Compared the effects of indirect hypnosis (e.g., metaphors, stories, vague suggestions, and implied directives) on muscle contraction headaches with a relaxation and a no-treatment control condition. Both hypnosis and relaxation conditions reduced symptoms more than did the no-treatment condition. Unlike relaxation, indirect hypnosis did not reduce the intensity and duration of headaches, although it did reduce the amount of medication and also benefitted sleep.

Chen, Andrew C.; Dworkin, Samual F.; Bloomquist, Dale S. (1981). Cortical power spectrum analysis of hypnotic pain control in surgery. International Journal of Neuroscience, 13, 127-136.

Cortical power spectrum (CPS) of brain potentials was recorded from the scalp between prefrontal and parietal regions in both right hemisphere (RH) and left hemisphere (LH). A pattern of laterality shift in CPS occurred at different stages during an extensive oral surgery, performed under hypnosis, in a young female patient. Video and audio recordings as well as psychophysiological recordings were obtained through the following 6 stages: Baseline, Hypnosis, Surgery (1 hr, no cortical recording), Immediate Postsurgery Procedure, Hypnotic Re-experience, Hypnotic Rest, and Posthypnotic Baseline. Indications of anxiety and pain scores were reported in writing by the patient through verbal command by the hypnotist. In each stage, 10 min of CPS (10 spectrum/stage, 8 epochs/spectrum, 6 seconds/epoch) were analyzed by a PDP-11 computer. The results of CPS analysis demonstrated significant large total power reduction at different stages. There was significant correlation between both hemispheres at baseline, but dissociation of hemispheric power output occurred during hypnosis stages. LH was more dominant than RH during baseline and presurgery hypnosis, but both were leveled- off immediately following the surgery procedure. However, RH became more dominant during all postsurgery hypnosis stages. Interestingly, this pattern shifted back to the original relationship during the posthypnotic baseline stage. Specific changes of spectral power in theta and alpha of EEG activities in both hemispheres also occurred in conjunction with hypnosis.

Subject was a 25 year old woman, described as only medium in hypnotizability. She scored 3 on the 5-point Stanford Hypnotic Clinical Scale, 7 on the 12-point Stanford Hypnotic Susceptibility Scale, and 3 on up-gaze, between 2 and 3 on eye roll, on the Spiegel eye roll test.
The principal hypnotic approach was a suggestion of dissociation, i.e. that the patient “experience herself swimming freely and powerfully, in a deep cold mountain lake, pre-occupied with the intensity of the blue-black color of the water, the shimmering of light from above, and the possibilities of exploration of rock formations, caves, etc. It was suggested that while she was experiencing the exhilaration and strenuous stimulation of the cold water and the vigorous exercise, an ‘observing-self’ would remain on the shore, watching and ensuring that no harm would come to the person. The suggestion was reinforced that any stimulation experienced was experienced in the body, not in the person” (p. 129).

The patient was trained in inductions and dissociation first in the therapist’s office, then with two sessions in the research laboratory (where tooth pulp stimulation pain thresholds were measured), and then two sessions in the hospital dental operatory.

The results of the computerized CPS were analyzed by hemispheres. “Large reductions in total power occurred at different stages associated with hypnosis and these reductions in power output of the CPS showed significant left-right differences” (p. 130).

“The total energy output of LH [left hemisphere] continued to diminish as hypnosis continued by as much as 80% of baseline value, while RH [right hemisphere] power output tended to be stabilized from the initial hypnosis recording stage until the awake baseline stage” (p. 130).

