1978
Benson, Herbert; Frankel, Fred H.; Apfel, Roberta; Daniels, Michael D.; Schniewind, Henry E.; Nemiah, John C.; Sifneos, Peter E.; Crassweller, Karen D.; Greenwood, Martha M.; Kotch, Jamie B.; Arns, Patricia A.; Rosner, Bernard (1978). Treatment of anxiety: A comparison of the usefulness of self-hypnosis and a meditational relaxation technique. Psychotherapy and Psychosomatics, 30, 229-242.
We have investigated prospectively the efficacy of two nonpharmacologic relaxation techniques in the therapy of anxiety. A simple, meditational relaxation technique (MT) that elicits the changes of decreased sympathetic nervous system activity was compared to a self-hypnosis technique (HT) in which relaxation, with or without altered perceptions, was suggested. 32 patients with anxiety neurosis were divided into 2 groups on the basis of their responsivity to hypnosis: moderate-high and low responsivity. The NIT or HT was then randomly assigned separately to each member of the two responsivity groups. Thus, 4 treatment groups were studied: moderate-high responsivity MT; low responsivity MT; moderate-high responsivity HT; and low responsivity HT. The low responsivity HT group, by definition largely incapable of achieving the altered perceptions essential to hypnosis, was designed as the control group. Patients were instructed to practice the assigned technique daily for 8 weeks. Change in anxiety was determined by three types of evaluation: psychiatric assessment; physiologic testing; and self-assessment. There was essentially no difference between the two techniques in therapeutic efficacy according to these evaluations. Psychiatric assessment revealed overall improvement in 34% of the patients and the self-rating assessment indicated improvement in 63% of the population. Patients who had moderate- high hypnotic responsivity, independent of the technique used, significantly improved on psychiatric assessment (p = 0.05) and decreased average systolic blood pressure from 126.1 to 122.5 mm Hg over the 8-week period (p = 0.048). The responsivity scores at the higher end of the hypnotic responsivity spectrum were proportionately correlated to greater decreases in systolic blood pressure (p = 0.075) and to improvement by psychiatric assessment (p = 0.003). There was, however, no consistent relation between hypnotic responsivity and the other assessments made, such as diastolic blood pressure, oxygen consumption, heart rate and the self-rating questionnaires. The meditational and self- hypnosis techniques employed in this investigation are simple to use and effective in the therapy of anxiety.
1978
Frankel, Fred H. (1978). Scales measuring hypnotic responsivity: A clinical perspective. American Journal of Clinical Hypnosis, 21, 208-218.
Differences in the experiences of clinicians and laboratory investigators regarding the distribution of hypnotizability are addressed. The use of various rating scales in the clinical context is reviewed, and the importance of the scales in defining the difference, conceptually, between hypnosis and other procedures capable of achieving similar results is emphasized. The use of the scales in determining the treatment strategy is compared with the customary practice of the experienced clinician, and with the importance of the characteristics of the total clinical situation. An illustrative case report is included.
Kaplan, Jerold Z.; Wakeman, John (1978). An experimental study of hypnosis in painful burns. American Journal of Clinical Hypnosis, 21, 3-12.
