up to $30,000; in first year they received 800 letters of intent, ultimately 500 applications. In Nursing Research they also have sponsored research with OAM. OAM and the Cancer Institute are evaluating studies on using visual imagery with cancer patients. July of this year there was a 3-day working conference, with 80 scientists–1/2 of them from NIH–; David Spiegel and Karen Olness were there. Forty draft RIA’s will be coming out. She will give us a draft of the RIA’s.
Fetzer Institute of Michigan has been involved, with Robert Lehman–new director–who vows to make it the leading institute for research on the mind. They funded the NIH Conference, but don’t give direct research support to investigators.
Marketing information on science and clinical medicine is not an interest for me, but Fetzer’s marketing effort has resulted in research support that previously we would not have had. We do not have enough research on the value (cost vs benefits) of hypnotherapy.
Jacknow & Associates looked at nausea in children; hypnotized patients had less nausea than the control group. Syrjala’s study (_Pain_, 1992) and this one did not have a cost benefit component.
A medical student and I learned that even HMOs don’t know the average costs for various treatments for migraine headaches. There are only 3 controlled studies on child migraine that compare drugs to placebos! 5-7% of children in U.S. have migraines; 18% of men and 22% of women also have migraines.
We need more studies of how hypnotic ability can be modified, to increase beneficial outcomes.
We are forming a pediatric multi-site group to study Tourette’s Syndrome and warts. A Wart Sensor is being developed to measure what is going away and in what order; by Case Western Reserve.
There should be increased funds available in the next 5-7 years. The magazine Scientific American, Sept 24 1993, predicts more support for the behavioral sciences.
It’s time to explain the mechanisms of what happens in hypnosis.
Olness, Karen N. (1993, October). Intentional immunomodulation – does it exist?. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
NOTES 1:
Robert Ader coined the term psychoneuroimmunology. The immune system is modulated by feedback mechanisms mediated via neural and endocrine processes, and by feedforward mechanisms, as well (see the second edition of Ader’s book).
Ader, Grota, and Cohen have shown that the immune system of animals also can influence behavior (e.g. genetic influences on preference for chocolate). She thinks this should be considered in designing controlled studies.
In her review of studies, some investigators request Ss to focus on changing an immune parameter; others to “relax.” There is evidence for intentional influence on the immune response. Black in England and Good in the U.S. presented studies (Manteaux, histamine sensitivity, etc.) and all were laboratory studies.
Olness (1986) worked with children: they were given self hypnosis practice with instructions to “increase the immune stuff in your spit.” This suggestion or request resulted in an increase in saliva IgA. [N.B. In giving suggestions to children, don’t’ use the words “I want you to …” because that phrasing may arouse resistance.]
The area of hypnosis and suggestion curing warts has a lot of research papers. We are doing a consortium study on treatment of warts with hypnosis and found that basic agreement on methods, such as “how you define a wart,” don’t exist.
Schoen, Marc (1993). Resistance to health: When the mind interferes with the desire to become well. American Journal of Clinical Hypnosis, 36, 47-54.
Secondary gain has long been viewed as a variable that can significantly affect a patient’s recovery from such conditions as chronic pain disorders, factitious and somataform disorders, and other psychological disorders. Secondary gain has not been evaluated in terms of its impact on major illnesses such as cancer or autoimmune disorders. In this paper I discuss how secondary gain can be present in such illnesses and how it results in a resistance to health. This resistance to health can lead not only to medical noncompliance, but can also ultimately affect the progression and recovery from the illness. I describe how hypnosis can be used to ferret out this resistance to health and how patients in a hypnotic state will indicate or express their resistance to becoming healthy. The advantage of this approach is that it enables the clinician to deal directly with the patient’s unconscious resistance to health.
Walker, Leslie G.; Johnson, Vanessa C.; Eremin, Oleg (1993). Modulation of the immune response to stress by hypnosis and relaxation training in healthy volunteers: A critical review. Contemporary Hypnosis, 10, 19-27.