“Those stages involving hypnosis were characterized by dominant RH energy output in the alpha spectrum. …
“Alpha output for the LH decreased an average of 65% between awake baseline levels and postsurgery hypnosis stages, while RH alpha only decreased approximately 50% of resting levels. This resulted in a relative shift of alpha output which was approximately equal in both hemispheres prior to surgery, to a 2:1 shift in favor of RH alpha output as hypnosis progressed. This differential shift in laterality of alpha was reversed when the subject awakened from hypnosis.
“Of interest was the observation that total power reductions and laterality shifts associated with hypnosis were not altered by the profound instrumentation of surgery and postoperative pain, nor were observed laterality shifts affected by hypnotic suggestions aimed at recreating the surgical experience (see Stage 5)” (p. 130).
During the experiment when the investigators used hypnotic suggestion to recreate the surgical experience, LH output continued to diminish while RH output did not change, making the LH-RH contrast highly significant. “This suggests that the RH is active during deep stages of hypnosis and can remain so despite hypnotic suggestions which are presumed to be intensely aversive” (p. 131).
In their Discussion, the authors reinforced the conclusion that overall cortical functioning is reduced during hypnosis, and that the left cerebral hemisphere shows a greater reduction than the right. They discuss the increased theta density in RH and LH during the postsurgery hypnosis stage in terms of reports that theta is associated with altered states of consciousness (Tebecis et al., 1975; Ulett et al., 1972; Anad, China, & Singh, 1961; Banquet, 1973; Kasamatsu & Hirai, 1966; Wallace, 1970) and with cognitive tasks like mental arithmetic (Dolce et al., 1974).
The authors note that their results are congruent with Hilgard’s neodissociation theory of hypnosis, and add that since their suggestions were dissociative in nature rather than of local anesthesia, the EEG may reflect the brain physiology of dissociation.
Finally, they comment on the implications for pain neurophysiology. “The total power changes and shifting patterns in laterality of cortical functioning observed more closely tracked the hypnosis experience than the pain experience; this is, in fact, a very puzzling issue. It appears on the face of it that the EEG measurements recorded are not reflective of EEG-related pain phenomenology despite the strenuous and invasive surgical procedures used. The observations that overall power output continued to decrease during the several hypnosis stages after strenuous surgery and then increased as the patient came out of hypnosis makes reasonable the possibility that _hypnosis_ has some functional brain correlates; we cannot conclude from the present cortical power spectrum analysis that any brain correlates of surgical _pain_ were revealed. We are well aware that EEG recordings were not available during actual surgery itself, because of artifacts resulting from head movements, etc. Nevertheless, it can be fairly claimed that recordings obtained immediately after such oral surgery of one hour duration, could reasonably be expected to be associated with a person in pain. But, both by verbal report and available objective data, any surgically induced traumatic pain was of brief duration under hypnosis” (p. 135).

Claghorn, James L.; Mathew, Roy J.; Largen, John W.; Meyer, John S. (1981). Directional effects of skin temperature self-regulation on regional cerebral blood flow in normal subjects and migraine patients. American Journal of Psychiatry, 138, 1182-1187.

Vascular headache of the migraine type is associated with vasomotor changes in cerebral arteries. The authors studied whether skin temperature training (biofeedback) reduced the frequency, severity, and duration of these headaches by measuring the regional cerebral blood flow (CBF) in 11 female migraine patients (27-52 years) and 9 female volunteers (22-37 years), using the noninvasive 133 Xe inhalation technique. Half of each group was randomly assigned to a hand-warming or a hand- cooling group. CBF increased in several regions of the left hemisphere to a significant degree only for the migraineurs who were in the hand-warming group. The pattern of vasomotor regulation apparently differed between migraine and normal Ss. The migraineurs” headache symptoms were affected by both warming and cooling, but warming produced more salutary effects.

Adams, Henry E.; Feuerstein, Michael; Fowler, Joanne L. (1980). Migraine headache: Review of parameters, etiology, and intervention. Psychological Bulletin, 87 (2), 217-237.

The migraine headache is a disorder of much interest to clinicians and researchers in the areas of psychology and medicine. Research that has investigated various characteristics of this disorder and the factors contributing to its etiology and a variety of treatment techniques have appeared in both the medical and the psychological literature. The present article provides a comprehensive critical appraisal of this literature, with particular emphasis on psychological intervention. Theoretical issues involving biological and psychological factors in migraine etiology are discussed, and a psychobiological model for the migraine disorder is proposed. Areas requiring further basic and clinical research are identified. Major conclusions include (a) that etiological factors of migraine remain unclear; (b) that pharmacological intervention does not constitute an adequate treatment method in terms of headache elimination; (c) that although a number of psychological treatment approaches have been reported in the literature, there are few well-controlled evaluations, and definitive conclusions regarding differential effectiveness of the various techniques are difficult; and (d) that a biofeedback approach directed at modifying the peripheral pain mechanism in migraine appears to be a promising treatment technique for this disorder.

Crowley, R. (1980). Effects of indirect hypnosis (Rapid Induction Analgesia) for relief of acute pain associated with minor podiatric surgery (Dissertation). Dissertation Abstracts International, 40, 45-49.

Lynn et al. (1993) cited this dissertation. They noted that all 30 volunteer subjects responded painfully when stimulated by a needle administered by a podiatrist and that the Rapid Induction Analgesia of Joseph Barber (RIA) was not as effective as local chemical analgesia. Furthermore, according to Lynn et al., RIA patients did not report a reduction in their anxiety following podiatric surgery comparable to that reported by patients who received chemical analgesia. The author also found that hypnotizability was related to multiple chronic pain indices.