The present study examines the usefulness of hypnosis in the control of acute pain in thermal and electrically burned patients as an adjunctive analgesic during the routine care of burn wounds. It was hypothesized that the use of hypnosis would lead to significant reductions in the amount of drugs needed as compared to patients using medication only. Anxiety and discomfort associated with daily tanking, debridement, and dressing changes were expected to be reduced because of the introduction of hypnotic procedures. The experimental study also examined the variables of age and percent of burns. Two studies were conducted including patients with 0-20% total body burns and 31-60% burns. A variety of hypnotic techniques were used. Both studies revealed significantly lower percentages of medication used (p <.01) by the hypnotic groups than control groups. The 7-18-year-old patients used significantly less medication (p < .05) than the adult groups. The implications of the findings, and usefulness of hypnosis and ego strengthening techniques for improvement of self-confidence and improved body image were considered. Parker, Jerry C.; Gilbert, Gary S.; Thoreson, Richard W. (1978). Reduction of autonomic arousal in alcoholics: A comparison of relaxation and meditation techniques. Journal of Consulting and Clinical Psychology, 46 (5), 879-886. To investigate and compare the effects of progressive relaxation training and meditation training on autonomic arousal in alcoholics, 30 subjects were selected from a population of alcoholics in a Veterans Administration hospital substance-abuse program. The subjects were randomly assigned to one of the following three experimental conditions: (a) progressive relaxation training group, (b) meditation training group, or (c) quiet rest control group. All groups met for 3 weeks during which state anxiety, blood pressure, heart rate, and spontaneous galvanic skin responses were measured. The measures were designed to assess the treatment effects following the first training session and at the end of the total training period. The results indicate that both progressive relaxation training and meditation training are useful for reducing blood pressure in alcoholics. In addition, significant differences between the groups in the effectiveness of the relaxation procedures were found. Meditation training induced blood pressure decreases at an earlier point in the 3-week training period and affected decreases in systolic blood pressure that progressive relaxation training did not. These results support the idea of considerable specificity of response to relaxation techniques. 1977 Albornoz-Ruiz, Jose M. (1977). Suggestibility as a factor in medical treatment. Maryland State Medical Journal, 26, 66-68. This paper presents the view that a physician must be aware of the great influence, direct and indirect, s/he has with the patient as a result of their relationship. "Here it should be remembered that the power of a suggestion, without the benefit of formalized hypnosis, is directly related to the intensity and nature of the emotional bond between the patient and the doctor, often colored by a marked transferential unconscious component, where the doctor stands 'in loco parentis' vis-a-vis the patient, regardless of the age, education or intellectual sophistication of the latter. Whatever the nature of the perception that is eventually presented by the patient as a symptom or identified by the doctor as a sign of illness, such perception will be elaborated upon by the patient's fancy, in lonely reveries where he defines for himself causes, nature and possible course of his disorder, not always in keeping with those established by the doctor as he exposes the same set of phenomena to his learned medical judgment" (p. 68). Barkley, R. A.; Hastings, J. E.; Jackson, T. L., Jr. (1977). The effects of rapid smoking and hypnosis in the treatment of smoking behavior. International Journal of Clinical and Experimental Hypnosis, 25 (1), 7-17. 29 Ss were assigned to one of 3 treatment conditions and treated for their cigarette smoking over a 2-week period. These conditions were: group rapid smoking, group hypnosis, and an attention-placebo control group. All treatments produced significant reductions in average daily smoking rates during the treatment phase but all Ss returned to near baseline levels of smoking by the 6-week follow-up. The rapid smoking and hypnosis groups did not differ from the control group in smoking rates at treatment termination or at the 6-week follow-up. They also did not differ from the control group in the number of Ss abstaining from smoking by treatment termination but did differ at follow-up. Eventually, at the 9-month follow-up, only Ss from the group rapid smoking condition had significantly more abstainers than the control group. The results suggested that rapid smoking can work as effectively in group procedures as previous individualized approaches had demonstrated. Group hypnosis, while less effective than some previous individualized approaches had indicated, was nevertheless only marginally less effective than the group rapid smoking procedure. The use of abstinence rates as opposed to average rates of smoking was strongly recommended as the best measure of treatment effectiveness for future research in this area. Stern, John A.; Brown, M.; Ulett, George A.; Sletten, Ivan (1977). A comparison of