NOTES 1:
They review literature on modulation of the immune response to stress with relaxation and/or hypnosis, and raise the following questions and conclusions: 1. It is not clear which dependent variables should be studied. 2. There is a need to clarify which independent variables are responsible for particular effects. 3. There is the question of moderator variables. 4. There is room for many more case studies, including single case research (given the uncertainties discussed and the costs of controlled studies). 5. There is evidence that pathways exist whereby the brain could alter or modulate aspects of immune reactivity. [They describe assigning 20 healthy volunteers randomly to experimental or control group. The experimental group received 3 weeks progressive relaxation and cue-controlled relaxation training, with hypnosis before exposure to an experimental stressor–video recording and playback of a doctor-patient role play. They evaluated not only the biochemical and immunological effects of relaxation training but also the effect in modulating the biological responses to stress.] 6. They concentrated on studies with healthy volunteers because there are already known immunological changes in patients who have tumors. However people with a healthy immune system may have a natural limit in how much they can improve their immune response with interventions like hypnosis.
Zachariae, Robert; Bjerring, P. (1993). Increase and decrease of delayed cutaneous reactions obtained by hypnotic suggestions during sensitization. Studies on dinitrochlorobenzene and diphenylcyclopropenone. Allergy, 48, 6-11.
Cutaneous reactivity to challenge with dinitrochlorogenzene (DNCB) and diphenylcyclopropenone (DCP) was studied in 16 subjects following hypnotic suggestions to increase and to decrease response during sensitization. The immunoreactivity to DNCB and DCP was modulated by direct suggestions and guided imagery under hypnosis. Subjects were high in hypnotizability as measured by the Harvard Group Scale of Hypnotic Susceptibility. Measurement of skin reactions to the challenge one month after sensitization was performed double blindly. Results showed a significant (.01) difference in visually scored reactions to DCP and DNCB between the group instructed to increase reaction to DCP and decrease reaction to DNCB and the group given the opposite instructions. A nonsignificant difference (.055) in skin thickness measured by ultrasound was found between the two groups. The study supports previous reports of experimental modulation of immunoreactivity and indicates that the specific immunological processes involved in the development of all allergic reactions may be susceptible to psychological factors.
1992
Ewin, Dabney M. (1992). Hypnotherapy for warts (verruca vulgaris): 41 consecutive cases with 33 cures. American Journal of Clinical Hypnosis, 35, 1-10.
Published, controlled studies of the use of hypnosis to cure warts are confined to using direct suggestion in hypnosis (DSIH), with cure rates of 27% to 55%. Prepubertal children respond to DSIH almost without exception, but adults often do not. Clinically, many adults who fail to respond to DSIH will heal with individual hypnoanalytic techniques that cannot be tested against controls. By using hypnoanalysis on those who failed to respond to DSIH, 33 of 41 (80%) consecutive patients were cured, two were lost to follow-up, and six did not respond to treatment. Self-hypnosis was not used. Several illustrative cases are presented.
NOTES
I do not consider self-hypnosis necessary, and I believe it may be contraindicated. Once the change in sensation has been acknowledged by an ideomotor signal, I suggest that the subconscious will take care of healing the warts and that the patient should ignore them and get interested in other things. Self-hypnosis would require regularly giving attention to the warts, and a high rate of cure is obtained without it. In their controlled study using DSIH with adults, Johnson and Barber (1978) included daily self-hypnosis and got cures in only 3 of 11 (27%) of the hypnotic group. This is the poorest result in the published literature. Their control group of 11 patients was given waking suggestions to ‘practice imagining that the specified wart(s) were tingling for a few minutes each day until they were gone’ and got no change in 3 months. Hellier (1951) got remission in 27 of 74 (36%) patients just using sham x-ray, (waking suggestion without any self-hypnosis). Spanos et al. (1988) instructed their hypnotic group to ‘count their warts every day, and after each counting to close their eyes and spend 3 to 4 minutes imagining the warts on their target hand disappearing.’ Only 2 of 8 patients (25%) with a single wart cleared, while 9 of 14 (69%) with multiple warts lost one or more warts at 6- weeks’ follow-up. My impression is that conscious daily attention to the lesion is contrary to normal body healing of injuries such as cuts, burns, sprains, in which healing progresses best when ignored while undue attention increases suffering” (pp. 3-4).
All Ss were private patients referred for hypnotherapy; most were diagnosed clinically.
