Hypnosis Session Research Articles

Effects of a Hypnosis Session Before General Anesthesia on Postoperative Outcomes in Patients Who Underwent Minor Breast Cancer Surgery

Hypnosis is now widespread in medical practice and is emerging as an alternative technique for pain management and anxiety. However, its effects on postoperative outcomes remain unclear. To evaluate the efficacy of a preoperative hypnosis session for reducing postoperative breast pain in patients who underwent minor breast cancer surgery. The HYPNOSEIN prospective randomized clinical trial was conducted from October 7, 2014, to April 5, 2016. In this multicenter study in France, 150 women scheduled for minor breast cancer surgery were randomized between control and hypnosis arms, and 148 (71 control and 77 hypnosis) were included in the intent-to-treat analysis. On the day of surgery, eligible patients were randomly assigned (1:1) to the control arm or the hypnosis arm. Patients (but not the care teams) were blinded to the arm to which they were assigned. A 15-minute hypnosis session before general anesthesia in the operating room was performed in the hypnosis arm. The primary end point was breast pain reduction (by 2 on a visual analog scale), assessed immediately before discharge from the postanesthesia care unit (PACU). Secondary end points were nausea/vomiting, fatigue, comfort/well-being, anxiety, and PACU length of stay, assessed at different times until postoperative day 30. The median patient age was 57 years (range, 33-79 years) in the control arm and 53 years (range, 20-84 years) in the hypnosis arm. Baseline characteristics were similar in the 2 arms. The median duration of the hypnosis session was 6 minutes (range, 2-15 minutes). The use of intraoperative opioids and hypnotics was lower in the hypnosis arm. The mean (SD) breast pain score (range, 0-10) was 1.75 (1.59) in the control arm vs 2.63 (1.62) in the hypnosis arm (P = .004). At PACU discharge and with longer follow-up, no statistically significant difference in breast pain was reported. Fatigue was significantly lower in the hypnosis arm on the evening of surgery (mean [SD] score, 3.81 [2.15] in the control arm vs 2.99 [2.56] in the hypnosis arm; P = .03). The median PACU length of stay was 60 minutes (range, 20-290 minutes) in the control arm vs 46 minutes (range, 5-100 minutes) in the hypnosis arm (P = .002). Exploratory analyses according to patient perception of whether she received hypnosis showed significantly lower fatigue scores in the perceived hypnosis subgroup on the evening of surgery (mean [SD], 4.13 [2.26] for no perceived hypnosis vs 2.97 [2.42] for perceived hypnosis; P = .01). Anxiety was also significantly lower on the evening of surgery in the perceived hypnosis subgroup (mean [SD], 0.75 [1.64] for perceived hypnosis vs 1.67 [2.29] for no perceived hypnosis; P = .03). The results of this study do not support a benefit of hypnosis on postoperative breast pain in women undergoing minor breast cancer surgery. However, other outcomes seem to be improved, which needs to be confirmed by further studies. EudraCT Identifier: 2014-A00681-46 and ClinicalTrials.gov Identifier: NCT03253159.

An evaluation of hypnosis practices in palliative care.

There are very few studies in existence today that look at the value of hypnosis in palliative care.The aim of our study was to measure the impact of hypnosis on managing symptoms in palliative care. This quantitative retrospective monocentric observational study evaluated pain and patient satisfaction using monitoring and evaluation sheets, which included a rating scale before and after hypnosis sessions in a palliative care unit.For two years, thirty-seven patients participated in hypnosis sessions mostly for pain (41%) and anxiety (27%). 51% reported a decrease in symptoms, with 35% even reporting that the intensity of their symptoms vanished. Most of the patients were satisfied with the approach and at the end of the study some of them were able to recreate its effects by using self-hypnosis.Despite the small sample, the results confirm those found in the few palliative studies that do exist, particularly relating to the improvement of symptoms such as pain, anxiety, nausea, and respiratory disorders.

Hypnosis Intervention Effects on Sleep Outcomes: A Systematic Review.