hypnosis, acupuncture, morphine, Valium, aspirin, and placebo in the management of experimentally induced pain. Annals of the New York Academy of Sciences, 296, 175-193. "What general conclusions can we come to on the basis of these investigations? We conclude that hypnosis and suggestions of analgesia, morphine, and acupuncture stimulation (of LI 4, 14, and 15 on the arm exposed to painful stimulation) are effective in reducing experimentally induced pain. This is true for both a cold pressor pain-induction procedure and an ischemic pain-induction procedure. Hypnotic suggestibility does not account for the effectiveness of acupuncture stimulation, though good hypnotic Ss show better protection against pain with hypnotic suggestion and morphine. "Good hypnotic Ss experience more pain than is true for Poor hypnotic Ss when exposed to the same pain-induction procedure. The effect is more marked for the cold-pressor than the ischemic pain procedure. Good hypnotic Ss are more responsive -- i.e., show grater reduction in pain perception -- to drugs and intervention procedures that produce significant subjective sensations (morphine and diazepam) than is true of Poor hypnotic Ss. This is not true for aspirin and p0lacebo. Last, but not least, Ss low in hypnotic susceptibility tend to perceive painful stimuli as more painful when under the influence of diazepam as compared to the nondrug condition" (p. 192). 1976 Moore, Mary E.; Berk, Stephen N. (1976). Acupuncture for chronic shoulder pain: An experimental study with attention to the role of placebo and hypnotic susceptibility. Annals of Internal Medicine, 84 (4), 381-384. One half of 42 Ss treated for painful shoulders received classic acupuncture, and one half received a placebo in which the needles did not penetrate the skin. Half of each of these groups was treated in a positive setting to encourage the subject, and half in a negative setting designed to keep encouragement at a minimum. All patients were independently rated for susceptibility to hypnosis. Although range of motion did not improve, the majority of patients reported significant improvement in shoulder discomfort to a blind evaluator after treatment; placebo and acupuncture groups did not differ in this respect, however. The positive and negative settings did not affect treatment outcome. In all groups, those who were not rated as highly susceptible to hypnosis tended to fail to achieve the highest levels of relief, but such differences were not statistically significant. There were 42 subjects, and they were tested with the Spiegel Hypnotic Induction Profile. "Both acupuncture and placebo proved to be effective in relieving shoulder discomfort. 69% of the total group made lower assessments of discomfort on the post-treatment rating than on the pretreatment rating" (p. 382). "Acupuncture was not more effective than placebo in relieving discomfort, however. The average percentage of improvement among those who had acupuncture was not, statistically, significantly different from those who had placebo. Indeed, what little difference there was actually was in the opposite direction, the placebo group improving on the average somewhat more than the acupuncture group" (pp. 382-383). "In the negative setting, however, where the subject was required to suffer in silence, acupuncture seemed to be less effective than the placebo in relieving discomfort" (p. 383). "Although the subjects perceived that the treatment relieved their shoulder discomfort, there was no objective evidence of improvement in the shoulder as measured by change in the range of motion scores before and after treatment" (p. 383). (The placebo was needle pricked against the skin at true site, then rapidly and lightly tapped against the surface of the skin without penetration.) "Those who were not susceptible to hypnosis failed to experience as much relief from discomfort as those who were" (p. 383). "The fact that acupuncture was not more successful in relieving shoulder discomfort than a sham procedure suggests that its much publicized success may be merely a powerful placebo effect" (p. 383). Katz, Kao, Spiegel et al (1974) also found that low hypnotizables did not benefit much in terms of pain relief with acupuncture. 1975 Andreychuk, Theodore; Skriver, Christian (1975). Hypnosis and biofeedback in the treatment of migraine headache. International Journal of Clinical and Experimental Hypnosis, 23 (3), 172-183. A study was made to explore the effects of subject hypnotizability in response to 3 treatment procedures applied to 33 migraine headache sufferers. These treatment procedures included biofeedback training for hand-warming, biofeedback training for alpha enhancement and training for self-hypnosis. The Hypnotic Induction Profile (HIP) of Spiegel & Bridger (1970) was given to each S to determine degree of hypnotizability and the MMPI was administered to all Ss. All 3 treatment groups showed significant reductions in headache rates and there were no significant differences between groups. Cutting across treatment groups, high hypnotizable Ss (N - 15) showed significant reductions in headache rates when compared with low hypnotizable Ss (N - 13). There was no correlation between HIP scores and the hysteria scale of the MMPI. This research investigated the relationship between hypnotizability and treatment outcome. Collison, David R. (1975). Which asthmatic- patients should be treated by