“…I found that there were sexual implications in 7 of the 16 miscellaneous warts in patients over 13, so I separated the cases into pre- and postpuberty to evaluate the results” (p. 4).
“An early success was with a medical student (Case 28) with whom I used suggestions of warmth, with the blood vessels dilating and bringing in antibodies, leukocytes, opsonins, etc. Changes were visible in 3 days. This biased me toward using ‘warm,’ but two of the children (Cases 6 and 9) got no result until I gave them a choice. Using ideomotor signals they chose cold. Only two healed with ‘warm,’ while five did with ‘cold.’ All of them had either had the warts cauterized or frozen previously and had a personal feeling about heat and cold. I’ve learned to give the patient a choice on the first visit” (p. 5).
“Three… were first treated using DSIH without result and later responded to hypnoanalysis. After obtaining an ideomotor signal that there was no more subconscious value to the warts, the suggestion was given that the body’s healing processes would take over without any more conscious attention by the patient. No self-hypnosis was prescribed” (pp 7-8).
Gildston, Phyllis; Gildston, Harold (1992). Hypnotherapeutic intervention for voice disorders related to recurring juvenile laryngeal papillomatosis. International Journal of Clinical and Experimental Hypnosis, 40 (2), 74-87.
Recurring juvenile laryngeal papillomatosis is resistant to cure, and thus usually requires multiple operations which may lead to the extensive proliferation of vocal fold scar tissue. Severe hoarseness, sharply lower pitch, and weak loudness levels are common sequelae. Adjunctive hypnotherapy can increase motivation for change, speed up the acquisition of vocal skills, and possibly even facilitate or sustain remission of growths in selected patients. An 8-year-old girl with severe active eruptions went into remission after 16 sessions, and a 12-year-old boy, already in remission at the beginning of the intervention period, remained free of neoplasms throughout the regimen. Whether or not hypnosis contributed significantly to the sanguine results, it is probable that, at the least, the hypnotic intervention facilitated the achievement of certain technical objectives in voice therapy. NOTES 1:
Includes a review of relevant studies of physiologic changes induced by hypnosis.
Hall, Howard R. (1992, October). Voluntary immunomodulation in adolescents: A cyberphysiologic approach. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES 1:
He is working with a normal population studying neutrophils.
Gave Ss 30 minutes of an imagery exercise to increase neutrophil adherence when compared with controls; e.g., imagery could be ping pong balls in the blood stream, clumping together with honey.
Phase 1: blood sample; strategy or rest; blood sample
practice for 1 week at home
blood sample; strategy; blood sample Hypothesis 2 Healthy adolescents who practice cyberphysiologic (imagery) strategies for 2 weeks will increase neutrophil adherence compared with controls.
Phase 2:
2 week training in cyberphysiologic technique
Session 1 and Session 2 same as in first study. (Thus, these Ss had practiced the technique already.)
Results were analyzed with ANOVA. Only one factor was significant: neutrophil adherence, the one they were studying.
The experimental group with no prior training showed less adherence than controls, as did the trained group in session 1; but the trained group in session 2 showed a large increase over session 1.
Does this reflect relaxation or an active cognitive process? The group that showed the most change did not show relaxation effect of lowered pulse and finger temperature, though the other two groups lowered pulse rate some. Therefore, it is not relaxation.
There was no association of hypnotizability to the increase in neutrophils, using the Penn State Group Hypnotizability Scale, which correlates with the Stanford Scale.
In future the author will look at whether Ss can increase and decrease neutrophil adherence.
Hall, Howard; Minnes, Luke; Tosi, Michael; Olness, Karen (1992). Voluntary modulation of neutrophil adhesiveness using a cyberphysiologic strategy. International Journal of Neuroscience, 63, 287-297.
In a study of voluntary immunomodulation, 45 subjects were assigned either to a control group or one of two experimental groups. All groups had blood and saliva samples collected before and after either a 30 minute rest condition (Control group) or a 30 minute cyberphysiologic strategy (Experimental groups) to increase neutrophil adherence. These samples were analyzed on a range of immunologic measurements including neutrophil adherence. The second experimental group practiced a cyberphysiologic strategy two weeks prior to the experimental session. Subjects in each group returned to repeat their exercise in a second session the following week. Analysis of all immune measurements revealed statistical significance for changes in neutrophil adherence. These studies suggest that such strategies may be used to effect changes in immune cell functions. Analysis further revealed that those subjects with prior cyberphysiologic training were able, by the second session, to induce a significant increase in neutrophil adherence.