Sleep improvement is a promising target for preventing and modifying many health problems. Hypnosis is considered a cost-effective and safe intervention with reported benefits for multiple health conditions. There is a growing body of research assessing the efficacy of hypnosis for various health conditions in which sleep was targeted as a primary or secondary outcome. This review aimed to investigate the effects of hypnosis interventions on sleep, to describe the hypnotic procedures, and to evaluate potential adverse effects of hypnosis. We reviewed studies (prior to January 2017) using hypnosis in adults for sleep problems and other conditions comorbid with sleep problems, with at least one sleep outcome measure. Randomized controlled trials and other prospective studies were included. One hundred thirty-nine nonduplicate abstracts were screened, and 24 of the reviewed papers were included for qualitative analysis. Overall, 58.3% of the included studies reported hypnosis benefit on sleep outcomes, with 12.5% reporting mixed results, and 29.2% reporting no hypnosis benefit; when only studies with lower risk of bias were reviewed the patterns were similar. Hypnosis intervention procedures were summarized and incidence of adverse experiences assessed. Hypnosis for sleep problems is a promising treatment that merits further investigation. Available evidence suggests low incidence of adverse events. The current evidence is limited because of few studies assessing populations with sleep complaints, small samples, and low methodological quality of the included studies. Our review points out some beneficial hypnosis effects on sleep but more high-quality studies on this topic are warranted.

(184) - The effects of pain-related anxiety on hypnosis treatment responses in adults with and without sickle cell disease

Pain is the most common symptom in sickle cell disease (SCD) and individuals with SCD exhibit pain hypersensitivity. Hypnosis can have beneficial effects on pain modulation, but it is unknown whether pain-related anxiety—a cognitive-affective factor also associated with pain modulation—attenuates the effects of hypnosis in individuals with SCD. This study examined if pain-related anxiety alters the effects of hypnosis on laboratory pain responsivity in adults with and without SCD. The sample included 14 adults with SCD and 14 race-matched healthy controls. Participants completed the Pain Anxiety Symptoms Scale (PASS-20) at baseline. Pain tolerance (°C), threshold (°C), and intensity (0–100) were collected during a standardized thermal pain protocol before and during a hypnosis session. Change in pain outcomes indicated participants' responses to hypnosis. Nonparametric tests were used and a median split determined within-group levels of pain-related anxiety. Pain-related anxiety did not significantly differ across SCD and non-SCD groups, and was not associated with pre-hypnosis pain tolerance or threshold in either group. In adults with SCD who had lower levels of pain-related anxiety, pain tolerance increased 5.68°C during hypnosis compared to 1.97°C in those with high anxiety (Z = -1.98, p < .05). The effect on pain threshold approached significance (1.97°C vs. -.38°C, Z = -1.85, p = .06). There was no effect of pain-related anxiety on change in pain responsivity in healthy controls. Results partially align with other pain anxiety research and suggest that higher pain-related anxiety may be particularly important to consider in individuals with SCD as it may attenuate pain modulatory effects of hypnosis. Further, in individuals with higher pain-related anxiety, a single hypnosis session may be insufficient to reduce modulatory effects of anxiety on pain responsivity. Thus, examination of long-term treatment effects in a larger sample is needed to confirm underlying mechanisms affecting hypnosis treatment responses in individuals SCD. Funding: NHLBI-1U54HL117718.

Treating Panic Disorder Hypnotically

A hypnosis protocol for treating panic disorder is provided. The implementation of this protocol is demonstrated through a case example involving the successful treatment of a 28-year-old firefighter presenting with a 4-month history of near-daily panic attacks. Core principles associated with this protocol include: (1) Elementary education about the physiology of panic; (2) A review of primary factors contributing to the evolution and manifestation of panic; (3) Encouragement of physical activity; (4) Utilization of hypnosis applications; and (5) Monitoring and measuring progress evidenced by a reduction in the frequency and intensity of panic attacks. Six years after his last hypnosis session, “Jason,” the once panicked firefighter returned to my office for concerns unrelated to panic, and reported that he remained panic-free, retained his job, and was twice promoted.