hypnotherapy?. Medical Journal of Australia, 1 (25), 776-781. Retrospective analysis of 121 asthmatic patients who were treated by hypnotherapy. Subjects were first broken down into one of three possible groups: "light," "medium," or "deep," according to the depth of trance typically achieved. Hypnoidal states were included in the light trance group and somnambulistic state in the deep trance. All sessions concentrated on suggesting physical and mental relaxation since we know this is one of the causes of the appearance of the "asthma attack." The actual wording varied however, and this involved discussion under hypnosis, of the main personalities of the environment, fears, failures, aims, hopes and frustrations. Post-hypnotic suggestions of continued relaxation and ability to cope with the various situations of life were given in all the cases. Auto-hypnosis was taught to enable the patient to reinforce the above suggestions and to remain in or selectively achieve a relaxed state. Results were classified into four different categories: "excellent," "good," "poor," and "nil." It was found that those patients who experienced a "high" trance depth were more likely to show excellent improvement than those who were measured as "medium" or "low" trance subjects. Mullen, G.; Perry, C. (1975). The effects of hypnotic susceptibility on reducing smoking behavior treated by a hypnotic technique. Journal of Clinical Psychology, 31, 498-505. In order to examine the relationship between hypnotizability and treatment outcome in which hypnosis is used, 54 people ages 19-47 who undertook to stop smoking were studied. Although it is logical that there should be a relationship, clinical anecdotal material published by people who used hypnosis (Freud, Weitzenhoffer, Lazarus, Sheehan, Orne) suggests that may not be the case. Hypnotic susceptibility was evaluated with a clinical procedure developed by Orne and O'Connell (the DRP). Patients were taught self hypnosis using a brief procedure developed by Herbert Spiegel. Baseline smoking rate and three-month follow-up with postcards mailed every week were employed as measures. Success in the treatment program was defined as a 50% reduction in smoking behavior. After 3 months, 7 people were abstinent, 10 had reduced smoking to criterion level (50%), 16 people had discontinued the investigation, and 21 did not change. Considering only the 15 most and 15 least hypnotizable, 12 of the 15 high susceptibles had reduced smoking by at least 50%, as compared to 5 of the 15 of the low susceptibles. (chi square = 4.88, df = 1, p<.05). Samko, Michael R.; Schoenfeld, Lawrence S. (1975). Hypnotic susceptibility and the Lamaze childbirth experience. American Journal of Obstetrics and Gynecology, 121, 631-6. This study explored the relationship between childbirth training and hypnotic susceptibility. A multiple linear regression analysis was performed on the various medical and attitudinal variables related to the subjects' Lamaze childbirth experience and these were tested against hypnotic susceptibility. The results of the analysis indicate that hypnotic susceptibility is not significantly related to Lamaze training, nor is it significantly related to the type of childbirth experience that a Lamaze trained woman has. Subjects used in this experiment (N = 55) were women who had received Lamaze training within the last two years, and had delivered only one child. The HIP was administered to find a score of hypnotizability and the women were given two questionnaires. The first of the questionnaires sought demographic and medical information, the second was an attitude questionnaire about her childbirth. A third questionnaire was given to the attending physician. "The correlations between hypnotic susceptibility and the physician's rating of how successful he felt the subject's use of the Lamaze technique (r = 0.12) and the physician's rating of how helpful he found the mother's use of the Lamaze technique was to delivery (r = 0.17) were both nonsignificant" p. 634). 1973 McReynolds, William T.; Barnes, AllanR.; Brooks, Samuel; Rehagen, Nicholas (1973). The role of attention-placebo influences in the efficacy of systematic desensitization. Journal of Consulting and Clinical Psychology, 41 (1), 86-92. Systematic desensitization was compared with two attention- placebo control treatments - one taken from Paul and one currently devised as an elaborate, highly impressive "therapeutic" experience - and no treatment. It was hypothesized that (a) fear reductions following desensitization would be no greater than those associated with an equally compelling placebo treatment and (b) fear and control measure changes following the previously used attention-placebo treatment would be less than those following desensitization and the present placebo control manipulations. Both hypotheses were supported, although support for the first was more consistent than for the second. 