Fifty-six volunteer medical students participated in three groups balanced for number of subjects, performance at last examination, and hypnotizability. The hypnosis and waking groups attended eight group sessions once a week with general ego- strengthening and specific suggestions for study habits, with a ninth session of age progression and mental rehearsal. Subjects in these two groups practiced self-suggestions (in self-hypnosis or waking respectively) daily for the study period of 9 weeks. The control group experienced sessions of passive relaxation induced by light reading for the same period of time. The hypnosis group improved significantly in coping with examination stress, but there was no significant change in performance on examinations by any of the groups.

Patterson, David R.; Questad, Kent A.; deLateur, B. J. (1989). Hypnotherapy as an adjunct to narcotic analgesia for the treatment of pain for burn debridement. American Journal of Clinical Hypnosis, 31, 156-163

This paper presents a hypnotherapeutic intervention for controlling pain in severely burned patients while they go through dressing changes and wound debridement. The technique is based on Barber’s (1977) Rapid Induction Analgesia (RIA) and involves hypnotizing patients in their rooms and having their nurses provide posthypnotic cues for analgesia during wound cleaning. Five subjects who underwent hypnotherapy showed reductions on their pain rating scores (Visual Analogue Scale) relative to their own baselines and to the pain curves of a historical control group (N – 8) matched for initial pain rating scores. Although the lack of randomized assignment to experimental and control groups limited the validity of the results, the findings provide encouraging preliminary evidence that RIA offers an efficient and effective method for controlling severe pain from burns.

Spiegel, David; Bloom, J. R.; Kraemer, H. C.; Gottheil, E. (1989, October 14). The beneficial effect of psychosocial treatment on survival of metastatic breast cancer patients: A randomized prospective outcome study. Lancet, 888-891.

The effect of psychosocial intervention on time of survival of 86 metastatic breast cancer patients was studied using randomized prospective design. The one-year treatment consisted of weekly supportive group therapy with training in self-hypnosis for pain management, and resulted in significant reductions in mood disturbance and pain. Both the treatment and control groups had routine oncologic care. At ten-year follow-up, only three of the original 86 patients were still alive, and death records were obtained for the other 83. Survival from the time of randomization and onset of intervention was 36.6 (sd = 37.6) months for the treatment group, compared with 18.9 (sd = 10.8) months for the control group, and this difference was highly significant (Z = 3.94, p <.0001) using the Cox life table regression model. Kaplan-Meier survival analysis indicated that the divergence in survival began at 20 months after entry into the study, or 8 months after the treatment intervention ended. These unexpected findings suggest that intensive psychosocial support affects the course of the illness, although the mechanism by which it does so is not clear. Stanton, Harry E. (1989). Hypnosis and rational-emotive therapy--a de-stressing combination: A brief communication. International Journal of Clinical and Experimental Hypnosis, 37 (2), 95-99. It has been suggested that teacher stress might be reduced through cognitive restructuring which is aimed at improving the rationality of their thinking. To test this hypothesis, 40 high school teachers were paired on their level of reasonable thinking, operationalized in terms of scores on the Teacher Idea Inventory (Bernard, Joyce, & Rosewarne, 1983), and allocated at random to one of 2 groups. They also completed the Face Valid Stress Test. The experimental group participated in 4 weekly treatment sessions involving a hypnotic induction and suggestions derived from key elements of Rational-Emotive Therapy. These focused on the reduction of what Ellis (Ellis & Grieger, 1977), the originator of this treatment, calls "irrational thinking." The control group spent the same amount of time discussing stress reduction methods. Both the Face Valid Stress Test and the Teacher Idea Inventory were re-administered at the end of this period and again 12 months after conclusion of the experiment. Results indicated that both the experimental and control groups significantly reduced their levels of irrational thinking and stess, although the former's improvement was more marked, particularly at the 12-month follow-up. Stress Test and the Teacher Idea Inventory were re-administered at the end of this period and again 12 months after conclusion of the experiment. Results indicated that both the experimental and control groups significantly reduced their levels of irrational thinking and stess, although the former's improvement was more marked, particularly at the 12-month follow-up. Stanton, Harry E. (1989). Hypnotic relaxation and the reduction of sleep onset insomnia. International Journal of Psychosomatics, 36, 64-68. A hypnotic relaxation technique was compared to stimulus control and placebo conditions as a means of reducing sleep onset latency (SOL). Forty-five subjects were matched on their baseline SOL as measured through sleep diaries. They were randomly assigned to one of the three groups and experienced four weekly sessions of 30- minutes' duration, with demand effects being controlled through the use of counter- demand instructions. Data generated by the study suggested that the particular hypnotic relaxation treatment used was effective in helping Ss sleep more quickly. Neither stimulus control nor placebo groups recorded similar improvement. Zane, Nolan W. S. (1989). Change mechanisms in placebo procedures: Effects of suggestion, social demand, and contingent success on improvement in treatment. Journal of Counseling Psychology, 36, 234-243. Investigated the treatment effects of three social influence variables frequently implicated in psychotherapy placebos. Socially anxious male Subjects participated in an experimental treatment for reducing dating anxiety. Subjects were either given or not given specific suggestions for decreasing social anxiety, placed in conditions of high or low social demand, and received feedback indicating either high or moderate success on the therapy task. Results support the importance of social influence variables in therapeutic change. Contingent success had its greatest impact on personal attributes; suggestion affected skill behaviors; and social demand effects were found in the self- evaluation of heterosocial performance. Various social influences appear to mediate change differently and do not exert the generic effects commonly assumed to be characteristic of therapy placebos. Implications for outcome research are discussed. 1988 Boeke, S.; Bonke, B.; Bouwhuis-Hoogerwerf, M. L.; Bovill, J. G.; Zwaveling, A. (1988). Effects of sounds presented during general anaesthesia on postoperative course. British Journal of Anaesthesia, 60, 697-702. In a double-blind, randomized study, patients undergoing cholecystectomy were administered one of four different sounds during general anaesthesia: positive suggestions, nonsense suggestions, seaside sounds or sounds form the operating theatre. The effect of these sounds on the postoperative course was examined to assess intraoperative auditory registration. No differences were found between the four groups in postoperative variables. Postoperative course was evaluated by 5 variables: pain, nausea and vomiting, evaluation by nursing staff, subjective well-being, and duration of postoperative hospital stay. From the chart they used amount of postoperative analgesia, volume of nasogastric suction or drainage and fluid lost through vomiting over 6 days post-operatively; duration of postoperative hospital stay was registered after discharge. See p. 699 for details, including wording of questions. They cite their own earlier study that got positive results, and explain the difference as possibly due to use of only male voices on tapes, lack of difference in the sounds on tapes in this study, insensitivity of outcome measures (patients stayed longer in first study than in this one), and sample too small in this study (106). Boeke et al. (1988) report that this double-blind, randomized study of positive suggestions, noise or sounds from the operating theatre presented to 3 groups of patients undergoing cholecystectomy during general anaesthesia had positive results for older patients. patients > 55 years who received positive suggestions had a significantly shorter postoperative hospital stay than the other patients in this age category.

