Hypnotic Intervention Research Articles

Hypnotic Intervention for Unexplained Dizziness in Patients with Advanced Cancer: A Preliminary Retrospective Observation Study.

Context:Patients with advanced cancer rarely complain of unexplained dizziness after excluding identifiable causes. Some patients become anxious because they attribute the dizziness to the progression of their cancer. We hypothesize that unexplained dizziness is associated with neck muscle hypertonicity, a noncancer-related secondary effect. However, most cases are associated with neck muscle hypertonicity, a noncancer-related secondary effect.Aims:We evaluated the usefulness of hypnotic intervention that made patients aware of the relation between dizziness and neck muscle hypertonicity through the experience of muscle relaxation and recognition of muscle tension.Settings and Design:Advanced cancer patients requiring palliative care with unexplained dizziness who received the intervention to induce neck muscle relaxation were retrospectively compared with patients who did not.Subjects and Methods:The severity of dizziness that was evaluated using a numeric rating scale and the intervention efficacy rate were compared between the hypnotic and nonhypnotic groups as the primary endpoints, 7 days after the start of the intervention. Secondary endpoints included the effect size based on dizziness handicap inventory (DHI) scores before and after the intervention, and changes in patients’ awareness of the cause of dizziness.Results:The hypnotic intervention had a significantly greater efficacy rate (0.67, 95% confidence interval: 0.46–0.88) than the nonhypnotic intervention (0.26, 95% confidence interval: 0.08–0.44). DHI scores, especially on the emotional subscale, showed significant improvement after the intervention, and 71% of the patients were aware that neck muscle hypertonicity was the cause of dizziness.Conclusions:The rapid improvement in dizziness in the hypnotic group was considered to result from a change in patients’ awareness of self-manageable neck muscle hypertonicity as the cause of dizziness.

The Hypnotic Induction in the Broad Scheme of Hypnosis: A Sociocognitive Perspective

Researchers and clinicians typically divide hypnosis into two distinct parts: the induction and the suggestions that follow. We suggest that this distinction is arbitrary and artificial. Different definitions of hypnosis ascribe different roles to the hypnotic induction, yet none clearly specifies the mechanisms that mediate or moderate subjective and behavioral responses to hypnotic suggestions. Researchers have identified few if any differences in responding across diverse hypnotic inductions, and surprisingly little research has focused on the specific ingredients that optimize responsiveness. From a sociocognitive perspective, we consider the role of inductions in the broader scheme of hypnosis and suggest that there is no clear line of demarcation between prehypnotic information, the induction, suggestions, and other constituents of the hypnotic context. We describe research efforts to maximize responses to hypnotic suggestions, which encompass the induction and other aspects of the broader hypnotic framework, and conclude with a call for more research on inductions and suggestions to better understand their role within hypnotic interventions in research and clinical contexts.

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.

Brief Psychological and Hypnotic Interventions in Chronic Pain Management

This article will explore how brief psychological approaches using hypnosis and imagery can be used with patients with chronic pain, predominantly in a Primary Care setting, although much that is discussed here could be applied in the Secondary sector. Chronic pain is defined as pain which endures for more than 6 months and may last for months or years. It serves no physiological purpose and persists after the time that ‘normal’ healing would be supposed to have taken place. Chronic pain may also range from that of cancer or arthritis, to that which seems to have no single or obvious physical causation. Teaching self-hypnosis and use of imagery can give these patients tools that they can use to help themselves, not only with pain, but also with the emotional distress that so often accompanies and exacerbates it. Unlike medication, self-hypnosis has only positive side effects and can give back some measure of control to patients who feel helpless and hopeless.