1970 Maher-Loughnan, G. P. (1970). Hypnosis and auto-hypnosis for the treatment of asthma. International Journal of Clinical and Experimental Hypnosis, 18 (1), 1-14. Conducted 2 controlled studies into the use of hypnosis in 252 asthma patients. Several different control procedures were used. Methods and results were summarized, and the same conclusion was reached: That hypnosis supplemented by autohypnosis was significantly more effective than control procedures. An outline is given of details of treatment methods. A current analysis of Ss involving up to 6 yr. of follow-up, is presented to provide a working guide to the regime in regular practice. To be fully effective hypnosis should be employed before steroids are started. Steroid-dependent asthma is rarely totally relieved by hypnotherapy. (Spanish & German summaries) (PsycINFO Database Record (c) 2003 APA, all rights reserved) 1969 Rock, Nicholas; Shipley, Thomas; Campbell, Colin (1969). Hypnosis with untrained, nonvolunteer patients in labor. International Journal of Clinical and Experimental Hypnosis, 17, 25-36. 20 nonvolunteer, untrained Ss were individually hypnotized during active labor and compared with 18 controls selected by the same criteria and receiving the same obstetrical treatment. Hypnotized Ss required less medication and obtained greater relief of pain than the controls. The time involved in induction of hypnosis was only 20 min., and the total time added by hypnotic procedures was only 45 min. longer than the regular care of the control group. It was concluded that hypnosis can be used easily on nonvolunteer, untrained patients in active labor, even in a noisy environment, without any serious sequelae. (Spanish & German summaries) (16 ref.) (PsycINFO Database Record (c) 2002 APA, all rights reserved) 1968 Faw, Volney; Sellers, David J.; Wilcox, Warren W. (1968). Psychopathological effects of hypnosis. International Journal of Clinical and Experimental Hypnosis, 16, 26-37. The probability that hypnotic induction produces psychopathological effects has not been experimentally determined. The present study hypothesizes various negative effects following hypnosis such as increased signs of personality disturbances, increased need for medical attention, greater tendencies toward suicide, and negative effects among the more maladjusted persons of the population sample. 107 college students were assigned at random to experimental and control groups. The experimental group was hypnotized 3 times in successive weeks. A comparison between control and experimental groups in respect to pre- and post-MMPI score differences plus a follow-up with the college counseling center and infirmary for a 90-day period following induction led to the rejection of the hypotheses. A comparison of measures yielded some significant differences in favor of the experimental group. It is concluded that there are nondetrimental effects when hypnosis is used with a normal college population. 1964 Leckie, F. H. (1964). Hypnotherapy in gynecological disorders. International Journal of Clinical and Experimental Hypnosis, 12 (3), 121-146. The attitude and position of a gynecologist employing hypnotherapy in clinical practice is emphasized. Particular consideration is given to dysmenorrhea (25 cases), dyspareunia (30 cases), vaginismus (15 cases), frigidity (12 cases), and anxiety states encountered in gynecological practice (26 cases). An indication is given of the general method and of the specific pattern of treatment, which initially is directed to symptom removal by direct suggestion. When this method proves ineffective, special techniques are employed to carry out therapy at a deeper level. Details of clinical data of all cases are presented together with evaluation of the percentage of success achieved. Results have proved encouraging. Several illustrative cases are described. 1962 Kolouch, Fred T. (1962). Role of suggestion in surgical convalescence. Archives of Surgery, 85, 144-155. The author is a surgeon who has offered hypnosis to many patients in his practice. His inductions were usually rapid (30 seconds to 10 minutes), stressing optimistic expectations. The procedure is described as follows: "Suggestion is then utilized in a purposeful manner to communicate a reality image of the entire surgical procedure to the patient. A frank but optimistic discussion of morbidity and mortality is made. An estimate of the pain to be experienced is offered with the emphasis that this can be controlled in part and it will be temporary. The patients are told that they may use opiates or sedatives if they feel a need for chemical pain relief. Any subconscious fears of surgery are investigated using ideomotor questioning. These are ventilated by the patient and put in the proper perspective in relationship to the realities of the forthcoming surgical procedure. If the patient is capable, he is taught glove anesthesia of the hand and given a posthypnotic suggestion for the transference of this to his operative site. He is asked to visualize himself at the conclusion of his convalescence, free of his pathology, alive and well and rehabilitated to normal productivity. It is emphasized to him that by judicious application of his subconscious thoughts to relaxation, pain control, normal respiratory, gastrointestinal, and urinary functions, he may rapidly accomplish his own preconceived notion of his convalescence. "He is given a posthypnotic suggestion that he will never respond to hypnosis without his consent. ... "A posthypnotic suggestion is given to establish a simple signal as a trance inducer for future hypnosis or to enable him to use autohypnosis. "The patient who is to have a general anesthetic is given the suggestion that while asleep he will not listen to any conversation in the operating room except that which is directed toward him by name. "In the patients undergoing minor outpatient