Hypnosis for reduction of background pain and pain anxiety in men with burns: A blinded, randomised, placebo-controlled study

Introduction‘Background pain’ and ‘pain anxiety’ are among the numerous problems of patients with burns. Non-pharmacological and pharmacological interventions have been used to reduce background pain and pain anxiety. This study compared the effectiveness of hypnosis and ‘neutral hypnosis’ (as a placebo in the control group) in decreasing the background burn pain and pain anxiety of adult male survivors with burns. DesignThis is a blinded, randomised, placebo-controlled study. MethodsSixty men with burns were included in the minimisation method (30 individuals in the intervention group and 30 individuals in the control group). Four hypnotherapy sessions were performed every other day for each participant in the intervention group. Four neutral hypnosis sessions were performed every other day in the control group. Burn pain and pain anxiety of the patients in both groups were measured at the end of the second and fourth sessions. Repeated measures ANOVA was used for data analysis. ResultsThere was no significant difference between the groups in the reduction in background pain intensity. There was a significant reduction in background pain quality and pain anxiety in the intervention group during the four hypnosis sessions. After two hypnotherapy sessions, a significant reduction was observed in the level of background pain quality and pain anxiety of participants. ConclusionHypnosis is effective in reducing background pain quality and pain anxiety of men with burns.

Assessment of a short hypnosis in a paediatric operating room in reducing postoperative pain and anxiety: A randomised study.

To assess the impact of a short hypnotic session on postoperative anxiety and pain in major orthopaedic surgery. Despite specific information given before a scheduled paediatric surgery, perioperative anxiety can become important. Randomised Clinical Study. The study is an open single-centre randomised clinical study comparing a "control" group versus a "hypnosis" group receiving a short hypnosis pre-induction session as additional experimental analgesic procedure. The primary endpoint was the postoperative anxiety, blindly assessed using a visual analogue scale. The study involved 120 children (age 10-18years). The results showed no difference between control group versus hypnosis group. Twenty-four hours after surgery (Day+1), the patient's anxiety score was not different between control and hypnosis groups (median [Q1-Q3]: 1 [0; 3] vs. 0 [0; 3], respectively, p=.17). Each group experienced a significant decrease in anxiety level between the day before surgery (Day-1) and the day after surgery (Day+1) (median ([Q1-Q3]) difference of the anxiety score: 2 [4; 0] and 2 [4; 0], respectively, p<.0001 in each group). The postoperative pain scores were low and not different between groups (median [Q1-Q3]: 2 [0; 3] in control group vs. 3 [1; 3] in hypnosis group, p=.57). This randomised study on a short hypnosis session performed in the operating room prior to a major surgery showed no difference in postoperative anxiety and pain levels. The decrease in anxiety and pain levels may be due to the addition of nurse pre-operative interviews and optimisation in communication in the operating room. As postoperative anxiety level was low in both control and hypnosis groups, nurse pre-operative interviews and nurse training in hypnosis may contribute to the optimisation of global management and decrease the postoperative anxiety level.

The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot study.