Effectiveness of Self-Hypnosis on the Relief of Experimental Dental Pain: A Randomized Trial

This randomized, controlled clinical trial evaluates the effectiveness of self-hypnosis on pain perception. Pain thresholds were measured, and a targeted, standardized pain stimulus was created by electrical stimulation of the dental pulp of an upper anterior tooth. Pain stimulus was rated by a visual analogue scale (VAS). The pain threshold under self-hypnosis was higher (57.1 ± 17.1) than without hypnotic intervention (39.5 ± 11.8) (p < .001). Pain was rated lower on the VAS with self-hypnosis (4.0 ± 3.8) than in the basal condition without self-hypnosis (7.1 ± 2.7) (p < .001). Self-hypnosis can be used in clinical practice as an adjunct to the gold standard of local anesthesia for pain management, as well as an alternative in individual cases.

The Illness/Non-Illness Model: Hypnotherapy for Physically Ill Patients

This article proposes a focused, novel sub-set of the cognitive behavioral therapy approach to hypnotherapy for physically ill patients, based upon the illness/non-illness psychotherapeutic model for physically ill patients. The model is based on three logical rules used in differentiating illness from non-illness: duality, contradiction, and complementarity. The article discusses the use of hypnotic interventions to help physically ill and/or disabled patients distinguish between illness and non-illness in their psychotherapeutic themes and attitudes. Two case studies illustrate that patients in this special population group can be taught to learn the language of change and to use this language to overcome difficult situations. The model suggests a new clinical mode of treatment in which individuals who are physically ill and/or disabled are helped in coping with actual motifs and thoughts related to non-illness or non-disability.

Brief Hypnotic Intervention Increases Throwing Accuracy

The present study examined whether motor skill learning could be enhanced through a hypnotic intervention. The task involved throwing a tennis ball overhand at a target. Participants were assigned to either a hypnosis or control group. Both groups first completed a pre-test of 20 throws. Prior to the second block of 20 throws (post-test), the hypnosis group received a 10-minute hypnotic intervention. The theme of the hypnosis session was to focus on the target while throwing. Participants were aroused from the hypnotic state prior to the throwing task. The control group was asked to relax in the same environment for the same length of time. Control group participants were told that focusing on the target had been shown to increase accuracy. On the post-test, as well as on a retention test (20 throws), conducted 5–8 days after the post-test, the hypnosis group showed an increase in throwing accuracy relative to the pre-test and more effective performance than the control group whose performance was similar to that on the pre-test. These findings show that hypnosis can have a positive impact on motor learning. Potential mechanisms for this effect are discussed.

A Pilot Investigation of Guided Self-Hypnosis in the Treatment of Hot Flashes Among Postmenopausal Women1 ,2

Previous research has demonstrated that a hypnotic intervention can reduce hot flashes, a significant problem for some women. Based on the authors' previous research, the present study was developed to evaluate the feasibility of a guided self-hypnosis intervention for hot flashes. Thirteen postmenopausal women received 5 sessions of guided self-hypnosis in which all hypnotic inductions were recordings. Guidance regarding symptom monitoring, individualization of mental imagery, and practice of self-hypnosis were provided. Hot flashes were determined through diaries. Results indicated average frequency of hot flashes decreased by 72% (p < .001) and hot-flash scores decreased by 76% (p < .001) on average. Guided self-hypnosis reduced perceived hot flashes in the pilot study with postmenopausal women supporting the possible feasibility and potential benefit of the intervention.

Oxytocin impedes the effect of the word blindness post-hypnotic suggestion on Stroop task performance

The ability to enhance sensitivity to relevant (post)hypnotic suggestions has implications for creating clinically informed analogues of psychological and neuropsychological conditions and for the use of hypnotic interventions in psychological and medical conditions. The aim of this study was to test the effect of oxytocin inhalation on a post-hypnotic suggestion that previously has been shown to improve the selectivity of attention in the Stroop task. In a double-blind placebo-controlled between-subjects study, medium hypnotizable individuals performed the Stroop task under normal conditions and when they had been given a post-hypnotic suggestion that they would perceive words as meaningless symbols. In line with previous research, Stroop interference was substantially reduced by the suggestion in the placebo condition. However, contrary to expectations, oxytocin impeded the effect of the word blindness suggestion on performance. The results are explained in terms of the requirement for the re-implementation of the word blindness suggestion on a trial-by-trial basis and the need to sustain activation of the suggestion between trials. The findings contrast with a recent study showing a beneficial effect of oxytocin on sensitivity to (post)hypnotic suggestions but are consistent with findings showing a detrimental effect of oxytocin on memory processes.