surgery, hypnosis is frequently induced in the operating room during the scrub time. "Patients undergoing general or regional anesthesia are frequently placed in a trance before the anesthetic period. ... "During the surgery care is taken to keep discussion at a level unrelated to the surgical procedure. ... "At the conclusion, consistent with an honest appraisal of the situation, optimistic, purposeful suggestions are offered the patient while he is still asleep or in hypnosis" (p. 305. The author evaluated the outcome for 100 surgical patients who had received this procedure, using subjective measures (confidence, well-being, freedom from fear and anxiety) and two objective measures (needs for postoperative pain-relieving drugs, and postoperative hospitalization). Seventy-five patients aged 6-80 had 81 different procedures (breast biopsies, tenorrhaphies, orchiopexies, herniorrhapies, thyroidectomies, a radical neck dissection, radical mastectomies, cholecystectomies, gastrectomies, rectal surgery, etc.); the remaining 25 patients had minor outpatient procedures under local or hypnoanesthesia. The author compared the dosage of medications needed by patients he judged to have benefitted from hypnosis and those who didn't benefit. He did the same analysis for length of stay. Based on his own observations, he judged that 75% of the hospitalized patients and nearly all of the OPD patients benefitted and experienced a simplified convalescence. Laparotomy patients required more medications than the other patients. The author compared the hospitalized patients who received hypnotic suggestion to a similar group who were not subjected to such suggestion, on needs for opiates and postoperative hospitalization. There was a reduction in drug needs in most categories of cases, but equal needs in the biliary cases. in the biliary cases. Patients subjected to thyroidectomy or herniorrhaphy left the hospital sooner if they had been given hypnosis, but the patients undergoing biliary and gastric surgery still required the usual hospital care. Herniorrhapy patients benefitted in terms of catheretization: only was catheterized in the hypnosis group compared to 7 in the nonhypnosis group. The author attributed this outcome to a combination of suggestion and local anesthesia. Postoperative complications were rare in the patients utilizing hypnosis. The economic advantages of suggestion are illustrated in a comparison of the costs of hospitalization of the series of patients undergoing herniorrhaphy and thyroidectomy with and without hypnosis: average cost of thyroidectomy with hypnosis used effectively ($196) and without hypnosis ($311); of herniorrhaphies with hypnosis used effectively ($125) and without hypnosis ($181). N.B. These costs are presumably from the time period of approximately 1959-60, inasmuch as the paper was read at the Annual Session of the Western Surgical Association on December 1, 1961. "Probably the most pleasure for the surgeon results from the observation of the responses of children to suggestion in hypnosis. A degree of cooperation and freedom from fear is exhibited that is nearly unbelievable. With hypnosis in children one may utilize local anesthesia in situations which previously required general anesthetics" (p. 310). 1962 Weitzenhoffer, Andre M. (1962). The significance of hypnotic depth in therapy. International Journal of Clinical and Experimental Hypnosis, 10 (2), 75-78. It is a common assumption that hypnosis has a quality of degree. While clinicians often state that success is unrelated to depth, the author maintains that depth determines the techniques one can successfully use in hypnotherapy. At the same time he believes that hypnotic behavior is multidimensional and that the major determinant of hypnotherapeutic success is the therapist''s ability to establish a meaningful interpersonal relationship. (PsycINFO Database Record (c) 2002 APA, all rights reserved) 1961 Pearson, R. E. (1961). Response to suggestion given under general anesthesia. American Journal of Clinical Hypnosis, 4, 106-114 Employed a double-blind design with placebo control. Audio tapes containing therapeutic suggestions were played to 43 experimental patients during anesthesia. The main theme of the suggestions was that the patient would cope better and recover faster if he could become relaxed. Placebo tapes (music or blank tapes) were played to the 38 control patients. Only E, who had no contact with the patients, knew which tape was played to a given patient. Three postoperative variables were studied: (a) number of doses of narcotics in the first 5 postoperative days; (b) a numerical rating by the surgeon of the postoperative course; and (c) number of postoperative days until release. Although no significant differences were found between the suggestion group and placebo group on need for narcotics or rated course of recovery, patients receiving suggestions were discharged an average of 2.42 days sooner (p < .05). 