Edwards, William Henry (1980). Direct versus indirect hypnosis for the relief of chronic pain in spinal cord injured patients (Dissertation, United States International University). Dissertation Abstracts International, 40 (10-B), 4996

This study compared effectiveness of direct hypnosis and indirect hypnosis (Rapid Induction Analgesia, developed by Joseph Barber) in reducing experimental and clinical pain in spinal cord injured patients. The 30 male paraplegic patients who had chronic benign pain volunteered for the study. They were administered three tests: the Pain Estimate Scale (Sternbach, 1974), Ischemic Muscle Pain Test (IMPT), and the Stanford Profile Hypnotic Susceptibility Scale, Form II — SPHSS — (Weitzenhoffer and Hilgard, 1967). Each patient experienced three sessions: (1) Baseline Control, (2) Direct Hypnosis, and (3) Indirect Hypnosis. Patients were randomly assigned to Sessions (2) and (3). The results indicated no significant statistical difference in the effectiveness of direct versus indirect hypnotic analgesia in these chronic pain patients. Direct and indirect hypnosis were equally effective; hypnotizability was not associated with outcome. Furthermore, there was no interaction between treatment effects and pretreatment pain level. The results were similar for both clinical and experimental pain.

Barber, Joseph; Donaldson, David; Ramras, Susan; Allen, Gerald D. (1979). The relationship between nitrous oxide conscious sedation and the hypnotic state. Journal of the American Dental Association, 99, 624-626.

Nitrous oxide-oxygen produces a state of consciousness in the patient that is reported to be similar to the hypnotic state. In this investigation, the authors test the hypothesis that nitrous oxide-oxygen heightens a patient’s responsiveness.
This study apparently did not have a control group receiving nitrous oxide but no suggestions, to evaluate the amnesia and analgesic effects of the drug alone.

Beers, Thomas M.; Karoly, Paul (1979). Cognitive strategies, expectancy, and coping style in the control of pain. Journal of Consulting and Clinical Psychology, 47, 179-180.

Measures of tolerance, self-reported pain threshold, and overall discomfort of cold-pressor pain were obtained from 114 male subjects in a pretest-training-posttest experiment. Training consisted of brief practice in one of four cognitive strategies: rational thinking, compatible imagery, incompatible imagery, and task-irrelevant cognition. Analyses of covariance indicated (a) that cognitive-imaginal strategies facilitated endurance of pain and raised self-reported threshold, (b) that rational thinking and compatible imagery were generally the most effective treatments, (c) that expectancy alone was not a significant pain-attenuating factor, (d) that treatments did not affect discomfort ratings, and (e) that individual differences in imaginal ability and coping style did not correlation with changes in any of the dependent measures.

Bennett, Henry L.; Giannini, Jeffrey A.; Kline, Mark D. (1979, September). Consequences of hearing during general anesthesia. [Paper] Presented at the annual meeting of the American Psychological Association, New York.

A double blind 2X2 study exposed 23 herniorraphy and cholecystectomy patients to either a 45 minute suggestion tape or to the actual sounds of the operation. Structured interviews conducted postoperatively assessed hypnotic susceptibility and regressed patients under hypnosis to operative events. Ten patients accurately recalled significant events from surgery but only under hypnosis. Recall was greater and more accurate in patients scoring high on the Stanford Clinical

Hypnosis Scale. Fewest number of pain medications were given postoperatively to patients receiving the suggestion tape. Hernia patients showed better recall than gallbladder patients.

Barber, Joseph (1978, August). Hypnosis: A suggestion for pain relief. Pain Topics, 7.

He lists 3 misconceptions that prevent hypnosis being used more widely for pain control: 1. Hypnosis renders a patient helplessly under the control of the hypnotist. 2. Hypnosis can only relieve psychogenic pain, not pain of a clearly somatic origin. 3. Hypnosis is effective only in ‘susceptible’ individual (the most damaging misconception). He also gives examples of indirect suggestions of pain relief (i.e. increased comfort, etc.)

Barber, Joseph (1977). Rapid induction analgesia: A clinical report. American Journal of Clinical Hypnosis, 19, 138-149.

This is a report of clinical dental experience using a newly developed, hypnotic pain control procedure. Characteristics of the procedure are outlined, an explanation for its success is suggested, and the broader implications of this success are discussed. The unusually high incidence of clinical analgesia rapidly obtained with this procedure leads the author to question the meaning and relevance of the concept of ‘hypnotic susceptibility’ for the practical clinical application of hypnosis.

Berk, Stephen N.; Moore, Mary E.; Resnick, Jerome H. (1977). Psychosocial factors as mediators of acupuncture therapy. Journal of Consulting and Clinical Psychology, 45 (4), 612-619.

