Hypnotic Susceptibility Research Articles

Multidisciplinary Approach to Hypnosis: Psychiatric Basis, Neuroimaging and Genetic Findings

Hypnosis, a practice often misunderstood and surrounded by misconceptions, has a rich historical lineage dating back to ancient civilizations. Our review explores the relationship between neuroanatomy, genetics, and hypnotic susceptibility, investigating organic factors influencing an individual's responsiveness to hypnosis. This review highlights the importance of hypnosis as a high-level cognitive activity, especially in pain and anxiety management, and emphasizes the potential benefits of integrating hypnosis into healthcare practices. Recent advancements in neuroimaging have provided insights into the neurological mechanisms of hypnosis, while genetic research has expanded its applications. However, persistent misconceptions hinder its acceptance. This article offers a multidisciplinary basic exploration of hypnosis, focusing on its origins, historical development related to psychiatry, the basic neuroimaging findings mainly affecting the limbic system responsible for emotion, and genetic underpinnings. We aim to inspire clinicians, social scientists, and healthcare professionals to effectively integrate the scientific basics of hypnosis into therapeutic practice, contributing to a better understanding of its role in augmenting outcomes.

Sleepiness may predict hypnotizability, while personality traits do not

ABSTRACT Sleepiness and personality traits have been controversially reported as associated to individual hypnotizability level i.e. receptiveness to hypnotic suggestions and behave accordingly. In this study, we further investigate the relationship between the level of general daytime sleepiness and personality traits with the level of hypnotizability. Seventy-eight healthy young volunteers (34 women) completed the fast assessment of general daytime sleepiness and personality with the Epworth Sleepiness Scale and the 10-item Big Five Inventory respectively, and underwent hypnotic evaluation through the Harvard Group Scale of Hypnotic Susceptibility Form A (HGSHS:A). Main findings revealed a correlation between sleepiness and hypnotizability levels, and no influence of personality traits. Interestingly, women exhibited higher levels of hypnotizability compared to men. Taken together, these results suggest that sleepiness assessment might be considered as a predictive tool to hypnotic suggestions, which would offer practical insight for enhancing hypnosis intervention efficacy.

A General Factor of Hypnotizability Revealed by Confirmatory Factor Analysis

ABSTRACT The objective of this study was to determine the model fit of a standardized hypnotizability measure in a targeted clinical sample. The Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) was administered to 168 post-menopausal women aged 39 to 75 years. Confirmatory factor analysis was conducted, and comparative fit index (CFI) and root mean square error of approximation (RMSEA) were used to determine goodness of fit. Results indicated that the single-factor structure modeled with twelve indicators based on the individual items on the SHSS:C provided the best description of fit. Results of the present study demonstrate that the SHSS:C has a single-factor structure. These findings suggest that new scales of hypnotizability can be optimized by focusing on the use of items that correlate highly with the overall score representing the unidimensional construct of hypnotizability. The findings should be interpreted with caution due to the small sample size, and further research is needed with other populations to clarify generalizability.

The Role of Interoceptive Sensitivity and Hypnotizability in Motor Imagery.

Motor imagery (MI) requires the mental representation of the body, obtained by integrating exteroceptive and interoceptive information. This study aimed to investigate the role of interoceptive sensitivity (IS) in MI performed through visual and kinesthetic modalities by participants with low (lows, N = 26; SHSS: A, M + SD: 1.00 + 1.52), medium (mediums, N = 11; SHSS: A, 6.00 + 0.77) and high hypnotizability scores (highs, N = 16; SHSS:A, 9.75 + 1.24), as measured by the Stanford Hypnotic Susceptibility Scale: Form A. The three groups displayed different MI abilities and IS levels. The efficacy of MI was measured using the chronometric index and self-reported experience, while IS was measured using the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire. Alpha and beta power spectrum densities (PSDs) were extracted from the EEG signals acquired during baseline, actual movement and visually and kinesthetically imagined movements. The chronometric indices do not reveal significant differences between groups and imagery modalities. The self-report MI efficacy indicates better kinesthetic imagery in highs and mediums than in lows, and no modality difference among lows. The MAIA dimensions sustain the differences in subjective experience and almost all the EEG differences. The latter are slightly different in highs, mediums and lows. This is the first report of the major role played by IS in MI and strongly supports the theory of embodied cognition.