1955 Hart, Hornell (1955). Measuring some results of autohypnosis. Journal of Clinical and Experimental Hypnosis, 3 (4), 229-242. The author developed self ratings for mood (euphoria-dysphoria) and alertness-fatigue, which were administered to college students in neutral conditions and after self-hypnosis conditions. The self hypnosis, or "auto-conditioning" usually involved deep relaxation self suggestions followed by other suggestions. The suggestions involved using the word 'you' to be able to re-instate the autoconditioning more and more effectively; suggestions for attitude change (e.g. that 'No matter what comes, we will grapple with it courageously'); and euphoria auto-suggestions (e.g. that 'you will come out of this deep relaxation, feeling rested, alert, cheerful and courageous'). In both single session experiments, as with a class of nurses who experienced an 8 minute auto-conditioning procedure, and in experiments extending over time, depression decreased. He noted that "for various reasons, the students who participated in autoconditioning experiments between February and May, 1955, were in many respects less successful than some of the previous experimental groups had been" (p. 235). Increased alertness and diminished fatigue was also observed. Many students chose to give themselves suggestions to correct the habit of procrastination. Two-thirds of the participants reported complete success, up to the level specified, and only one of 43 experiments on correcting procrastination was a "flat failure." P RESEARCH PAIN MANAGEMENT 2002 GOW, MICHAEL (2002). Treating dental needle phobia using hypnosis. [Paper] Presented at IFDAS/SAAD 10th International Dental Congress on Modern Pain Control, Edinburgh, June 2003, also at BSMDH (Scot) meeting December 2003. "This case illustrates the effectiveness of short-term hypnosis treatment for a dental needle phobia. What is significant is the dental history of the patient and the longstanding effect of her dental phobias and how quickly hypnosis was able to remove this problem. Aim: To manage dental needle phobia using hypnosis integrated into an anxiety management treatment plan." Case History: Female, 48, had traumatic and painful experience at the dentist when 5, developed phobia of dental injections and treatment. Has had a dozen General Anaesthetics for dental treatment. Experiences psychosomatic pain prior to treatment. Methods: Medical, dental and phobia history explored. Pre-treatment questionnaire assessed dental anxiety, reasons for anxiety, and ascertained management options. Post-treatment questionnaire assessed changes in dental anxiety and attitudes. Anxiety management techniques: Needle Desensitisation, Relaxation, and Hypnosis (Regression, Progressive Muscular Relaxation, Glove Anaesthesia, Future Rehearsal etc.). Results: Pre-treatment questionnaire revealed high level anxiety (26 out of high of 30 modified Corah score; and high anticipation of future pain during dental treatment (10 out of high of 10 on a Visual Analogue Scale. Post-treatment questionnaire revealed low level anxiety (12/30) and low anticipation of future pain (4/10). Conclusion: Hypnosis was an effective adjunct to anxiety management in this case, demonstrating how a non pharmacological approach can find long term solutions by addressing the causes of the anxiety. Previous pharmacological approach had only addressed the symptoms of the immediate anxiety. Successful completion of prescribed dental treatment plan and changes in patient?s attitudes highlight positive outcome Gravitz, M.A. (2002). Hypnosis in the conquest of pain. Hypnos: Swedish Journal of Hypnosis in Psychotherapy and Psychosomatic Medicine, 29, 19-28.. Hypnosis has long been utilized for the management of pain and as surgical anesthesia. This article discusses early applications in various countries. Despite cynicism and disapproval by some, hypnosis has proven to be beneficial in numerous cases 2000 Eimer, Bruce. N. (2000). Clinical applications of hypnosis for brief and efficient pain management psychotherapy. American Journal of Clinical Hypnosis, 43 (1), 17-40. (July) This paper describes four specific clinical applications of hypnosis that can make psychotherapy for pain management briefer, more goal-oriented, and more efficient: (1) the assessment of hypnotizability; (2) the induction of hypnotic analgesia and development of individualized pain coping strategies; direct suggestion, cognitive reframing, hypnotic metaphors, and pain relief imagery; and (4) brief psychodynamic reprocessing during the trance state of emtoional factors in the patient''s experience of chonic pain. Important theoretical and clinical issues regarding the relationship between hypnotizability to the induction of hypnotic analgesia are presented, and attempts to individualize pain treatment strategies on the basis of assessed differences in hypnotizability and patients'' preferred coping strategies are described. Some ways are also presented of integrating direct hypnotic suggestion, COGNITIVE-EVALUATIVE reframing, hypnotic metaphors, and imagery for alleviating the SENSORY and AFFECTIVE-MOTIVATIONAL components of pain, with an exploratory, insight-oriented, and brief psychodynamic reprocessing approach during trance for resolving unconscious sources of resistance to treatment, and reducing the emotional overlay associated with chronic pain. Some basic assumptions underlying the use of this approach are discussed, and a brief step-by-step protocol is outlined. Horton-Hausknecht J.; Mitzdorf U.; Melchart D. (2000). The effect of hypnosis therapy on the symptoms and disease activity in rheumatoid arthritis . Psychology and Health, 14 (6), 1089-1104.. from: http://www.imp-muenchen.de/The_effect_of_hypnos.698.1.html In this study we aimed to assess the effectiveness of clinical hypnosis on the symptoms and disease activity of rheumatoid arthritis (RA). 