Malone, M.; Strube, M. (1988). Meta-analysis of non-medical treatment for chronic pain. Pain, 34, 231-234.

Conducted a meta-analysis of 109 published studies which assessed the outcome of various nonmedical treatments for chronic pain, 48 of which had sufficient information to calculate effect sizes. The remainder were examined according to proportion of patients rated as improved. Mood and number of subjective symptoms consistently showed greater responses to treatment than did pain intensity, pain duration, or frequency of pain, indicating the importance of using a multidimensional framework for pain assessment. Effect sizes for treatments were 2.74 for autogenic training, 2.67 for hypnosis, 2.23 for pill placebo, 1.33 for package treatments that allowed patients to choose from diverse pain management strategies, .95 for biofeedback, .76 for cognitive therapy, .67 for relaxation, .55 for operant conditioning, and .46 for TENS units. However, the largest numbers of studies were in the area of biofeedback, a treatment package, and relaxation, and we must be cautious in interpreting the effect sizes due to the small number of studies in the sample.

Neufeld, V.; Lynn, Steven Jay (1988). A single-session group self-hypnosis smoking cessation treatment: A brief communication. International Journal of Clinical and Experimental Hypnosis, 36 (2), 75-79.

This study was designed to assess the efficacy of a manual-based, single-session group of self-hypnosis intervention. At 3 months follow-up, 25.92% of the total number of participants (14 male, 13 females) reported continuous abstinence, and at 6 months, 18.52% of the participants reported continuous abstinence. Reported social support and motivation to quit were both associated with successful outcome. Comparison of the current data with other findings reported by the American Lung Association (Davis, Faust, & Ordentlich, 1984) suggests that treatment effects may not be solely attributable to the use of a maintenance manual, education, and attention. Limitations of the research associated with issues of experimental control, generalizability of the findings, and outcome measures are discussed.

Spinhoven, Philip (1988). Similarities and dissimilarities in hypnotic and nonhypnotic procedures for headache control: A review. American Journal of Clinical Hypnosis, 30 (3), 183-194.