BackgroundVaso-occlusive pain crises (VOCs) are the “hallmark” of sickle-cell disease (SCD) and can lead to sympathetic nervous system dysfunction. Increased sympathetic nervous system activation during VOCs and/or pain can result in vasoconstriction, which may increase the risk for subsequent VOCs and pain. Hypnosis is a neuromodulatory intervention that may attenuate vascular and pain responsiveness. Due to the lack of laboratory-controlled pain studies in patients with SCD and healthy controls, the specific effects of hypnosis on acute pain-associated vascular responses are unknown. The current study assessed the effects of hypnosis on peripheral blood flow, pain threshold, tolerance, and intensity in adults with and without SCD.Subjects and methodsFourteen patients with SCD and 14 healthy controls were included. Participants underwent three laboratory pain tasks before and during a 30-minute hypnosis session. Peripheral blood flow, pain threshold, tolerance, and intensity before and during hypnosis were examined.ResultsA single 30-minute hypnosis session decreased pain intensity by a moderate amount in patients with SCD. Pain threshold and tolerance increased following hypnosis in the control group, but not in patients with SCD. Patients with SCD exhibited lower baseline peripheral blood flow and a greater increase in blood flow following hypnosis than controls.ConclusionGiven that peripheral vasoconstriction plays a role in the development of VOC, current findings provide support for further laboratory and clinical investigations of the effects of cognitive–behavioral neuromodulatory interventions on pain responses and peripheral vascular flow in patients with SCD. Current results suggest that hypnosis may increase peripheral vasodilation during both the anticipation and experience of pain in patients with SCD. These findings indicate a need for further examination of the effects of hypnosis on pain and vascular responses utilizing a randomized controlled trial design. Further evidence may help determine unique effects of hypnosis and potential benefits of integrating cognitive–behavioral neuromodulatory interventions into SCD treatment.

Hypnoanalgesia and clinical nursing reasoning

Hypnoanalgesia is practised in accordance with care ethics and as a complement to other medical and/or psychological therapies. It is aimed at people with acute, chronic or treatment-related pain. Its practice is founded on clinical nursing reasoning, which targets the health problem and the therapeutic objectives guiding the hypnosis session. A clinical assessment finalises the interactional process.

Impact of a preoperative conversational hypnotic session on propofol consumption using closed-loop anesthetic induction guided by the bispectral index: A randomized controlled trial.

Objective:The automated administration of propofol in a closed loop could be used to objectively evaluate the nonpharmacological anesthetic action of hypnotherapy. The objective of this study was to evaluate the impact of a conversational hypnosis session on the consumption of propofol for anesthetic induction.Design:A randomized, usual care-controlled, single-center, patient-blind trial.Setting:Tertiary care center in France from November 2012 to December 2013.Participants:Adult patients scheduled for a surgical procedure under general anesthesia.Interventions:Before surgery, patients were randomized with a computer-generated random list for a preoperative conversational hypnosis session or for usual care. The conversational hypnosis session was conducted and individualized by the therapist with an academic degree in hypnosis in a quiet environment. Anesthetic induction was automatically performed by propofol without opioids and was assisted by the bispectral index in a closed loop.Outcome:Primary endpoint was the propofol dose required for anesthesia induction, defined as a Bispectral index less than 60 for at least 30 seconds.Results:The study included 48 patients in the hypnosis group and 49 patients in the control group. No difference in propofol consumption to obtain anesthesia induction was observed between the groups (total dose: 138.6 [67.5] and 130 [47.9] mg, P = .47; adjusted dose: 2.15 [1.09] and 1.95 [0.66] mg/kg, P = .28, for the hypnosis and control groups, respectively). Hetero-evaluation of arm movement during propofol injection (no reaction: 98% and 74%; P = .004, in the hypnosis and control groups, respectively) and face reaction at venous access placement (no reaction 59% and 30%; P = .017, in the hypnosis and control groups, respectively) were lower in the hypnosis group. No adverse event was reported.Conclusions:No difference in propofol consumption was observed in this study designed to evaluate the effect of a hypnotic conversational session on anesthesia induction using an automated tool for propofol administration.

Effects of hypnosis during pregnancy: A psychophysiological study on maternal stress

Because it induces a state of reduced awareness and deep relaxation, hypnosis is thought to be efficient at relieving stress and anxiety. This study examined whether hypnosis may alter the pattern and time evolution of maternal and fetal stress. Here we report a 23-yrs-old primigravida woman at 31-weeks’ gestation who underwent daily sessions of hypnosis during one week. An A (baseline)-B (intervention) – A′ (return to baseline) design was used. Each study phase lasted one week. The State Anxiety Inventory (SAI) was completed daily. Uterine contractions as well as maternal and fetal heart rate were recorded over 24-h periods in each of the study phase. Uterine contractions and maternal systolic blood pressure showed clear reductions during the hypnosis phase. In addition, a statistically significant declining trend in anxiety scores was observed during the hypnosis phase, and anxiety re-increased in the return-to-baseline phase (p<0.05). Coefficient of variation of maternal heart rate was found to be considerably lower during the hypnosis phase. Our results suggest that a short-lived hypnosis intervention (combined with standard care) holds sufficient promise for antenatal stress relief to justify testing its efficacy in larger groups of pregnant women.