This study investigated a number of psychosocial variables that have been suggested as possible mediating factors in acupuncture therapy. Forty-two volunteers with bursitis and/or tendonitis of the shoulder served as subjects. All were randomly assigned to one of four treatment groups: acupuncture – positive milieu, acupuncture – negative milieu, placebo acupuncture – positive milieu, and placebo acupuncture – negative milieu. Pretreatment and posttreatment subjective pain reports and shoulder motion studies, as well as pretreatment assessments of hypnotic susceptibility and suggestibility, were determined for each subject. Results indicated that (a) acupuncture and placebo acupuncture were equally effective in producing highly significant (p <.001) reductions in subjective pain reports; (b) neither treatment effectively improved objective shoulder motion; (c) subjects treated in the positive milieu reported more improvement than those in the negative milieu (p <.053); and (d) hypnotic susceptibility, suggestibility, belief in the treatment, and the satisfaction of expectations showed no relationship to treatment outcome. It is concluded that acupuncture therapy provides a powerful placebo. Treatment milieu variables warrant future study in the attempt to understand the acupuncture phenomena. Chertok, Leon; Michaux, D.; Droin, M. C. (1977). Dynamics of hypnotic analgesia: Some new data. Journal of Nervous and Mental Disease, 164, 88-96. Following two surgical operations under hypnotic anesthesia, it was possible, during subsequent recall under hypnosis, to elicit a representation of the past operative experience. It would seem that under hypnosis there is a persistence that under hypnosis there is a persistence of the perception of nociceptive information and of its recognition as such by the subject. From an analysis of these two experiments in recall, it is possible to formulate several hypotheses concerning the psychological processes involved in hypnotic analgesia. In consequence of an affective relationship, in which the hypnotist's word assumes a special importance for the subject, the latter has recourse to two kinds of mechanism: a) internal (assimilation to an analogous sensation, not, however, registered as dangerous-- rationalization); and b) external (total compliance with the interpretations proposed by the hypnotist), which lead to a qualitative transformation of nociceptive information, as also the inhibition of the behavioral manifestations normally associated with a painful stimulus. 1976 Chaves, John F.; Barber, Theodore Xenophon (1976). Hypnotic procedures and surgery: A critical analysis with applications to 'acupuncture analgesia'. American Journal of Clinical Hypnosis, 18 (4), 217-236. Although hypnotic procedures are useful for reducing the anxiety of surgery and helping patients tolerate surgery, they do not consistently eliminate pain. Six factors that are part of or associated with hypnotic procedures help patients tolerate surgery. These factors pertain to patient selection, the patient-physician relationship, the preoperative 'education' of the patient, the adjunctive use of drugs, and the use of suggestions of analgesia and distraction. It appears that the same factors account for the apparent successes of 'acupuncture analgesia' as well. A frequently-overlooked fact, that most internal tissues and organs of the body do not hurt when they are cut by the surgeon's scalpel, is also important in understanding how surgery can be performed with either 'hypnoanesthesia' or 'acupuncture analgesia.' 1975 Ahlberg, D.; Lansdell, H.; Gravitz, M. A.; Chen, T. C.; Ting, C. Y.; Bak, A. F.; Blessing, D. (1975). Acupuncture and hypnosis: Effects on induced pain. Experimental Neurology, 49, 272-280. The reactions of 14 volunteers to electrical stimulation near the supra- orbital nerve were studied under acupuncture, placebo-acupuncture, and hypnosis. As the intensity of stimulation increased, a minimum sensation, a minimum pain, and then a maximum or intolerable pain sensation were produced. Under hypnosis the average intensity of the stimulus for producing these sensations was higher than before the trance induction. Under acupuncture and placebo-acupuncture no clear increase in current intensity was observed. Acupuncture, as well as hypnosis, did not consistently change the blood, blood pressure, pulse rate, EKG, respiratory rate, or EEG. Anderson, J. A. D.; Basker, M. A.; Dalton, R. (1975). Migraine and hypnotherapy. International Journal of Clinical and Experimental Hypnosis, 23 (1), 48-58. Therapeutic measures for migraine are largely ineffective. Prophylaxis by hypnosis (including autohypnosis) and prochlorperazine is difficult to assess because of the intermittency of the disease and the subjective nature of the disabling symptoms. A method of studying this problem is described in this article. Random allocation of 47 patients was made to one or other prophylactic measure. This was followed by monthly assessments and independent evaluation of 1 year of continuous care. Criteria of improvement were the number of attacks per month, number who had Grade 4 attacks, and complete remission. Results showed that the number of attacks and the number who suffered blinding attacks were significantly lower for the group receiving hypnotherapy than for the group receiving prochlorperazine. For the group on hypnotherapy, these 2 measures were significantly lower when on hypnotherapy than when on previous treatment. Prochlorperazine seemed about as effective as previous treatment. 