Hypnotic Tape Intervention Ameliorates Stress: A Randomized, Control Study

This study (N = 35) used a randomized control design, and participants were collected from a variety of groups. After evaluating their degree of stress and burnout, coping styles, general well-being, and hypnotizability, participants were matched by stress level and randomly assigned to an intervention or wait-list group. The intervention comprised an audio recording of a hypnotic induction accompanied by suggestions for progressive relaxation, imagery, and anchoring to be used for 2 weeks. The results show that, as compared with baseline and wait-list conditions, the hypnotic intervention had a medium-to-large beneficial effect on participants’ experience of stress, burnout, and well-being. Some participants also decreased their use of the coping strategy escape-avoidance postintervention. Hypnotizability correlated significantly or marginally with some outcomes of the intervention, but only for 1 group.

Enhancing Placebo Effects: Insights From Social Psychology

Placebo effects are widely recognized as having a potent impact upon treatment outcomes in both medical and psychological interventions, including hypnosis. In research utilizing randomized clinical trials, there is usually an effort to minimize or control placebo effects. However, in clinical practice there may be significant benefits in enhancing placebo effects. Prior research from the field of social psychology has identified three factors that may enhance placebo effects, namely: priming, client perceptions, and the theory of planned behavior. These factors are reviewed and illustrated via a case example. The consideration of social-psychological factors to enhance positive expectancies and beliefs has implications for clinical practice as well as future research into hypnotic interventions.

P05.49. Development of a model for the conduct of randomized clinical trials of hypnotic intervention

Purpose Research on the efficacy of hypnosis has been limited due to the lack of a sham hypnosis (placebo) for comparison to use as a control in randomized clinical trials. Researchers have used a variety of controls ranging from wait-lists to structured attention, resulting in a lack of blinding of participants and inconsistency. A sham hypnosis methodology would provide a means to compare study results and make aggregate statements regarding hypnosis’ efficacy beyond placebo effects. The purpose of this study involved two primary aims: 1) to evaluate whether white noise can be considered an “inert” procedure; and 2) to evaluate the feasibility of a model of sham hypnosis that uses white noise as a potential form of “hypnosis” when presented within the hypnotic context.

Group hypnotherapy versus group relaxation for smoking cessation: an RCT study protocol

BackgroundA significant number of smokers would like to stop smoking. Despite the demonstrated efficacy of pharmacological smoking cessation treatments, many smokers are unwilling to use them; however, they are inclined to try alternative methods. Hypnosis has a long-standing reputation in smoking cessation therapy, but its efficacy has not been scientifically proven. We designed this randomised controlled trial to evaluate the effects of group hypnosis as a method for smoking cessation, and we will compare the results of group hypnosis with group relaxation.Methods/DesignThis is a randomised controlled trial (RCT) to compare the efficacy of a single session of hypnosis with that of relaxation performed in groups of 8-15 smokers. We intend to include at least 220 participants in our trial. The inclusion criteria include smoking at least 5 cigarettes per day, not using other cessation methods and being willing to quit smoking. The intervention is performed by a trained hypnotist/relaxation therapist. Both groups first receive 40 min of mental preparation that is based on motivational interviewing. Then, a state of deep relaxation is induced in the hypnosis condition, and superficial relaxation is induced in the control condition. Suggestions are made in the hypnosis condition that aim to switch the mental self-image of the participants from that of smokers to that of non-smokers. Each intervention lasts for 40 min. The participants also complete questionnaires that assess their smoking status and symptoms of depression and anxiety at baseline, 2 weeks and 6 months post-intervention. In addition, saliva samples are collected to assess cotinine levels at baseline and at 6 months post-intervention. We also assess nicotine withdrawal symptoms at 2 weeks post-intervention.DiscussionTo the best of our knowledge, this RCT is the first to test the efficacy of group hypnosis versus group relaxation. Issues requiring discussion in the outcome paper include the lack of standardisation of hypnotic interventions in smoking cessation, the debriefing of the participants, the effects of group dynamics and the reasons for dropouts.Trial registrationCurrent Controlled Trials, ISRCTN72839675.