Similarities and differences between hypnosis and similar psychological procedures in the treatment of headache are reviewed. A brief outline of various hypnotic and nonhypnotic interventions for headache reduction shows that none of these procedures has consistently proved to produce superior results. Possible common denominators such as control of physiological processes, placebo factors, and the alteration of cognitive factors are discussed. The positive relationship between hypnotic susceptibility and hypnotic pain reduction indicates that the value of hypnosis seems to be less a matter of therapeutic procedure per se than of which context activates a patient’s hypnotic potential for pain reduction.

The author summarizes literature on biofeedback and relaxation: “(a) biofeedback with home practice of relaxation is, at least in some cases, effective in reducing migraine and tension headache; (b) relaxation training alone has also produced some success in reducing migraine and tension headaches; and (c) there is not sufficient evidence that biofeedback in the treatment of these pain problems yields results superior to relaxation training” (p. 184). Hypnotherapy for headache is not reviewed in detail, but he provides a table showing various controlled studies and their results. “With the exception of the methodologically problematic study of Anderson, Basker, and Dalton (1975), no differences in effect are found between hypnosis and biofeedback (Andreychuck & Skriver, 1975; Schlutter, Golden, & Blume, 1980; Friedman & Taub, 1984) and hypnosis and relaxation (Friedman & Taub, 1984; Spinhoven, Van Dyck, Zitman, & Linnsen, 1985)” (p. 184). He notes that there are no studies that directly compare hypnosis and nonhypnotic relaxation interventions for headache.
“In all the studies in which hypnotizability was related to outcome, irrespective of patient selection method of measurement, and hypnotic procedure used, a significant positive relationship between hypnotizability and therapy results was found in more than 350 patients (Andreychuck & Skriver, 1975; Cedercreutz, Lahteenmaki, & Tulikoura, 1976; Cedercreutz, 1978; Friedman & Taub, 1984; Spinhoven et al., 1985). If we consider the level of hypnotizability rather than the details of the hypnotic procedure, it seems that headache patients who are highly hypnotizable benefit more from hypnosis in the reduction of headache.
“However, little reliable information is available concerning the underlying dimensions of hypnotic susceptibility relevant for pain reduction. In the neodissociation theory of Hilgard it is suggested that highly hypnotizable patients register pain covertly outside conscious awareness (Hilgard, 1977, 1979). In the social learning model of Spanos and his coworkers (Spanos, Radtke-Bodorik, Ferguson, & Jones, 1979; Spanos, Kennedy, & Gwynn, 1984), it is assumed that high susceptibles show a relatively greater preference for focusing attention on internal thoughts and images as a way of attenuating pain than low susceptibles.
“A recent experimental study of Miller and Bowers (1986), which directly compared hypnotic analgesia, cognitive-behavior therapy, and cognitive-behavior therapy defined as hypnosis in high and low susceptibles, suggests that pain reduction achieved by highly hypnotizable subjects during hypnosis is not mediated by the deliberate use of cognitive strategies (such as imaginative inattention). Cognitive strategy use resulted in pain reduction only during behavior therapy. Clinical studies about the experiential aspects of high and low susceptible headache patients during hypnosis, biofeedback, relaxation training, and cognitive-behavior therapy are urgently needed. If process research in a clinical setting validates that hypnotic analgesia involves the activation of a subsystem of pain control temporarily dissociated from conscious executive control, a therapy component specific for hypnosis will have been identified” (pp. 189-190).

Wagstaff, Graham F. (1988). Comments on the 1987 Home Office Draft Circular. A response to the comments of Gibson, Haward, and Orne. [Comment/Discussion] .

“Conclusions. Perhaps the most prudent recommendation to be made is that of Gibson to outlaw the forensic use of hypnotic procedures. However, at the same time, Haward could be right in arguing that such a recommendation would in practice result in the baby being thrown out with the bathwater” (p. 48). Author goes on to suggest that the police request the advice of professional hypnosis organizations so that memory enhancement procedures would be applied with “strict safeguards.”

Rogers, Malcolm; Reich, Peter (1986). Psychological intervention with surgical patients: Evaluation outcome. Advances in Psychosomatic Medicine, 15, 23-50.