10 out of 23 patients on hypnotherapy achieved "complete remission" during the last 3 months of the trial as opposed to only 3 out of 24 on prochlorperazine. It is concluded that further trials of hypnotherapy are justified against some other treatment not solely associated with the ingestion of tablets. -tic measure. This was followed by monthly assessments and independent evaluation of 1 year of continuous care. Criteria of improvement were the number of attacks per month, number who had Grade 4 attacks, and complete remission. Results showed that the number of attacks and the number who suffered blinding attacks were significantly lower for the group receiving hypnotherapy than for the group receiving prochlorperazine. For the group on hypnotherapy, these 2 measures were significantly lower when on hypnotherapy than when on previous treatment. Prochlorperazine seemed about as effective as previous treatment. 10 out of 23 patients on hypnotherapy achieved "complete remission" during the last 3 months of the trial as opposed to only 3 out of 24 on prochlorperazine. It is concluded that further trials of hypnotherapy are justified against some other treatment not solely associated with the ingestion of tablets. 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. Carli, G. (1975). Some evidence of analgesia during animal hypnosis [Abstract]. Experimental Brain Research, 23, 35. The purpose of this study was to investigate the response to painful stimuli during animal hypnosis. The experiments were performed on unanesthetized, free-moving rabbits carrying implanted electrodes for recording the EEG and EMG activity and nerve stimulation. Injection of formaline into the dorsal region of the foot produced long lasting EEG desynchronization and motor pain reactions. In some rabbits a procedure of habituation was used to reduce hypnosis duration below 45 sec. Hypnosis was induced by inversion. The following results were obtained: 1) Polysynaptic reflexes eliced [sic] by electrical stimulation of cutaneous and muscle afferents were depressed during hypnosis. 2) Hypnosis transitorily suppressed all the painful manifestations due to formaline injection and was characterized by hygh [sic] voltage slow wave activity in the EEG, 3) In habituated rabbits, a significant increase in hypnotic duration and EEG synchronization was observed when hypnosis was preceded by formaline injection. Hypnosis duration was not potentiated by painful stimuli when Naloxone (5mg/Kg i.v.) was injected before hypnosis induction. 4) In habituated rabbits a recovery in hypnotic duration coupled to EEG synchronization was obtained, in absence of painful stimuli, following subanalgesic injection of Morphine (1mg/Kg). It has been previously shown that in the rabbit administration of 5-20 mg/Kg of Morphine produces EEG synchronization and strong reduction of pain reactions. It is suggested that, during animal hypnosis in a condition of continuous nociceptive stimulation, the pain response is blocked by a mechanism which exibit [sic] similar effects of Morphine both at spinal cord (polysynaptic reflexes) and at cortical levels (EEG synchronization). Clawson, T. A.; Swade, R. H. (1975). The hypnotic control of blood flow and pain: The cure of warts and the potential for the use of hypnosis in the treatment of cancer. American Journal of Clinical Hypnosis, 17 (3), 160-169. Case histories show that hypnosis can control massive bleeding and pain, and it can remove warts, probably by stopping blood flow to them. We propose that blood flow to cancerous tumors can likewise be controlled, which could destroy them outright, or which control could be a useful adjunct to chemo- or radio-therapy. 1974 Chaves, John F.; Barber, Theodore Xenophon (1974). Acupuncture analgesia: A six-factor theory. Psychoenergetic Systems, 1, 11-21. The dramatic successes claimed for acupuncture suggest that Western medicine has failed to identify important factors that pertain to the nature of pain and its control. This may not be the case, as there are at least six factors which are often overlooked by writers describing the absence of pain (i.e., analgesia) during acupuncture: (a) the patients accepted for surgery under acupuncture usually believe that it will work, (b) drugs are frequently used in combination with acupuncture, (c) the pain associated with surgical procedures is less than is generally assumed, (d) the patients are prepared in special ways for surgery under acupuncture, (e) the acupuncture needles distract the patient from the pain of surgery and, (f) suggestions for pain relief are present in acupuncture treatment. It is concluded that more research is needed to determine whether additional factors are needed to help explain the phenomenon of acupuncture analgesia Chaves, John F.; Barber, Theodore Xenophon (1974). Cognitive strategies, experimenter modeling, and expectation in attenuation of pain. Journal of Abnormal Psychology, 83 (4), 356-363. Verbal reports of pain were obtained