HGSHS-5:G-First results with the short version of the test for the Harvard Group Scale of Hypnotic Susceptibility and a comparison with the full version.

The HGSHS:A is one of the most commonly used measures of hypnotic suggestibility. However, this test suffers from low feasibility due to a time requirement exceeding 1 h, and from a questionable representation of the normal population. Recently, a short version of HGSHS-5:G was developed and published, and now the first results are available. The scope of this investigation was to verify the assumption of equally positioned and normally distributed scores, resulting in equally sized suggestibility groups in a number of different studies with full or short versions of HGSHS, and to compare the results of the 11-item score with the 5-item score, the latter being calculated from either the full version or the short version test. Data from 21 studies with testing for HGSHS were analyzed, 15 using the HGSHS:A full version and six using the HGSHS-5:G short version, for a total of 2,529 data sets. Position and distribution of both the 11-item score and the 5-item score were tested. Linear regression analysis was used to compare the two scores, as well as cross-table and weighted Cohen's kappa to determine the match of grouping into low and high suggestibility. To evaluate contributing factors to the observed differences in the study results, a multifactorial analysis of variance was performed. In the different studies, position and distribution of scores, as well as group sizes for low and high suggestibles, varied. All score distributions were found to be non-normal and shifted to the right from the middle score; the shift was more extensive with the 11-item score. The correlation between both scores calculated from full version tests was moderate (R 2 = 0.69), as was the match of suggestibility grouping (κ = 0.58). Studies using the short version involving less student-dominated populations showed sufficient agreement with the full version, but lower scores were caused by an increase in the zero score. A normal population is not represented in most applications of HGSHS, and grouping into low and high suggestibles varies, mainly due to different positions of score distributions. A direct comparison of full and short versions of HGSHS tested in the same subjects is still missing.

French Norms for a Shortened Online Adaptation of the Harvard Group Scale of Hypnotic Susceptibility, Form A

ABSTRACT This study presents the norms and psychometric properties for a shortened online adaptation of a French version of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A). Assessment of involuntariness and subjective intensity was added to the traditional scoring. A total of 373 individuals completed an online hypnotizability screening test on their own computer. Participants received the HGSHS:A script through an audio recording lasting about 30 minutes. The results showed that the item difficulty and reliability of the short online HGSHS:A were consistent with the offline version of the scale and with the reference samples. Involuntariness and subjective intensity corrections improved significantly the accuracy in the measurement of the scale and helped to dissociate between different phenomenologies in hypnotic responding. These findings indicate that the short online HGSHS:A is a reliable tool for measuring hypnotizability. Moreover, we suggest that using complementary measures of involuntariness and subjective intensity helps to shed more light on hypnotizability as part of a multi-componential approach to hypnotic response.

The influence of experience and modality of presentation (online vs. offline) on hypnotizability.

Hypnotizability is conceptualized as a stable personality trait describing the ability to respond to suggestions given under hypnosis. Hypnotizability is a key factor in explaining variance in the effects of hypnotic suggestions on behavior and neural correlates, revealing robust changes mostly in high hypnotizable participants. However, repeated experience and training have been discussed as possible ways to increase willingness, motivation, and ability to follow hypnotic suggestions, although their direct influence on hypnotizability are still unclear. Additionally, it is important whether hypnotizability can be assessed reliably online. We investigated the influence of the degree of experience with hypnosis and the presentation mode (online versus live) on the stability of hypnotizability in two groups of 77 and 102 young, healthy students, respectively. The first group was tested twice with the Harvard Group Scale of Hypnotic Susceptibility (HGSHS) after two weeks. During this period, participants either repeatedly listened to a hypnosis or trained on a progressive muscle relaxation or served as waitlist control group. In the secondgroup, participants performed both an online or offline version of the HGSHS, with varying time intervals (1-6 weeks). Contrary to our expectations, hypnotizability declined from the first to second assessment in the first group. The reductionwas most prominent in initially highly hypnotizable subjects and independent of the experience intervention. We observed a similar reduction of hypnotizability in the second group, independent of presentation modality. The reduction was again driven by initially highly hypnotizable subjects, while the scores of low hypnotizable subjects remained stable. The presentation modality (online vs. offline) did not influence HGSHS scores, but the test-retest reliability was low to moderate (rtt = 0.44). Our results favor the conclusion that generally, hypnotizability is a relatively stable personality trait which shows no major influence of preexperience or modality of assessment. However, particularly highly hypnotizable subjects are likely to experience a decline in hypnotizability in a retest. The role of the concrete assessment tool, psychological factors, and interval length are discussed. Future studies should replicate the experiments in a clinical sample which might have higher intrinsic motivation of increasing responsiveness toward hypnotic interventions or be more sensitive to presentation mode.