Hall, Howard R.; Mumma, Gregory H.; Longo, Santo; Dixon, Richard (1992). Voluntary immunomodulation: A preliminary study. International Journal of Neuroscience, 63 (3-4), 275-285.
This study explored the effects of relaxation and imagery procedures on the voluntary self-regulation of immune responses. Immune studies of 19 adults were made before and after a 45 minute intervention consisting of relaxation with imagery aimed at enhancing immune activity. A self-report measure of psychological distress was completed before each blood sample. Results indicate that the seven blood measures of immune functioning were measured with adequate reliability and consisted of two sets of immune parameters. A statistically significant increase in one of the mitogen measures and a marginally significant increase in one of the blood count measures was found following the relaxation/imagery procedure. Age, hypnotizability, and their interaction significantly predicted change on the set of blood count measures but not on the set of mitogen measures. As expected, level of subjective psychological distress generally decreased following the intervention. The methodological limitations of this study included limited sample size and absence of a control group.
Holroyd, Jean (1992). Hypnosis as a methodology in psychological research. In Contemporary hypnosis research (pp. 201-226). New York: Guilford Press.
NOTES 1:
This chapter deals with how the changes brought about by hypnosis (in cognition, behavior, motivation, etc.) may be used in research in other areas of psychology. “The distinction between experimental effects attributable to a personality trait (i.e. hypnotizability), hypnosis context (i.e. an induction), and interaction between the two is particularly important in using hypnosis as a research strategy.
The author discusses suggestibility, imagery enhancement, and changes in the mind-body relationship (immunology, pain, cognitive neuropsychology, attention, learning and memory, and awareness) as they might be employed in social psychology or psychophysiology research. She reviews problems inherent in using hypnosis as part of the research methodology, while noting that hypnosis nevertheless offers new information when introduced into traditional content areas. “For example, in cognitive psychology it has re-introduced the importance of studying experiential aspects of cognition, i.e. I think, I remember, or self reference (Kihlstrom, 1987)” (p. 223).
She concludes, “Hypnosis as a research method will continue to benefit from contributions of radically different theoretical views of hypnotic phenomena. Social- cognitive psychologists have contributed significantly toward unifying the fields of hypnosis research and general experimental psychology. At the same time, advances in neurophysiology and psychosomatic medicine employing hypnosis indicate that there is a role for hypnosis as a research strategy, solely because of its altered-state characteristics. If theoretical physics can reconcile both wave and particle theories of light, it is conceivable that psychology can accommodate both behavioral and state theories of hypnosis” (p. 224).
Isenberg, S. A.; Lehrer, P. M.; Hochran, S. (1992). The effects of suggestions and emotional arousal on pulmonary functions in asthma: A review and a hypothesis regarding verbal mediation. Psychosomatic Medicine, 54, 192-216.
This paper reviews the empirical literature on the relation between asthma, suggestion, and emotion, and proposes the hypothesis that these effects are mediated parasympathetically. The literature indicates that, among asthmatics, suggestion can produce both bronchoconstriction and bronchodilation, and that stress can produce bronchoconstriction. The proportion of asthmatic subjects showing bronchoconstriction to both suggestion and stress averages 35%-40% across studies, but, because of methodological considerations, might be conservatively estimated as closer to 20%. The effect is smaller for suggestion of bronchodilation, and is very short-lived among nonasthmatics. No clear connection has been found between these responses and such subject variables as age, gender, asthma severity, atopy, or method of pulmonary assessment, although some nonsignificant tendencies appear. Most studies in this literature used small n”s and did not systematically examine various somatic, environmental, and demographic factors that could influence results. A hypothesis is presented regarding vagal mediation of psychological effects on the airways, as well as possible alternative mechanisms, and recommendations for future research to evaluate these hypotheses.
Isenberg, S. A.; Lehrer, P. M.; Hochron, S. (1992). The effects of suggestion on airways of asthmatic subjects breathing room air as a suggested bronchoconstrictor and bronchodilator. Journal of Psychosomatic Research, 36, 769-776.