from 120 subjects during a base-level pretest and also during a posttest conducted under one of several experimental treatments. The pain stimulus was a heavy weight applied to a finger for two minutes. During the posttest, subjects who had been asked to utilize cognitive strategies for reducing pain (to imagine pleasant events or to imagine the finger as insensitive) showed a reduction in pain as compared to uninstructed control subjects. Subjects led to expect a reduction in pain, but not provided with cognitive strategies, also showed reduced pain during the posttest as compared to control subjects, but the reduction was smaller than for subjects using cognitive strategies. An experimenter modeling procedure, used with one half of the subjects under each experimental treatment, was effective in reducing verbal reports of pain only for subjects with high pretest levels who were asked to imagine pleasant events. 1972 Cedercrentz, C. (1972). The big mistakes: A note. International Journal of Clinical and Experimental Hypnosis, 20, 15-16. In his book, A System of Medical Hypnosis, Ainslie Meares writes, "Most books on hypnosis, from Bernheim to the present time, devote a great deal of space to the description of successful and dramatic cures. These accounts may be of prestige value to the author, and may do something to inform the profession of the potential value of hypnosis in medicine, but these success stories are really of little help to those who would learn the technique of hypnotherapy because the emphasis is always on the success of the treatment rather than on anlysis of the psychodynamic mechanisms which brought it abauot. As in everything else, we learn most from a study of our failures [p. 3]." These comments remain as true today as they were ten years ago. With the notable exception of Meares, few colleagues have been willing to share their errors, allowing us to profit from their experience. Thus, when Dr. Cedercreutz sent along a note describing his experience with one of his patients, I was struck by his generosity, and it seemed most appropriate for all of us to share his experience by way of the Journal. Hopefully, this may encourage other colleagues to share their failures as well as their successes so that all of us may learn to be more effective therapists and better scientists. M.T.O. [Martin Orne] The case reported involves a patient who had migraine headache removed with hypnosis, but later developed gastrointestinal symptoms that were operated surgically with absence of positive (physical) pathology noted. Subsequent investigation of the psychological component of the problem with hypnosis revealed an early trauma (seeing a soldier killed with a bayonette) that led to migraine-like pain in the head and vomiting. 1970 Bowers, Kenneth S.; Kelly, P. (1970). Stress, disease, psychotherapy, and hypnosis. Journal of Abnormal Psychology, 490-505. Presents evidence for the importance of suggestion and hypnotic ability in the healing or amelioration of various somatic disorders. It is argued that even in some treatment interventions that are not explicitly hypnotic, suggestion and hypnotic ability may be hidden factors that help to promote successful healing. Consequently, hypnotic ability may be an individual difference variable that influences treatment outcome in a manner not heretofore recognized by many investigators and clinicians involved in helping the psychologically and physically ill. Evans, Michael B.; Paul, Gordon L. (1970). Effects of hypnotically suggested analgesia on physiological and subjective responses to cold stress. Journal of Consulting and Clinical Psychology, 35 (3), 362-371. Relative effects of suggested analgesia and hypnotic induction were evaluated with regard to reduction of stress responses (self-report, heart rate, pulse volume) to the physical application of ice-water stress. Four groups (N = 16 each) of undergraduate female Ss, equated on hypnotic susceptibility, were run individually, receiving (a) hypnotic induction plus analgesic suggestion, (b) hypnotic induction alone, (c) waking self-relaxation plus analgesic suggestion, or (d) waking self-relaxation alone. The major findings were that suggestion, not hypnotic induction procedures, produced reductions in the self-report of distress, and that the degree of reduction was related to hypnotic susceptibility in both "hypnotic and "waking" conditions. Neither suggestion nor hypnotic induction procedures resulted in reduction of the physiological stress responses monitored in this study. Several methodological issues are discussed. Although findings add to the bulk of evidence supporting the "skeptical" view of hypnotic phenomena, results are related to other literature, suggesting that an adequate evaluation of hypnotic analgesia as used clinically has not yet been undertaken. the bulk of evidence supporting the "skeptical" view of hypnotic phenomena, results are related to other literature, suggesting that an adequate evaluation of hypnotic analgesia as used clinically has not yet been undertaken. 