Intimate relationships and hypnosis: insecure adult attachment affects emotions and absorption during hypnosis.

Hypnosis research indicates that subjects are not equally hypnotizable. Most studies on hypnotizability focused on the relationships with personality or cognitive variables. At the same time, only a few proposed the contribution of the attachment style, defined as the result of the childhood relationship with the caregivers and influencing the adult relations. In the present investigation, two studies were carried out to test the possible association between adult attachment and hypnotic responsivity. The adult attachment was assessed using the Experiences in Close Relationships-Revised (ECR-R) questionnaire, while hypnosis was assessed through the Harvard Group Scale of Hypnotic Susceptibility (HGSHS:A; Study 1) and the Phenomenology of Consciousness Inventory: Hypnotic Assessment Procedure (PCI-HAP; Study 2) in order to adopt a behavioral and a phenomenological approach, respectively. Analyses showed that attachment factors (anxiety and avoidance) were not associated with the level of hypnotizability, whereas it was associated with variations of consciousness during hypnosis, mainly internal dialogue, absorption and negative emotions. Overall, the insecure attachment styles yielded increased mind wandering and restlessness during hypnosis when compared to the secure style. The reason probably lies in the feeling of anxiety or danger of insecurely attached individuals when involved in intimate or confidential relationships. These findings clarify a still poorly investigated aspect concerning the influence of attachment style on hypnotic experience and further highlight the need to consider inter-individual differences and the phenomenological perspective when assessing hypnosis and hypnotizability.

Interoception as a function of hypnotizability during rest and a heartbeat counting task.

The hypnotizability-related differences in morpho-functional characteristics of the insula could at least partially account for the differences in interoceptive accuracy (IA) observed between high and low hypnotizable individuals (highs, lows). Our aim was to investigate interoceptive processing in highs, lows, and medium hypnotizable individuals (mediums), who represent most of the population, during a 10-minute open eyes relaxation condition (Part 1) and three repetitions of consecutive 2-minute open eyes, closed eyes, and heartbeat counting conditions, followed by a 2-minute post-counting condition (Part 2). Electrocardiogram and electroencephalogram were recorded in 14 highs, 14 mediums, and 18 lows, classified according to the Stanford Hypnotic Susceptibility Scale: Form A. Heartbeat-evoked cortical potentials (HEP) were extracted throughout the entire session, and IA index was obtained for the heartbeat counting task (HCT). In Part 1, significant hypnotizability-related differences were observed in the right central region in both early and late HEP components, with lows showing positive amplitudes and highs/mediums showing negative amplitudes. In Part 2, the same group differences were limited to the early component. Moreover, in the left frontal regions, only mediums modified their HEP during the counting task with respect to the open/closed eyes conditions, whereas highs displayed HEP differences between counting and post-counting rest. HCT did not show significant group differences. In conclusion, highs and mediums seem to be more similar than mediums and lows regarding HEP, despite the absence of significant differences in HCT. Nonetheless, a negative correlation between hypnotizability scores and HEP amplitudes was observed in the regions showing group differences.

Hypnotizability-related risky experience and behavior

Risk is the probability of an adverse event. The proneness to take a risk and the risk taking behavior differ among the general population.Hypnotizability is a stable psychophysiological trait expressing the individual proneness to modify perception, memory and behavior following specific suggestions also in the ordinary state of consciousness. Some hypnotizability-related neurophysiological and behavioral correlates suggest that hypnotizability level, measured by standard scales classifying individuals as low (lows), medium (mediums) and high hypnotizable (highs) subjects, can be related to risk propensity and risk-taking. To study whether hypnotizability modulates risk propensity and behavior, we recruited healthy participants, classified through the Standford Hypnotic Susceptibility scale, form A, and compared lows’ (n = 33), mediums’ (n = 19) and highs’(n = 15) experiential and behavioral risk perception and propensity variables through the Domain-specific risk-taking scale and the Balloon Analogue Risk Task. MANOVA results indicated that different hypnotizability levels are not associated with different risky behavior and experience, except for higher expected financial benefits from risky behavior in lows. However, hypnotizability-related risk profiles were identified through correlational analyses. In fact, highs exhibited a negative association between risk perception and propensity to risk-taking, whereas mediums and lows displayed a positive association between risk propensity and expected benefit. In conclusion, the highs’ profile indicates a more automatic behavior with respect to mediums and lows.