Cognitive Behavioral Hypnotherapy for Dissociative Disorders

Dissociative disorders (DD) prevail as sequelae to overwhelming experiences in childhood. These readily formed post-traumatic responses and trance states develop in high hypnotizable subjects whose dysregulations become organized into ego states. A cognitive behavioral hypnotherapeutic treatment model will effectively contain, explore, metabolize, and resolve these life-endangering conditions. This article will detail the cognitive hypnotic world of DD patients, the relational spaces of the ego states, and the triphasic treatment mode to successfully resolve the dissociative pathology. Structured and phase appropriate hypnotic interventions will be described.

Hypnotic Intervention in a 7-Year-Old Thumbsucker: A Case Study

Thumbsucking is a common habit among younger children. Usually, the child outgrows this habit by age 6. When a child over the age of 6 continues to suck his or her thumb, it can be a cause of potential harm due to peer pressure, ridicule, and shunning. It can also lead to malocclusions requiring eventual orthodontic interventions. In this case study, the author demonstrates a hypnotic intervention in a 7-year-old girl. Validation of her habit and imaging a role model sucking her thumb were employed in trance. Using this approach, the child was able to end her dependence on thumbsucking in 1 session.

&lt;b&gt;Psychotherapy for chronic pain in multidisciplinary pain &lt;/b&gt;&lt;b&gt;center: its indication and its effect &lt;/b&gt;

The effect of hypnotic intervention for the refractory chronic pain patients was examined along with the process of patients' selection and their psychological characteristics. The total 596 visit patients in the first year were statistically examined concerning duration of pain, scores of psychological distress (Hospital Anxiety and Depression Scale) and disability (Pain Disability Assessment Scale) at the initial visit and the treatment outcome at the end of the first year. The duration of chronic pain was significantly related to disability but not to psychological distress at the initial visit. At the end of the first year of multidisciplinary pain treatment, 44% of total patients were under treatment, 19% finished treatment (10% evidently improved and 9% accepted their pain), 12% were referred and 25% dropped out. The group of patients who were evidently improved was not different concerning the duration of pain, but significantly less anxious, less depressed and less disabled at the initial visit than the other groups. Among the 261 patients under treatment, 33 patients (5.6% of total patients) were introduced into individual psychological interventions in consideration of 1) poor outcome in pharmacological and physical treatments, 2) unstable treatment relationship and marked pain behaviors, 3) obvious psychological distress, 4) event-related fluctuations in pain. They were significantly more anxious and depressed at the initial visit, than those who were not introduced to psychological intervention. Multiple bio-psycho-social factors were identified; tender points in 21 patients (by physiotherapist), stressful life events around the onset of pain in 26, serious daily conflicts at present in 30, catastrophizing thinking in 21, repressive thinking in 12, avoidance in 2 and perseverative coping in 6. Many of them did not or partly perceive their somatic tension / discomfort. Multiple factors were considered to inhibit the effect of treatment in those patients. In individual hypnosis, therapeutic conversation, permissive induction and indirect suggestions were employed. Direct suggestions for analgesia were not applied. Among 33 patients, 25 patients experienced hypnotic analgesia during sessions, 14 of whom finished their sessions with the decreased daily pain level or the enhanced effect of medication until the end of the 3rd year. Among them, 5 patients evidently improved (one phantom limb pain and 4 other chronic pain). Hypnosis successfully helped 42% of the patients who had failed to respond to multi disciplinary treatment. The psychosomatic resources in patients need to be more attended and utilized in chronic pain treatment.