The Notes are a direct quotation of the authors’ Conclusions. “There is well documented evidence that psychological and behavioral preparation prior to surgery can effect post-operative recovery. In almost all instances, except when patients are characterized by avoidance or denial defenses predominantly, the outcome results have been positive. The effect of interventions have been most consistently positive in reducing length of hospitalization and post-operative pain, but a variety of other improvements in affect and physiologic stability have been shown. As others such as Auerbach have pointed out [76], in all but a handful of studies different intervention approaches have been combined, making it impossible to sort out the specific effects of information, psychotherapeutic relationship, relaxation training, or suggestion given either with or without hypnosis. Indeed it is not only likely that each has had an effect, but there may also be synergistic effects.
“More recent investigations have begun to include measurements of personality differences between patients so that the nature of the intervention can be more specific and appropriate to the individual’s coping style.
“The reduction in length of hospitalization alone (clearly shown to result from pre- operative psychologic preparation) argues forcefully on a cost benefit basis for the inclusions of careful pre-operative preparation. The reduction in pain is also of major importance, and may well reduce future avoidance behavior or post-traumatic disorders, although these latter potential outcomes have not been investigated. It should be kept in mind that there are also a number of studies which have failed to demonstrate the efficacy of psychological intervention on these outcome measures. Moreover, it is extremely difficult in studies of this nature to control adequately for the subtle effects on behavior of experimenter and subject expectation.
“A few points can be made about future strategies in this field. The evidence accumulated to date suggests that all patients undergoing surgery or certain difficult procedures be given the option of pre-operative psychological preparation. The preparation should emphasize what the patient will experience and when, and how to cope with it, i.e., how to move, or breathe, or relax. Rapidly evolving audiovisual capabilities and hospital televisions connected by cable to health education channels will routinely offer such preparation in the future. Patients could choose or not choose to watch (thereby protecting mechanisms of denial).
“Finally, future studies should focus on outcome measures uniquely important to a particular operation and also on longer term rehabilitation outcome measures. An example of the former might be post-operative sexual functioning after prostatectomy. A study by Zokar et al. [77] has shown that the likelihood of this post-operative function is correlated with not only the level of pre-operative anxiety and general ‘life satisfaction’, but also whether the patient received a pre-operative explanation of what to expect from the surgery” (pp. 45-46).

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.

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

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

The authors begin with a discussion of the importance of being able to reduce the amount of blood factor concentrate required by hemophiliacs, including the problems of obtaining uncontaminated blood in an era of HTLV-III and LAV contamination and the fact that some patients with Hemophilia A have developed antibodies to Factor VIII (so- called inhibitor patients). When an inhibitor patient hemorrhages, it is potentially life- threatening. Earlier controlled clinical research by LaBaw (1975) indicated that hypnosis might be useful for decreasing blood usage. The current study builds upon that research and adds further control procedures.

The hypotheses of this study were: “(a) hemophiliacs who received the comprehensive training program including self- hypnosis along with education, support, and relaxation for stress management would significantly reduce the amount of factor concentrate used to control spontaneous bleeding in comparison to randomly assigned waiting list controls; (b) the general distress level, as measured by the SCL-90 (Derogatis, 1977), would significantly decrease for the treatment group from pretraining to follow-up; and (c) hypnotizability as measured by the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. C. Orne (1962) would show a positive correlation with the treatment effect” (p. 74).

Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. C. Orne (1962) would show a positive correlation with the treatment effect” (p. 74).
The Subjects were patients of a hematologically severe status (less than 1% clotting factor present in the blood); ages 11-50, mean age 30; normally distributed on socioeconomic variables; and prescreened to rule out serious psychological dysfunction. The treatment and control groups did not differ in SES or pretest bleeding severity. Control Ss were informed that they would receive the same training after the initial follow- up period. Three Ss were lost from the treatment group because they did not complete the 6 weekly self-hypnosis training sessions, and three from the control group due to geographic move or decision to obtain treatment elsewhere.
Patients recorded their factor usage on log sheets, and their reports were checked with distribution records kept at the clinic. (Factor received during hospital stays was not included. Also 3 “inhibitor” patients–2 treatment, 1 control–were removed from some analyses because they must infuse Factor IX at a level that far exceeds the amount appropriate for body were an inhibitor not present.)
The Ss, in groups of 3-4 people, were educated about the effects of stress on bleeding, physiological signals of overstress, and then trained as a group in self hypnosis. Each training session began with a group hypnosis induction followed by various suggestions and imagery. They were given a cassette tape with suggestions for decreased bleeding, ego-strengthening, relaxation, and sensations of floating. In addition to listening to the tape at least once each day, they were taught rapid (1-2 minute) inductions to combat stress, and were to develop their own self-hypnosis procedure.
In terms of results, 9 of 11 (82%) treatment Ss and 4 of 10 (40%) control Ss decreased in blood factor usage (p<.05). There was a great deal of variability between Subjects. While the treatment group demonstrated an overall decrease in factor usage, the control group actually had an overall increase in usage. The authors speculate that possibly a change in season caused the increase, because several Ss reported that a change in season ordinarily caused an increase due to their arthritic joints. Also, a change to warmer weather might have led to increased physical activity. General distress, measured by General Severity Index of the SCL-90, was reduced significantly for the treatment group. (Results of SCL-90 aren't reported for control group.) The third hypothesis was not supported. In fact, the correlation between HGSHS:A and treatment effect was in the opposite direction from what was expected (- .25, n.s.). However, "there was a significant correlation (rho = .56, p<.025) between Ss' self-reported trance usage and change scores, indicating that those Ss who practiced self- hypnosis more were more likely to have decreased factor usage. There was also a trend (rho = .44, p<.10) between treatment Ss' change scores and their initial distress levels (GSI), suggesting that those Ss who were initially more distressed tended to profit more from treatment" (pp. 78-79). In their Discussion, the authors suggest that the fact that the treatment effect of decreased factor usage was consistent throughout the follow-up period suggests that reduced usage was not due to a placebo effect. They note that placebo responses are usually brief, and situation-specific (Frank, 1976). They see the need for further research to clarify which component(s) of the treatment program are effective (self-hypnosis, relaxation, education, social support), and to extend the length of follow-up period. Since hypnotizability did not correlate with outcome, the results might be due to some other component. Since outcome did correlate with amount of self hypnosis practice, motivation may be an important determiner of effect. Decreased stress was not only reported by Ss but also reflected in changes on the test scores (SCL-90). Also, several Ss spontaneously used the self hypnosis for school and occupational performance, and to relieve headaches. In terms of financial benefits, "the one patient who had the most significant decrease in factor usage noted an average monthly savings of $850. For the entire treatment group (including those few Ss whose factor usage increased), the training resulted in savings of $1240 per month over the follow-up period" (p. 81). performance, and to relieve headaches. In terms of financial benefits, "the one patient who had the most significant decrease in factor usage noted an average monthly savings of $850. For the entire treatment group (including those few Ss whose factor usage increased), the training resulted in savings of $1240 per month over the follow-up period" (p. 81). 1985 Jeffrey, Timothy B.; Jeffrey, Louise K.; Greuling, Jacquelin W.; Gentry, William R. (1985). Evaluation of a brief group treatment package including hypnotic induction for maintenance of smoking cessation: A brief communication. International Journal of Clinical and Experimental Hypnosis, 33 (2), 95-98. Hypnotic, cognitive, and behavioral interventions were used in a 5-session treatment program to assist 35 Ss with maintenance of smoking cessation. 63% of the treated Ss discontinued smoking, and 31% maintained abstinence for 3 months (p <.005). These results include 13 dropouts, all of whom were smoking at 3 months follow-up. No S in the waiting-list-control group quit smoking. The results demonstrate that a brief, group treatment program, including hypnotic techniques, can be effective for smoking cessation. 