Hypnosis measured with monitors of anesthetic depth - EEG changes during the test for Harvard Group Scale of Hypnotic Susceptibility.

Hypnotic trance can be defined as a non-ordinary state of consciousness that is accompanied by a number of neurophysiological changes, including brain electrophysiology. In addition to subjective measures, corresponding objective parameters are needed in experimental and clinical hypnosis research but are complex, impractical, or unspecific. A similar challenge exists for the measurement and monitoring of drug-induced hypnosis, namely general anesthesia. The observation of changes in EEG induced by narcotics has led to the development of monitors for the depth of anesthesia based on EEG parameters. We investigated whether two such monitors react to the induction and maintenance of hypnosis during a highly standardized procedure. A total of 56 volunteers were monitored for the bispectral index (BIS) and cerebral state index (CSI) (range 0-100, >95 considered "awake") during the Harvard Group Scale of Hypnotic Susceptibility test. For this test, trance is induced by a taped text and followed by 12 tasks performed under hypnosis. In contrast to random forms of hypnosis, this represents a standardized, worldwide-established condition. According to the resulting score, participants were classified into suggestibility groups in order to evaluate whether the electrophysiological measurements of BIS and CIS indices differ between high and low suggestible persons. Furthermore, participants were asked to rate their hypnotic depth (HD, 1-10) at every task of the test. Scores dropped significantly from a mean of 97.7 to 86.4 for BIS and from 94.6 to 77.7 for CSI with the induction of hypnosis to stay throughout hypnosis at levels of approximately 88.6 or 82.9, respectively. Results did not differ between high- and low-suggestible participants. The means of the subjective score of hypnotic depth and of the electrophysiological measurements showed a similar course. However, no correlation was found between BIS or CSI values and scores of hypnotic depths. Monitors for depth of anesthesia respond to changes in consciousness, including trance states of hypnosis. However, specificity is unclear. Practically, in hypnosis research with the exclusion of drug effects or sleep, these monitors might be helpful to test and compare the efficacy of induction texts and to detect disturbances of trance state.

Hypnotherapy for agoraphobia-Feasibility and efficacy investigated in a pilot study.

https://classic.clinicaltrials.gov/ct2/show/NCT03684577, identifier: NCT03684577.

Hypnotic and direct suggestions affect attitudes toward seeking professional psychological help

ABSTRACT This study investigated the impact of hypnotic suggestions on improving attitudes toward seeking professional psychological help (ATSPPH). The study administered the Chinese version of the ATSPPH scale on 303 college students, of which 61 with low levels of ATSPPH were recruited as the participants (male: 18; female: 43). All participants were tested with the Harvard Group Scale of Hypnotic Susceptibility, Form A, prior to the formal experiment and assigned with balancing hypnotic susceptibility in hypnotic suggestion, relaxation, or control groups. The main results were as follows: (1) counter-attitudinal information significantly improved explicit ATSPPH only for the hypnotic suggestion and relaxation groups, (2) the hypnotic suggestion group exhibited improvement in implicit ATSPPH and (3) a difference was observed between explicit and implicit attitudes in the process of providing counter-attitudinal information when changing ATSPPH.

Do Polymorphisms Predict Hypnotherapy Response in Children With Functional Abdominal Pain Disorders: An Explorative Study.