Thirty-three asthmatic subjects were told they were receiving, alternately, an inhaled bronchoconstrictor and inhaled bronchodilator, although they actually were only breathing room air. No subjects showed suggestion-produced effects on FEV1, although two (of the 19 on whom FEF50 was measured) showed effects of greater than 20% on measures of maximal midexpiratory flow. The incidence of the effect is smaller than reported previously, possibly because some subjects in previous studies inhaled saline, a mild bronchoconstrictor, and reversal of effect was not required for classification as a reactor. Higher percentages of subjects in this study showed decreased MMEF in response to the ”bronchoconstrictor”, but this appeared to reflect fatigue rather than suggestion effects. However, the fact that the effect occurred in a relatively non-effort-dependent measure suggests that real changes occurred in bronchial caliber, not just in test effort. Suggestion had a significant effect on perception of bronchial changes, but the correlation between actual and perceived changes was minimal. There was an increase in FVC prior to administration of the ”bronchoconstrictor”, possibly reflecting a preparatory response to the expected drug. Correlations among self-report variables suggested the existence of three personality dimensions among our population related to suggestion and asthma: cognitive susceptibility to suggestion of bronchial change; feeling of physical vulnerability; and anxiety. However, there was no significant relationship between airway response to suggested changes and hypnotic susceptibility, as measured by the Harvard Group Scale of Hypnotic Susceptibility
Ruzyla-Smith, Patricia; Barabasz, Arreed; Barabasz, Marianne (1992, October). Effects of hypnosis and restricted environmental stimulation therapy on the immune response: B- and T-cells, helper and suppresser cells. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES 1:
This research extends Robert Hall’s work with B-cells and T-cells, adding helper cells and suppressor cells to the dependent measures also.
Random assignment of high hypnotizable people and low hypnotizable people to 3 groups resulted in 6 groups: Hypnosis High Hypnotizables (10) Hypnosis Low Hypnotizables (11) REST High Hypnotizables (13) REST Low Hypnotizables (11) Control High Hypnotizables (10) Control Low Hypnotizables (10)
The Research Procedure entailed: Orientation to hypnosis, plateauing hypnosis response through repeated inductions Assigned participants randomly by hypnotizability to above groups Orientation to immune response measurement Administration of the Symptom Check List – 90, Revised Skin conductance response (taken during blood draws to measure anxiety) Pretreatment blood draw Audiotaped hypnotic induction Self hypnosis instructions Posttreatment 1 blood draw One week Treatment 2 Induction Posttreatment 2 Blood draw Post Experimental inquiry
Prior to first session Ss in Group 1 received orientation to flotation tank Pretreatment blood draw One hour REST session [with no suggestions to alter the immune response] Posttreatment 1 blood draw One week Treatment 2 REST session Posttreatment 2 Blood draw Post experimental inquiry
Waiting list controls experienced: First blood draw Second blood draw after 1 hour One week follow up Third Blood draw Post experimental inquiry
(N.B. SCL-90 apparently was being taken on each experimental visit.)
RESULTS
The analysis used covariate of pretreatment measurements. Immune response measured was a standard procedure, e.g. % B-Cells by FACS (the dot measure of immune response). Post Treatment 1 showed high and low hypnotizables increasing their B-cells in the hypnosis condition; also H-cells increased. Highs in hypnosis had higher T-cells when compared with highs in REST but not in other treatment and control groups.
No significant changes were observed in T suppressor cells, though high hypnotizables in the hypnotized condition seemed to have increase in suppressor cells. Maybe it was the way the suggestion was given; perhaps we should say they would not only increase their helper cells but would decrease their suppressor cells.
The author viewed the results as supporting Hilgard’s neodissociation theory.
Spiegel, David (1992, October). Hypnotizability. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES 1:
Dr. Spiegel announced that this was a last minute substitution for Fred Frankel’s presentation on Hypnotizability.
We have ongoing a major replication of the study that we published on group therapy with terminally ill breast cancer patients. The matched control patients get educational materials but not psychotherapy. We are looking at NKC cytotoxicity and delayed hypersensitivity.