1984 Funch, Donna P.; Gale, Elliot N. (1984). Biofeedback and relaxation therapy for chronic temporomandibular joint pain: Predicting successful outcomes. Journal of Consulting and Clinical Psychology, 52 (6), 928-935. Fifty-seven patients with chronic temporomandibular joint (TMJ) pain were randomly assigned to receive either relaxation or biofeedback therapy. Therapy efficacy was assessed (immediate posttreatment and 2-year follow-up), and pretherapy factors (demographic, clinical, personality) were used to predict successful outcomes for each therapy group. Although there were no significant differences in outcomes, characteristics of patients with successful outcomes were not similar for the two therapies. Successful patients in the relaxation condition tended to be younger, had experienced TMJ pain for a shorter period of time, and had reported problems with other psychophysiologic disorders. Successful patients in the biofeedback group tended to be older, married, had experienced TMJ pain for a longer period of time, and had not received prior equilibration treatment. Only two of these factors, equilibration and presence of other disorders, were related to both short- and long-term outcomes, suggesting that they may be particularly useful as predictors of outcome. These findings do suggest that knowledge of pretherapy factors, particularly clinical, may allow for more optimal assignment to therapy conditions. Manganiello, Aaron J. (1984). A comparative study of hypnotherapy and psychotherapy in the treatment of methadone addicts. American Journal of Clinical Hypnosis, 26, 273-279. This study sought to examine the effects of hypnotherapy on the ability of methadone-maintained patients to reduce and/or eliminate their drug-taking behavior. Seventy adult volunteers at a methadone maintenance program were randomly assigned to experimental and control groups. The experimental group received hypnotherapy for 6 months in addition to the psychotherapy offered as standard clinic treatment. The control group received only psychotherapy. After treatment a 6-month follow-up was conducted by interviews. Groups were compared to determine significant differences in the number of successful withdrawals, the mean change in methadone dose level, incidence of illicit drug use, and degree of discomfort. Significant differences were found on all measures. The experimental group had significantly less discomfort and illicit drug use, and a significantly greater number of withdrawals. At six-month follow-up, 94% of the Ss in the experimental group who had achieved withdrawal remained narcotic-free. determine significant differences in the number of successful withdrawals, the mean change in methadone dose level, incidence of illicit drug use, and degree of discomfort. Significant differences were found on all measures. The experimental group had significantly less discomfort and illicit drug use, and a significantly greater number of withdrawals. At six-month follow-up, 94% of the Ss in the experimental group who had achieved withdrawal remained narcotic-free. Murphy, Joseph K.; Fuller, A. Kenneth (1984). Hypnosis and biofeedback as adjunctive therapy in blepharospasm: A case report. American Journal of Clinical Hypnosis, 27, 31-37. The efficacy of ophthalmologic, hypnotic, and biofeedback treatment procedures in a case of blepharospasm was evaluated. Manual eye rubbing and eye opening served as dependent measures which were assessed by the patient during treatment and a three month follow-up. Results indicated that ophthalmologic treatment had a limited effect. In contrast, brief hypnosis had a dramatic but short-lived effect and biofeedback had a moderate but sustained effect. Results are discussed in terms of the efficacy of psychological intervention, the limitations of the report, and the need for future research. Whorwell, P. J.; Prior, Alison; Faragher, E. B. (1984, December 1). Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet, 1232-1234. 30 patients with severe refractory irritable-bowel syndrome were randomly allocated to treatment with either hypnotherapy or psychotherapy and placebo. The psychotherapy patients showed a small but significant improvement in abdominal pain, abdominal distension, and general well-being but not in bowel habit. The hypnotherapy patients showed a dramatic improvement in all features, the difference between the two groups being highly significant. In the hypnotherapy group no relapses were recorded during the 3-month follow-up period, and no substitution symptoms were observed. 1983 Classen, Wilhelm; Feingold, Ernest; Netter, Petra (1983). Influence of sensory suggestibility on treatment outcome in headache patients. Neuropsychobiology, 10, 44-47. In 45 headache patients the relationship between sensory suggestibility and three measures of treatment effect-ratings on (1) intensity of headaches; (2) efficacy of drugs, and (3) physician's competence - was investigated in a double-blind long-term crossover study. Subjects scoring high on sensory suggestibility clearly showed more relief of headaches upon the analgesic as well as upon the placebo. The physician's competence was rated higher by high-suggestible patients, whereas ratings on drug efficacy were low in all patients. The seemingly controversial behavior of high-suggestible patients was interpreted as a call for continuation of the physician's efforts in spite of the relief the patients already achieved. Flatt, Jennifer R. (1983). What makes therapy work? Thoughts provoked by a case study. Australian Journal of Clinical and Experimental Hypnosis, 11 (2), 63-72. The case described is offered as illustrating the doubt common to introspective therapists: what _did_ cure the patient? "Francesca's" presenting problem and the object of the short-term psychological intervention described here, was a -chological intervention described here, was a fairly circumscribed set of fears related to enclosed spaces. The therapeutic approach adopted was primarily hypnobehavioural, with hypnotically-assisted systematic desensitization and "in vivo" exposure being the main components of the planned programme. However, at the client's suggestion, one hypnotic session with content planned by the therapist as age regression produced rather dramatic and unexpected results claimed by the patient to effect complete cure. The therapist suggested that "her mind would take her back to a time that was important in understanding her fears and that she would be able to stay calm and relaxed while this past event was revealed to her" (p. 69. She subsequently imagined being in a cave, peaceful and calm. "On being roused from hypnosis, Francesca eagerly described her cave image. She was enthusiastic about the significance of this experience, claiming that it was evidence that in a _previous life_ she had died from being locked into a cave as some sort of punishment and that this pexperience made her fear of enclosed places rational and comprehensible to her" (p. 69). 