Changes in the sense of agency during hypnosis: The Hungarian version of the Sense of Agency Rating Scale (SOARS-HU) and its relationship with phenomenological aspects of consciousness.

Changes in the sense of agency are defining feature of hypnosis. The Sense of Agency Rating Scale (SOARS) is a 10-item questionnaire, administered after a hypnosis session to assess alteration in the sense of agency. In the present study, a Hungarian version of the measure (SOARS-HU) is presented. The SOARS-HU and the Phenomenology of Consciousness Inventory (PCI) were administered to 197 subjects following hypnotizability screening with the Harvard Group Scale of Hypnotic Susceptibility Scale, Form A (HGSHS:A). Confirmatory factor analysis and correlations with hypnotizability demonstrate the reliability and validity of the SOARS-HU. Changes in the Involuntariness and Effortlessness subscales of the SOARS-HU were associated with alterations in subjective conscious experience, as measured by the PCI. These changes in subjective experience remained significant after controlling for HGSHS:A scores. These results indicate that changes in the sense of agency during hypnosis are associated with alterations of consciousness that are independent of hypnotizability.

Effects of self-conditioning techniques in promoting weight loss in patients with severe obesity: a randomized controlled trial protocol

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Obesity is a worldwide epidemic; most obese individuals who lose weight after lifestyle educative treatments, soon regain it. Our aim is to evaluate the effectiveness of a training to teach self-conditioning technique (self-hypnosis) added to standard care in determining weight loss compared with standard care in patients with obesity&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This randomized controlled open trial will recruit 120 obese patients (BMI 35-50 Kg/m&lt;sup&gt;2&lt;/sup&gt;), aged 20-70 years. The control group will receive a traditional approach: diet + exercise + behavioral recommendations. The experimental group will receive self-conditioning techniques + traditional approach.&lt;/p&gt;&lt;p&gt;Three individual sessions of hypnosis with rapid-induction techniques will be administered by trained personnel. All the participants of both groups will be assessed at three, six, nine and twelve months after randomization. The primary outcome is weight loss difference between groups at 12 months after randomization; secondary outcomes are changes in adherence to dietetic and exercise recommendations, appetite and satisfaction/well-being, waist circumference and body fat, blood pressure and blood metabolic and inflammatory variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The results of this trial will assess whether a self-conditioning approach, based on self-hypnosis, is able to help participants to modulate unhealthy patterns of eating and sustain weight loss in the long term.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

ED06.06 Decisions in Case of Intractable Symptoms

ED06.06 Decisions in Case of Intractable Symptoms

Hypnosis for Chronic Pain Management

Recent psychophysiological data supports the concept that hypnotic interventions for pain management are beneficial. The aim of this study was to evaluate pain relief induced through hypnosis in two chronic pain conditions: fibromyalgia (FM) and chronic migraine (CM). Participants were treated during 5 weekly hypnosis sessions, each lasting 60 minutes. A battery of self-reported questionnaires assessing quality of life, pain intensity, and depression levels were administered at the beginning and at the end of treatment. We observed important group differences in outcomes, in particular for CM patients.

Group Hypnotizability Of Inpatient Adolescents

This study investigated group hypnotizability in 167 adolescents (ages 13-17) in an inpatient behavioral healthcare setting through use of the Waterloo-Stanford Group Scale, Form C. It also investigated the influence of hypnotic inductions on group hypnotizability. Adolescents were randomly assigned to either a group session of hypnosis (n = 84) with a hypnotic induction or a comparison “no-induction” group (n = 83) that received identical suggestions without a hypnotic induction. Adolescents’ imaginative absorption and dissociation were measured to examine their influence on hypnotizability. A between-group comparison showed the induction condition had a significantly higher score than the no-induction group on both behavioral and subjective measures of hypnotizability.