The Impact of Hypnotic Suggestibility In Clinical Care Settings

Hypnotic suggestibility has been described as a powerful predictor of outcomes associated with hypnotic interventions. However, there have been no systematic approaches to quantifying this effect across the literature. This meta-analysis evaluates the magnitude of the effect of hypnotic suggestibility on hypnotic outcomes in clinical settings. PsycINFO and PubMed were searched from their inception through July 2009. Thirty-four effects from 10 studies and 283 participants are reported. Results revealed a statistically significant overall effect size in the small to medium range (r = .24; 95% Confidence Interval = –0.28 to 0.75), indicating that greater hypnotic suggestibility led to greater effects of hypnosis interventions. Hypnotic suggestibility accounted for 6% of the variance in outcomes. Smaller sample size studies, use of the SHCS, and pediatric samples tended to result in larger effect sizes. The authors question the usefulness of assessing hypnotic suggestibility in clinical contexts.

Oxytocin as a moderator of hypnotizability

Since hypnosis was popularly recognized in the nineteenth century, the phenomenon of hypnotizability has remained poorly understood. The capacity to increase hypnotizability has important implications because it may increase the number of people who can benefit from hypnotic interventions for psychological and medical conditions. Current theories emphasize that rapport between hypnotist and subject is pivotal to motivate the respondent to engage in strategies that allows them to suspend reality and respond to suggestions. The neuropeptide oxytocin is implicated in social bonding, and enhances a range of social behaviors in animals and humans. This study tested the proposal that oxytocin administration, which enhances social bonding in humans, may enhance hypnotic responding by administering intranasal spray of oxytocin or placebo prior to hypnosis in 40 low hypnotizable male subjects. When low hypnotizable individuals were administered oxytocin via nasal spray, their level of hypnotic responding increased significantly compared to hypnotic responding levels prior to oxytocin administration. This is the first demonstration of a neurochemical basis for hypnotic responding, and points to a potential neural mechanism to explain hypnotizability.

Assessing the Immediate and Maintained Effects of Hypnosis on Self-Efficacy and Soccer Wall-Volley Performance

This study evaluated the effects of hypnosis on self-efficacy and soccer performance. Fifty-nine collegiate soccer players were randomly allocated to either a hypnosis (n = 30) or video attention-control group (n = 29). A pretest-posttest design with an additional 4-week follow-up was used. Self-efficacy was measured via a task-specific questionnaire comprising 10 items relating to good performance on a soccer wall-volley task. The hypnotic intervention comprised three sessions using ego-strengthening suggestions. The control group watched edited videos of professional soccer games. Results indicated that, following the intervention, the hypnosis group were more efficacious and performed better than the control group. These differences were also seen at the 4-week follow-up stage. Although changes in self-efficacy were associated with changes in performance, the effect of hypnosis on performance was not mediated by changes in self-efficacy. The study demonstrates that hypnosis can be used to enhance and maintain self-efficacy and soccer wall-volley performance.

Hypnosis: Exploring the Benefits for the Role of the Hospital Social Worker

This article will provide an examination of Erickson's model of hypnosis and the impact hypnosis has made on the psychosocial well being of the medically ill patient. The intrinsic three stage process of a hypnotic intervention, as well as its value, practice assumptions, and its relevance to alleviating pain, distress, and anxiety with oncology patients will be discussed. We have found this approach to be particularly effective with adult oncology patients at alleviating the side effects of the arduous treatment that is often endured. Case vignettes will demonstrate the benefits of utilizing this intervention with adult patients in the hospital setting as well as provide specific insight into the creative methods in which we have woven hypnosis into our clinical work. Finally, we will explore the use and rationale of hypnosis in medical settings and the impact of using this intervention on the role of the hospital social worker.