1969 Barber, Theodore Xenophon (1969). An empirically-based formulation of hypnosis. American Journal of Clinical Hypnosis, 12 (2), 100-130. A formulation is presented which does not invoke a special state of consciousness ("hypnosis" or "trance") to account for the behaviors that have been historically associated with the word hypnotism. Instead, so-called hypnotic behaviors - e.g., "analgesia," "hallucination," "age-regression," and "amnesia" - are conceived to be functionally related to denotable antecedent variables which are similar to those that control performance in a variety of interpersonal test-situations. The antecedent variables which determine behavior in a "hypnotic" situation include Ss' attitudes, expectancies, and motivations with respect to the situation, and the wording and tone of instructions- suggestions and of questions used to elicit subjective reports. The formulation is exemplified by several dozen experimental studies, and prospects for further research are delineated. 1967 Dahinterova, Jeanette (1967). Some experiences with the use of hypnosis in the treatment of burns. International Journal of Clinical and Experimental Hypnosis, 2, 49-53. EXPERIENCE WITH HYPNOSIS AS A MEANS OF ELIMINATING PAIN DURING SURGICAL PROCEDURES FOR THE TREATMENT OF SEVERE BURNS HAS BEEN FAVORABLE IN 3 OUT OF THE 4 CASES DISCUSSED. THESE INCLUDE PATIENTS WHO HAD RELATIVELY CHRONIC, SERIOUS, AND SEVERE BURNS. IT IS CONCLUDED THAT HYPNOSIS CAN BE AN IMPORTANT AND USEFUL ADJUNCT IN PSYCHOTHERAPEUTIC TREATMENT OF BURNS. (GERMAN + SPANISH SUMMARIES) (PsycINFO Database Record (c) 2002 APA, all rights reserved) 1965 Bernstein, Norman R. (1965). Observations on the use of hypnosis with burned children on a pediatric ward. International Journal of Clinical and Experimental Hypnosis, 13 (1), 1-10. Several cases are described and observations made about the interplay of forces between staff, patient, and therapist, as well as the expectations of the patients to assess how these factors influenced the use of hypnosis. Hypnosis appears to be a particularly useful means for reaching isolated and depressed children with burns and for improving the morale of the staff team working with these children. The results may be along specific lines in terms of pain tolerance and improved eating, or in general improvement of cooperativeness and mood on the part of the child. (PsycINFO Database Record (c) 2002 APA, all rights reserved) 1964 Attar, A.; Muftic, M. (1964). Narcohypnosis in abdominal surgery. British Journal of Medical Hypnotism, 16 (1), 29-32 Effectiveness of a relaxation technique to increase the comfort level of patients in their first postoperative attempt at getting out of bed was tested on 42 patients, aged 18 to 65, who were hospitalized for elective surgery. Study group patients were taught the relaxing technique; control group patients were not taught the technique. Each group had an equal distribution of cholecystectomy, herniorrhaphy, and hemorrhoidectomy patients. Blood pressure, pulse, and respiratory rates of subjects in both groups were compared prior to surgery and after the postoperative attempt to get out of bed. Subjects' reports of incisional pain and bodily distress were measured via a pain and distress scale after their attempt at getting out of bed. Amount of analgesics used in the first 24 hrs following surgery was examined. Mean differences in report of incisional pain and body distress, analgesic consumption, and respiratory rate changes were statistically significant, supporting the hypothesis that use of a relaxation technique to reduce muscular tension will lead to an increased comfort level of postoperative patients. 1961 Cangello, V. W. (1961). The use of hypnotic suggestion for pain relief in malignant disease. International Journal of Clinical and Experimental Hypnosis, 9, 17-22. Using hypnotic suggestion, pain relief was attempted in 22 cases. 13 of these patients showed a decrease in narcotic requirements. Duration of effectiveness was from 1 week to 41/2 months. It is concluded that this method should be tried before resorting to either chemical or surgical procedures since it is relatively simple to perform, has no harmful complications, and is not unduly time consuming. From Psyc Abstracts 36:02:2II17C. (PsycINFO Database Record (c) 2002 APA, all rights reserved) Cedercreutz, Claes (1961). Hypnosis in surgery. International Journal of Clinical and Experimental Hypnosis, 9, 93-95. (Author''s Summary) "It is possible to treat painful conditions and spasms in the alimentary canal by hypnosis. In the rehabilitation of patients with limb injuries and fractures, hypnosis has also proved useful. There is seldom reason to resort to this method of inducing anaesthesia in surgery" (p. 95). 