Peripheral Blood Flow Responses to Pain Following a Hypnosis Intervention in Sickle Cell Disease

Introduction: Vaso-occlusive pain crises are considered the "hallmark" of sickle cell disease (SCD). Persistent occurrence is thought to lead to changes in the peripheral and central nervous system, which can then in turn lead to changes in pain sensitivity. Imaging studies have shown that hypnotic analgesia can reduce activity in supraspinal areas of the "pain matrix." To date there are no published studies looking at the effectiveness of hypnosis in altering pain perception in patients with SCD. The purpose of this study was to investigate changes in peripheral blood flow in response to a 30-minute hypnosis intervention and its relationship to pain sensitivity.Methods: To assess the effectiveness of increasing vasodilation, a laboratory based, single session hypnosis protocol was administered to a sample of 14 SCD patients and 14 healthy controls. Continuous readings for SpO2, pulse rate and pulse waveform was monitored using a pulse oximetry transducer placed on the left thumb. Bio-behavioral pain measures were collected during a standardized pain protocol before and after a hypnosis session, performed by a trained therapist. The protocol consisted of assessing pain tolerance and threshold via a heat probe (˚C) for "pain task 1", preceded by an anticipation period. "Pain task 2" consisted of assessing pain intensity via the same heat probe (˚C) on a 1-100 visual analog scale (VAS), preceded by another anticipation period.Results: To investigate blood-flow responses to their respective baseline (baseline vs. hypnosis), all recorded signal following these two periods was normalized respectively. Independent sample t-tests between both normalized anticipation and pain responses periods revealed controls showed no response to hypnosis for anticipation period 1(t(23.42) = .184, p = .855, d = .072), but SCD patients showed a large increase in blood flow (t(16.99) = 4.189, p = .0006, d = 1.79). Neither controls (t(21.05) = .00, p = .994, d = .003) or SCD patients (t(19.99) =.718, p = .481, d = .305) showed an effect of hypnosis in response to pain task 1. Neither controls (t(23.96) = -.139, p = .890, d = -.05) or SCD patients (t(18.82) = 1.035, p = .313, d = .441) showed a response to anticipation period 2, but the effect size reveals that this may be due to a lack of power. Neither controls (t(16.52) = .258, p = .799, d = .101) or SCD patients (t(19.63) = p = .5375, d = .268) showed no changes in response to hypnosis for pain task 2. Independent sample t-tests revealed no significant difference in pain threshold (t(13) = 0.941, p = .364, d = .251) or tolerance (t(13) = 0.937, p = 0.366, d = 0.250) in SCD patients before and after hypnosis. Differences in pain ratings were marginal but showed a decrease with medium effect (t(13) = -1.5315, p = 0.150, d = 0.409). The same tests revealed significant decreases in controls for pain threshold (t(13) = 2.825, p = 0.01, d = .755), pain tolerance (t(13) = 2.482, p = 0.02, d = 0.664), and pain rating (t(13) = 2.950, p = 0.01, d = .789).Conclusion: Results revealed that hypnosis may be an effective treatment in helping manage vasoconstriction in SCD as a response to cognitive appraisals about pain, as well as reducing pain sensitivity. The data presented provide preliminary clinical evidence of the use of hypnosis as a treatment method to improve vasodilation in SCD patients and decreasing pain crises, thus increasing overall quality of life. DisclosuresNo relevant conflicts of interest to declare.

The Beneficial Effect of Hypnosis in Elective Cardiac Surgery: A Preliminary Study.