66 RA patients participated in a controlled group design. 26 patients learnt the hypnosis intervention, 20 patients were in a relaxation control group, and 20 patients were in a waiting-list control group. During hypnosis , patients developed individual visual imagery aimed at reducing the autoimmune activity underlying the RA and at reducing the symptoms of joint pain, swelling, and stiffness. Subjective assessments of symptom severity and body and joint function, using standardized questionnaires and visual analogue scales, were obtained. Objective measures of disease activity via multiple blood samples during the therapy period and at the two follow-ups were also taken. These measurements were of erythrocyte sedimentation rate, C-reactive protein, hemoglobin, and leukocyte total numbers. Results indicate that the hypnosis therapy produced more significant improvements in both the subjective and objective measurements, above relaxation and medication. Improvements were also found to be of clinical significance and became even more significant when patients practiced the hypnosis regularly during the follow-up periods. Willmarth, Eric K. (2000, August). Modification of experienced pain with hypnotically induced positive mood. [Paper] Presented at the annual meeting of the American Psychological Association, Washington, D. C.. This study investigated the relationship between chronic pain and depressed mood within the context of Associative Network Theory and the High Risk Model of Threat Perception. A bi-directional relationship was hypothesized and tested by comparing pain ratings before and after the hypnotic induction of positive mood by suggestion of positive memories. These results were compared to the pain ratings of two control groups: participants who received hypnotic suggestion for relaxation only and participants who received non-hypnotic suggestion for relaxation and enhanced mood. Participants were 96 patients of a hospital-based Pain Management Center. Following assessment of hypnotic ability using the Harvard Group Scale of Hypnotic Susceptibility: Form A, and the Subjective Experiences Scale, participants recorded levels of depressed mood, sensory pain, affective pain, global pain and self control of pain before and after listening to an audio-taped treatment session. Results show that the inducton of a positive mood did influence a decrease in self-reports of pain. In addition, the level of the participants' hypnotic ability was also found to be a significant factor, suggesting that screening for predisposing factors, such as hypnotic ability, and the clinical use of hypnosis for mood enhancement are warranted in a chronic pain population. - Abstract taken from Psychological Hypnosis: A Bulletin of [Amer Psychol Assn] Division 30, Fall 2000. -bility: Form A, and the Subjective Experiences Scale, participants recorded levels of depressed mood, sensory pain, affective pain, global pain and self control of pain before and after listening to an audio-taped treatment session. Results show that the inducton of a positive mood did influence a decrease in self-reports of pain. In addition, the level of the participants' hypnotic ability was also found to be a significant factor, suggesting that screening for predisposing factors, such as hypnotic ability, and the clinical use of hypnosis for mood enhancement are warranted in a chronic pain population. - Abstract taken from Psychological Hypnosis: A Bulletin of [Amer Psychol Assn] Division 30, Fall 2000. 1999 Capafons, A. (1999). Applications of emotional self-regulation therapy. In Kirsch, I.; Capafons, A.; Cardeqa, E.; Amigs, S. (Ed.), Clinical hypnosis and self-regulation: Cognitive-behavioral perspectives (pp. 331-349). Washington, D.C.: American Psychological Association. This chapter reviews the main applications of emotional self-regulation therapy, which have received empirical support: smoking reduction, obesity, fear of flying, drug addictions, and premenstrual distress and dysmenorrhea. The logic of each treatment and main empirical results are summarized. Liossi, Christina; Hatira, Popi (1999). Clinical hypnosis versus cognitive behavioural training for pain management with pediatric patients undergoing bone marrow aspirations. International Journal of Clinical and Experimental Hypnosis, 47 (2), 104-116. A randomized controlled trial was conducted to compare the efficacy of clinical hypnosis versus cognitive behavioral (CB) coping skills training in alleviating the pain and distress of 30 pediatric cancer patients (age 5 to 15 years) undergoing bone marrow aspirations. Patients were randomized to one of three groups: hypnosis, a package of CB coping skills, and no intervention. Patients who received either hypnosis or CB reported less pain and pain-related anxiety than did control patients and less pain and anxiety than at their own baseline. Hypnosis and CB were similarly effective in the relief of pain. Results also indicated that children reported more anxiety and exhibited more behavioral distress in the CB group than in the hypnosis group. It is concluded that hypnosis and CB coping skills are effective in preparing pediatric oncology patients for bone marrow aspiration 1998 Alden, Phyllis; Heap, Michael (1998). Hypnotic pain control: Some theoretical and practical issues. International Journal of Clinical and Experimental Hypnosis, 46 (1), 62-76.