Genetic variations, in specific COMT , OPRM1 , and MAO-A polymorphisms, have been associated with hypnotizability in adults. The aim of this exploratory study was to investigate whether these polymorphisms are also associated with response to hypnotherapy (HT) in children. Patients (8-18 years, n = 260) diagnosed with a functional abdominal pain disorder (FAPD) from a previous trial assessing HT efficacy were approached for participation and 144 agreed to collect a buccal sample. Primary aim was to explore the association between COMT , OPRM1 , and MAO-A polymorphisms with treatment success (TS) after 3-month HT. Additionally, associations between these polymorphisms and adequate relief, anxiety, depression, quality of life, somatization, hypnotic susceptibility, expectations, pain beliefs, and coping strategies were evaluated. Participants with different variations of COMT , MAO-A , and OPRM1 achieved similar TS levels ( P > 0.05). No associations were found between these polymorphisms and secondary outcomes. This suggest that in pediatric patients with FAPDs, COMT , OPRM1 , and MAO-A polymorphisms do not predict HT response.

Transcranial electrical stimulation of the prefrontal cortex to boost the hypnosis experience: who benefits most?

Many attempts have been made to enhance hypnotizability. The most recent studies adopted the non-invasive brain stimulation to deactivate the dorsolateral prefrontal cortex (DLPFC) during hypnosis, indicating this as a promising approach. However, it is still no clear whether individual factors can predict the effects of stimulation on hypnotizability. In the present study we adopted the phenomenological consciousness inventory (PCI) to retrospectively assess the mental processes during hypnosis and to predict hypnotizability, here defined as "hypnoidal state." The aim was to investigate the possible role of the hypnotic susceptibility on the efficacy of a validated approach of hypnosis enhancement through cathodal transcranial electrical stimulation (tDCS) of the left DLPFC. Results indicated that the lower hypnoidal state at baseline predicted the greater enhancement after the active tDCS. These findings suggest the subjects with lower hypnotic responsiveness as the best candidates for the tDCS interventions of hypnosis enhancement, at least for the montage targeting the left DLPFC. Neurocognitive underpinnings and clinical implications of the results are discussed.

Reliability and Validity of the Elkins Hypnotizability Scale within a Clinical Sample

ABSTRACT Hypnotherapy is used in clinical settings to treat mental and physical health-related conditions. Hypnotic response can be measured through hypnotizability scales to help interventionists personalize treatment plans to suit the patients’ individualized hypnotic abilities. Examples of these scales are the Elkins Hypnotizability Scale (EHS) and the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C). According to the previous literature, these scales have good discriminating ability and internal consistency (α = 0.85) in collegiate samples, but the psychometric properties of the EHS for a targeted clinical population have not been determined yet. This study assessed said properties, and results showed adequate reliability of the EHS in a targeted clinical sample and strong convergent validity of the EHS to the SHSS:C. The authors conclude that the EHS is a strong and useful measure of hypnotizability that is pleasant, safe, brief, and sensible to individualities in hypnotic ability found in diverse clinical samples.

Is Hypnotic Induction Necessary to Experience Hypnosis and Responsible for Changes in Brain Activity?

The relevance of formal hypnotic induction to the experience of trance and its neural correlates is not clear, in that hypnotizability, beliefs and expectation of hypnosis may play a major role. The aim of the study was assessing the EEG brain activity of participants with high (highs) or low hypnotizability scores (lows), aware of their hypnotizability level and informed that the session will include simple relaxation, formal hypnotic induction and neutral hypnosis. A total of 16 highs and 15 lows (according to the Stanford Hypnotic Susceptibility Scale, form A) were enrolled. Their EEGs were recorded during consecutive conditions of open/closed-eyes relaxation, hypnotic induction, neutral hypnosis and post hypnosis not interrupted by interviews. The studied variables were theta, alpha and gamma power spectral density (PSD), and the Determinism (DET) and Entropy (ENT) of the EEG signal Multidimensional Recurrence Plot (mRP). Highs reported significantly greater changes in their state of consciousness than lows across the session. The theta, alpha and gamma PSD did not exhibit condition-related changes in both groups. The Alpha PSD was larger in highs than in lows on midline sites, and the different sides/regions' theta and gamma PSD were observed in the two groups independently from conditions. ENT showed no correlation with hypnotizability, while DET positively correlated with hypnotizability during hypnosis. In conclusion, the relevance of formal hypnotic induction to the experience of trance may be scarce in highs, as they are aware of their hypnotizability scores and expecting hypnosis. Cognitive processing varies throughout the session depending on the hypnotizability level.

Modulation of the heartbeat evoked cortical potential by hypnotizability and hypnosis.