Background Single-session hypnosis has never been evaluated as a premedication technique in patients undergoing coronary artery bypass grafting (CABG). The aim of the present study was to evaluate the beneficial effects of clinical hypnotherapy on perioperative anxiety, pain perception, sedation, and necessity for ventilator assistance in patients undergoing CABG. Methods Double-blind, randomized, clinical trial was performed. Forty-four patients undergoing CABG surgery were randomized into two groups. The patients in group A received preprocedural hypnosis by an anesthesiologist. Patients in group B (control) had only information on the surgical intervention by the same anesthesiologist. State-Trait-Anxiety Index-I (STAI-I) and Beck Depression Inventory (BDI) were performed preoperatively in both groups. Visual analog scale (VAS) and Ramsay sedation scale (RSS) were evaluated on 0th, 1st, 2nd, 4th, 6th, 8th, 10th, 12th, and 24th hours, postoperatively. Postoperative anxiety level, analgesic drug consumption, and duration of ventilator assistance and intensive care unit (ICU) stay were also documented. Results When anxiety and depression levels were compared, significantly lower STA-I and BDI values were detected in group A after hypnotherapy (p = 0.001, p = 0.001, respectively). Significantly less total doses of remifentanil (34.4 ± 11.4 vs. 50.0 ± 13.6 mg) and morphine (4.9 ± 3.3 vs. 13.6 ± 2.7 mg) were administered in group A in the postoperative period. Ventilator assistance duration (6.8 ± 2.0 vs. 8.9 ± 2.7 hours) was also shorter in group A when compared with that in group B (p = 0.007). Conclusion Hypnosis session prior to surgery was an effective complementary method in decreasing presurgical anxiety, and it resulted in better pain control as well as reduced ventilator assistance following CABG surgery.

A Case Study of Hypnosis for Phagophobia: It’s No Choking Matter

In this case study the author reviews the benefits of hypnosis for a 13-year-old female suffering from a specific phobia involving a fear of choking and generalized fear of swallowing that resulted in an episode of Restrictive Food Intake Disorder with associated significant weight loss. At the time of the initial consultation, three weeks after her choking episode, the patient weighed 93 pounds. Standing at 5’2”, her Body Mass Index (BMI) was 17 (15th percentile) indicative of healthy weight for a child her age and height. She continued to lose weight over the course of 2 months and at her worst weighed 85 pounds (BMI = 15.5, 3rd percentile, classified as underweight). Prior to the incident, she weighed 105 pounds with a BMI of 19.2 (46th percentile). Treatment initially consisted of 12 hypnosis sessions (over a 5-month period), conducted on a weekly and eventually biweekly basis. A scheduled one-month follow-up visit was conducted following the 12th session, at which time the patient was consuming solid foods without fear of choking. Her BMI at that time was 18.7 (39th percentile). Two months after terminating treatment, the patient experienced a mild relapse triggered by conflicts with some female peers. After four additional hypnosis sessions, the patient’s symptoms again remitted. During her last session we shared a pizza, providing clear and convincing evidence that she had overcome her fear of swallowing. She retained therapeutic benefits for at least 3 years following treatment.

False memory syndrome: A review and emerging issues, following a clinical report

False Memory Syndrome (FMS) is caused by memories of a traumatic episode, most commonly childhood sexual abuse, which are objectively false, but in which the person strongly believes. These pseudomemories usually arise in the context of adult psychotherapy and are often quite vivid and emotionally charged. FMS is rare and sometimes could be confused with psychotic disorder and malingering. The infrequency with which it is encountered makes this syndrome a diagnostic challenge. Failure to diagnose can lead to significant morbidity.We studied a 26-year-old female with no prior Psychiatric history who started to recall vivid memories of sexual abuse perpetrated by her father, following few sessions of clinical hypnosis. She presented a low mood, disorganized behaviour and aggressivity towards her father when she was admitted to our ward. After a normal CT brain scan and lab tests and a meticulous clinical history, the clinical diagnosis was made. She was successfully managed with supportive psychotherapy combined with mood stabilizer medications.This case illustrates the unknown field between memory and confabulation and the value of a complete history. Physicians should be alert and keep an open mind about this iatrogenic disorder. Research is needed on the identification of memory mechanisms, specific situations and personality factors involved in this syndrome.Disclosure of interestThe authors have not supplied their declaration of competing interest.