1955 Ament, Phillip (1955). A psychosomatic approach to the use of anesthesia for a hysterical dental patient: A case history. Journal of Clinical and Experimental Hypnosis, 3, 120-123. (Abstracted in Psychological Abstracts 56: 1280) Author describes a case highly resistant both to anesthesia and dentistry. Although very responsive to hypnosis, she continued moaning and moving from side to side (later determined to be her way of preventing dental work even though anesthetized). Ultimately a combination of hypnosis and multiple anesthetics was needed, including nembutal, sodium pentothal, nitrous oxide and novocain. In the author's experience, most other patients require only hypnosis or hypnosis plus novocaine. PARALYSIS 1988 Radil, T.; Snydrova, I.; Hacik, L.; Pfeiffer, J.; Votava, J. (1988). Attempts to influence movement disorders in hemiparetics. Scandinavian Journal of Rehab. Med. Suppl., 17, 157-161. Step duration, measured in hemiparetic patients walking on a circular path, showed that step duration of the affected foot is usually longer. Functional electrical stimulation of the peroneal nerve in the swing phase of the step (eliminating foot drop) shortened step duration in the majority of cases. Hypnosis induced by the verbal fixation technique was used in hemiparetic patients (a) to ascertain whether the patients' mobility would increase during hypnosis and to determine (in positive cases) whether this approach might be used to predict the effect of rehabilitation performed by classical methods; (b) to use hypnosis as a method of auxiliary treatment. The general finding was that the extent of movements of the hemiparetic upper extremity considerably improved during and immediately after hypnosis. This effect could be observed both at the level of severe impairment (at the beginning of treatment) and during the later stages when mobility greatly improved due to rehabilitation and recovery. 1985 LaRiccia, P. J.; Katz, R. H.; Peters, J. W.; Atkinson, G. W.; Weiss, T. (1985). Biofeedback and hypnosis in weaning from mechanical ventilators. Chest, 87, 267-269. Weaning patients from mechanical ventilation can be hindered by both physical and psychologic factors. Biofeedback has been used successfully as an adjunct in difficult weaning problems. We have used a combination of hypnosis and biofeedback to wean a patient with neurologic disease who previously failed weaning by standard procedures. A 30-year-old woman with respiratory failure secondary to multiple sclerosis with transverse myelitis was given eight sessions of biofeedback over 12 days in which the movements of her chest wall, as monitored by magnetometers, were displayed on an oscilloscope. The patient was praised for targeted respiratory rate, amplitude, and rhythm. These sessions included hypnosis in which the patient was given suggestions of well-being and that she could breathe as she had five years earlier. In this manner the patient was successfully weaned. Respiratory biofeedback and hypnosis appear to be useful adjuncts in weaning patients form ventilators. Pajntar, M.; Roskar, E.; Vodovnik, L. (1985). Some neuromuscular phenomena in hypnosis. In Waxman, D.; Misra, P.C.; Gibson, M.; Basker, M.A. (Ed.), Modern trends in hypnosis (pp. 181-206). New York: Plenum Press. The phenomena presented here allow us to conclude that with hypnosis, the functioning of the neuromuscular system may be significantly influenced, either by increasing or decreasing the functioning of voluntary or electrically stimulated contractions, and that the function of movements may be improved. Two suggestions proved to be most efficient: 1) physical and mental relaxation, and 2) age regression. In age regression the patient recalls the ideomotor system, which is likely to result in a reconstruction of the forgotten motor contractions or in a strong intensification of these contractions under additional suggestions. With regard to relaxation, on one hand it intensifies the functioning of the voluntarily stimulated neuro-muscular systems, and on the other hand it prevents an excessive functioning of the involuntarily reflex stimulated anagonistic systems" (pp 202; 204). , on one hand it intensifies the functioning of the voluntarily stimulated neuro-muscular systems, and on the other hand it prevents an excessive functioning of the involuntarily reflex stimulated anagonistic systems" (pp 202; 204). 1981 Nardi, T. J. (1981). Treating sleep paralysis with hypnosis. International Journal of Clinical and Experimental Hypnosis, 29 (4), 358-365. The use of hypnosis in the management of sleep paralysis is described and discussed. 2 cases are presented in which autohypnsis was used to desensitize the patients to the anxiety that accompanied their sleep paralysis. The autohypnosis also provided a means of terminating the attacks. Follow-up data suggests that this approach may serve to decease the frequency of sleep paralysis attacks. 1980 Pajntar, Marjan; Jeglic, Anton; Stefancic, Martin; Vodovnik, Lojze (1980). Improvements of motor response by means of hypnosis in patients with peripheral nerve lesions. International Journal of Clinical and Experimental Hypnosis, 28 (1), 16-26. In order to accelerate rehabilitation of patients with peripheral nerve lesions, hypnosis was employed to encourage them voluntarily to move those muscles with weak re-innervation and to achieve the best possible activity of the affected muscle groups. By measuring muscle force and endurance and by observing the electrical activity of the affected muscles, it was found that the activity of the affected muscles was much better while patients were in hypnosis than when they were in the waking state. The patients were able to contract even paretic muscles having only weak re-innervation with such strength, that clinically perceptible contraction of the muscles and movement of paretic extremities occurred. Such early and improved activation is very important for prevention of much permanent damage. 1977