1981 Frankel, Fred H. (1981). Reporting hypnosis in the medical context: A brief communication. International Journal of Clinical and Experimental Hypnosis, 29 (1), 10-14. Data relating to hypnosis in medicine fall into 3 categories: studies of efficacy, surveys, and reports of rare cases. Studies of the comparative efficacy of hypnosis pose special problems; surveys focused on the possible association between hypnotic responsivity and the nature of a clinical situation or its treatment are encouraged; and the presentation of unique or rare cases is considered. Goldstein, Y. (1981). The effect of demonstrating to a subject that she is in a hypnotic trance as a variable in hypnotic interventions with obese women. International Journal of Clinical and Experimental Hypnosis, 29 (1), 15-23. In order to investigate the question of whether or not Ss experiencing a phenomenon during trance which would be very unlikely to occur outside of trance improves the efficacy of hypnotic treatment for obesity, a S pool of obese women was divided into 3 groups: a non-hypnotic behavior modification group, a hypnosis group without any special phenomenon structured into it, and a hypnosis group with such a phenomenon (hand levitation). Weight-loss data were collected 4 weeks and 6 months after the start of treatment. All treatments resulted in at least moderate weight loss. Statistically significant differences were found between the hypnosis-with-hand-levitation treatment effect and the other treatment effects. Possible reasons for the treatment effects adn the differences obtained are discussed. Gruenewald, Doris (1981). Failures in hypnotherapy. International Journal of Clinical and Experimental Hypnosis, 29 (4), 345-350. Failures in hypnotherapy are discussed in the context of considerations applying to treatment in general. Emphasis is given to the principle that hypnotherapy must be structured according to patients' personality and needs. When treatment fails, therapists should examine carefully what may have led to an unsatisfactory outcome. Wilson, John F. (1981). Behavioral preparation for surgery: Benefit or harm?. Journal of Behavioral Medicine, 4, 79-102. Elective surgery patients were prepared for surgery with training in muscle relaxation or with information about sensations they would experience. Relaxation reduced hospital stay, pain, and medication for pain and increased strength, energy, and postoperative epinephrine levels. Information reduced hospital stay. Personality variables (denial, fear, aggressiveness) were associated with recovery and influenced patients' responses to preparation. Less frightened patients benefitted more from relaxation than did very frightened patients. Nonaggressive patients reacted to information with decreased hospital stay along with increased pain, medication, and epinephrine. Aggressive patients responded to information with decreased hospital stay along with decreased pain, medication, and epinephrine. Patients using denial were not harmed by preparation. A catharsis/moderation model is proposed to explain how information benefits patients. An active coping model is proposed to explain the benefits of relaxation. This study suggests that behavioral preparation benefits even frightened, aggressive, or denying elective surgical patients. 1980 Bornstein, Philip H.; Devine, David A. (1980). Covert modeling-hypnosis in the treatment of obesity. Psychotherapy: Theory, Research and Practice, 17 (3), 272-276. Investigated the efficacy of a covert modeling/hypnosis treatment package in the control of obesity. 48 overweight female volunteers (who had been administered the Harvard Group Scale of Hypnotic Susceptibility, Eating Patterns Questionnaire, and Rotter's Internal-External Locus of Control Scale) were randomly assigned to 1 of the following groups: (a) covert modeling/hypnosis, (b) covert modeling, (c) no-model scene control, and (d) minimal treatment (where Ss received a shortened version of the covert modeling/hypnosis procedure following an 8-wk no-treatment period.) Results indicate a significant effect for weight loss from pretreatment to follow-up across all groups combined. Proportion weight loss measures indicated significantly greater weight loss only for the covert modeling/hypnosis group as compared to the no-model controls. Implications for combining behavior therapy and hypnotic techniques are discussed. (30 ref). 1980 Deyoub, P. L.; Wilkie, R. (1980). Suggestion with and without hypnotic induction in a weight reduction program. International Journal of Clinical and Experimental Hypnosis, 28 (4), 333-340. Identical suggestions for the control of obesity were administered to a group receiving hypnotic induction and a group receiving task-motivational instructions. A no-treatment control group was also included. The only significant finding was greater weight loss by Ss in the task-motivational group than Ss in the control group. Much of the difference was attributed to weight gain of Ss in the control group. Within groups, highly suggestible Ss lost more weight in the hypnotic group, while suggestibility was unrelated to weight loss in the task-motivational group. The possibility that task-motivational and hypnotic Ss approached treatment with different mental sets and expectations was discussed. The role of hypnotizability in the hypnotic treatment of obesity was discussed. Ss approached treatment with different mental sets and expectations was discussed. The role of hypnotizability in the hypnotic treatment of obesity was discussed. Lundy, Richard M.; Heide, Frederick J.; Wadlington, W. L. (1980). Hypnotic responsivity as a predictor of outcome in meditation. International Journal of Clinical and Experimental Hypnosis, 28 (4), 358-366. TM