Hypnotizability is a psychophysiological trait measured by scales and associated with several differences, including interoceptive accuracy and the morpho-functional characteristics of interoception-related brain regions. The aim of the study was to assess whether the amplitude of the heartbeat evoked cortical potential (HEP), a correlate of interoceptive accuracy, differs in participants with low (lows) and high (highs) hypnotizability scores (assessed by the Stanford Hypnotic Susceptibility Scale, Form A) before and after the induction of hypnosis. ECG and EEG were monitored in 16 highs and 15 lows during an experimental session, including open eyes baseline (B), closed eyes relaxation (R), hypnotic induction (IND), neutral hypnosis (NH), and post session baseline (Post). No significant difference was observed between groups and conditions in autonomic variables. The HEP amplitude was lower in highs than in lows at the right parietal site, likely due to hypnotizability related differences in the functional connection between the right insula and parietal cortex. It increased in highs and decreased in lows across the session, possibly due to the highs' preeminently internally directed attention and to the lows' possible disengagement from the task. Since interoception is involved in several cognitive-emotional functions, its hypnotizability related differences may contribute to the variability of experience and behavior in daily life.

The nature and persistence of the effects of posthypnotic suggestions on food preferences: The final report of an online study.

The persistence of food preferences, which are crucial for diet-related decisions, is a significant obstacle to changing unhealthy eating behavior. To overcome this obstacle, the current study investigates whether posthypnotic suggestions (PHSs) can enhance food-related decisions by measuring food choices and subjective ratings. After assessing hypnotic susceptibility in Session 1, at the beginning of Session 2, a PHS was delivered aiming to increase the desirability of healthy food items (e.g., vegetables and fruit). After the termination of hypnosis, a set of two tasks was administrated twice, once when the PHS was activated and once deactivated in counterbalanced order. The task set consisted of rating 170 pictures of food items, followed by an online supermarket where participants were instructed to select enough food from the same item pool for a fictitious week of quarantine. After 1 week, Session 3 mimicked Session 2 without renewed hypnosis induction to assess the persistence of the PHS effects. The Bayesian hierarchical modeling results indicate that the PHS increased preferences and choices of healthy food items without altering the influence of preferences in choices. In contrast, for unhealthy food items, not only both preferences and choices were decreased due to the PHS, but also their relationship was modified. That is, although choices became negatively biased against unhealthy items, preferences played a more dominant role in unhealthy choices when the PHS was activated. Importantly, all effects persisted over 1 week, qualitatively and quantitatively. Our results indicate that although the PHS affected healthy choices through resolve, i.e., preferred more and chosen more, unhealthy items were probably chosen less impulsively through effortful suppression. Together, besides the translational importance of the current results for helping the obesity epidemic in modern societies, our results contribute theoretically to the understanding of hypnosis and food choices.

Hypnotic analgesia in chronic pain: role of psychopathology and alexithymia

ABSTRACT Although the belief that hypnotizability is a mental dysfunction has been refuted over time, there is still research today that seeks to explore and clarify this preconception. The results of recent research indicate that, on the contrary, greater psychopathology is more frequent in subjects with low hypnotic susceptibility. Using the Stanford Hypnotic Susceptibility Scale type A (SHSS-A) for hypnotizability, Symptom Checklist-Revised (SCL-90-R) for psychopathology, and the Somatosensory Amplification Scale (SSAS) and Toronto Alexithymia Scale (TAS-20) for psychosomatic dimensions, we found no relationship between baseline psychopathology, alexithymia and hypnotizability in 69 subjects with chronic pain in this retrospective observational study. Psychopathology did not affect the 2-month outcomes of hypnotic suggestions for pain in terms of either pain (assess using Italian Pain Questionnaire), anxiety or depression (assessed through Hospital Anxiety and Depression Scale) scores. Furthermore, i) no relationships were found between hypnotizability and degree of either psychopathology or alexithymia, definitively eliminating any doubts about the belief that hypnosis is a mental dysfunction; ii) only single hypnotic phenomena (SHSS-A) could be linked to some psychopathological dimensions; iii) analgesia suggestions also acted on anxiety and depression; and iv) the use of hypnotic suggestions for analgesia revealed a close relationship between improvements in sensorial and evaluative dimensions of pain and mitigation of anxiety. Hypnosis thereby seems to be a powerful tool in psychosomatic medicine whose effects on mind and body are inextricably linked.