reportedly diminishes Trait Anxiety (not State Anxiety). Spielberger's Anxiety Scale was administered. Non-analytical attention is increased in TM. Spanos, et al. found a relationship between sustained attention in a meditation task and hypnotizability. Both load on the same factor. Used Control and Experimental groups pretested on a scale of hypnotizability (Harvard Scale?): Lows = 1-4; Mediums = 5-7; Highs = 8-12. Subjects were given instructions for modified TM, including a lecture on physiological benefits. "Let the sound 'OM' repeat itself; let that sound pass through and return to the mantra." Subjects logged practice on their 20 minute meditation twice a day, for 7 days. They were given pre- and posthypnotic tests of State and Trait anxiety. RESULTS. Meditators decreased Trait anxiety but not State anxiety. But anxiety was reduced more for high hypnotizables than for other levels. There was greater change in anxiety for High hypnotizables who practiced meditation . No difference in pre- and posthypnotic test on Harvard, confirming Spanos, et al. CONCLUSIONS. This provides more evidence that the skill of hypnotizability has more utility than we had thought, in therapy. Spanos, et al. also found that improvement in meditation was correlated with hypnotizability (in terms of number of intrusions) and Benson, Frankel, et al., found Lows benefit less in blood pressure change with either meditation or hypnosis 1979 Frankel, Fred H.; Apfel, R. J.; Kelly, S. F.; Benson, H.; Quinn, T.; Newmark, J.; Malmaud, R. (1979). The use of hypnotizability scales in the clinic: A review after six years. International Journal of Clinical and Experimental Hypnosis, 27 (2), 63-73. This is a review of the use, after 6 years, of the Stanford Hypnotic Susceptibility Scale, Forms A and B (Weitzenhoffer & E. R. Hilgard, 1959); the Harvard Group Scale of Hypnotic Susceptibility, Form A (Shor & E. Orne, 1962); the Hypnotic Induction Profile (Spiegel & Bridger, 1970); and the Stanford Hypnotic Clinical Scale (Morgan & J. R. Hilgard, 1975) in the clinical situation. The great majority of over 300 patients found their experience with the scale to be a positive one, despite the authors' initial hesitancy about exposing them to the probability of failure on at least some of the items. The standardized scales were administered as specific tests, not as part of therapy. The data on responsivity has not only contributed to clinical strategy in individual cases, but has also added to our understanding of hypnosis, of psychopathology, and of therapeutic outcome. Horowitz, Mardi J. (1979). States of mind: Analysis of change in psychotherapy. New York NY: Plenum Medical Book Company. (Also published in London, England) Provides a configurational analysis approach to describe problems, resources, and processes of change in psychotherapy. Uses psychoanalytic (ego psychology) model "that emphasizes information processing and the structural aspects of self and object representations" (p. ix). The book provides methods for evaluating treatment outcome using increasingly precise ways of observing clinical material. As an example of how the author writes about states of mind, consider that "One could subject Hamlet to a description of his recurrent states of ambivalence, paralysis of action, deadly decisiveness, and pretense of gaiety or of madness; one could describe his various self-images and core models of role relationship, and explain his changes in state by the ways in which he processed information. Similarly, in a psycho-history one could plot the states, images, and information-processing styles of a person whose decisions interacted with important events" (pp. x-xi). Pederson, Linda L.; Scrimgeour, William G.; Lefcoe, Neville M. (1979). Variables of hypnosis which are related to success in a smoking withdrawal program. International Journal of Clinical and Experimental Hypnosis, 27 (1), 14-20. 65 habitual smokers were randomly assigned to one of 4 groups: live-hypnosis plus counseling, videotape-hypnosis plus counseling, relaxation-hypnosis plus counseling, and counseling alone. The content and mode of presentation of the hypnosis session varied among the first 3 groups. At 6 months posttreatment, the live-hypnosis plus counseling group contained significantly more abstainers than the other 3 groups. The importance of the specific content of the hypnosis session and the presence of the hypnotherapist for the effectiveness of the procedure is discussed. Perry, Campbell; Gelfand, Robert; Marcovitch, Phillip (1979). The relevance of hypnotic susceptibility in the clinical context. Journal of Abnormal Psychology, 88 (5), 592-603. Despite experimental evidence that hypnotic susceptibility is a relatively stable characteristic of the individual, and one that is very difficult to modify, clinical investigators tend to see susceptibility as irrelevant to therapeutic outcome. Such investigators view motivational and interpersonal variables as more essential to the therapeutic change. The evidence for the clinical relevance of hypnotizability is sparse and contradictory. Most existing studies stem from medical hypnosis and indicate that susceptibility plays an important role in the successful treatment of such conditions as clinical pain, warts, and asthma. Two studies are reported that seek to pursue a contrary finding reported by Perry and Mullen, who found that susceptibility was unrelated to the successful treatment of a socially learned behavior (cigarette smoking). Both studies confirmed the earlier finding of a lack of relation. In Study 1, however, stepwise multiple regression analysis located three inventory items concerning the motivation of cigarette smokers. The combination of items was found to predict outcome for 67.39% of 46 clients treated either by hypnosis or by rapid smoking. The finding was replicated in Study 2, which utilized a combined hypnosis - rapid smoking technique and employed a different therapist. The outcome for 9 of the 13 quitters and 37 of the 62 nonquitters across the two studies could be predicted by the three motivational questionnaire variables.