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van Tilburg MAL, Monis EL, Braumann RE, Fleishman K, Lamm K. Hypnotherapy as a medical treatment: Evidence-based or pseudoscience? Complement Ther Clin Pract 2024; 55:101841. [PMID: 38387324 DOI: 10.1016/j.ctcp.2024.101841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Hypnotherapy continues to be a controversial practice in medicine. It is surrounded by myth and misuses that instill doubts about its legitimacy and usefulness. PURPOSE In this paper, we will distinguish pseudoscientific claims from evidence-based uses of hypnotherapy. RESULTS The use and acceptability of hypnotherapy has varied over history. Pseudoscientific uses, based on outdated theories that it can access the unconscious mind, have delegitimized hypnotherapy. Modern theories that hypnosis uses common social, emotional, and cognitive processes combined with evidence-based methods have re-established the use of hypnotherapy in many physical and mental health disorders and symptoms. Currently it is a widely accepted and recommended treatment for irritable bowel syndrome, with evidence building for many other applications. CONCLUSION Hypnotherapy, as a pseudoscience, can become unethical and cause distress for the patient and their families. Hypnotherapy, as an evidence-based treatment, can be used as a powerful tool to treat physical and psychological symptoms related to medical ailments.
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Affiliation(s)
- Miranda A L van Tilburg
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA; Marshall University, Huntington, WV, USA; University of North Carolina, Chapel Hill, NC, USA; University of Washington, Seattle, WA, USA.
| | - Elizabeth L Monis
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Ryan E Braumann
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Kenneth Fleishman
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Kevin Lamm
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
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2
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Fuhr K, Bender A, Wiegand A, Janouch P, Drujan M, Cyrny B, Schweizer C, Kreifelts B, Nieratschker V, Batra A. Hypnotherapy for agoraphobia-Feasibility and efficacy investigated in a pilot study. Front Psychol 2023; 14:1213792. [PMID: 37637902 PMCID: PMC10448829 DOI: 10.3389/fpsyg.2023.1213792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/17/2023] [Indexed: 08/29/2023] Open
Abstract
A number of case studies describing hypnotherapy in the treatment of anxiety disorder patients have already been published. Only a few randomized controlled trials (RCTs) investigated the efficacy of hypnotherapy but focused mainly on symptoms rather than specific mental disorders. The goal of this study was to investigate whether hypnotherapy (HT) was superior to a waitlist control group (WL) in the reduction of agoraphobia-related symptoms. Further goals were to report the feasibility of hypnotherapy as well as attrition and completion rates and detect (epi-)genetic variables, which might play a role in treatment outcome. This pilot study was based on a monocentric two-armed randomized controlled rater-blind clinical trial that was conducted between 2018 and 2020 with a waitlist control group. A total of 36 patients diagnosed with agoraphobia were randomized to either HT or WL. Patients in HT received individual outpatient treatment with hypnotherapy with 8 to 12 sessions for a period of 3 months. Patients in WL received HT after 3 months. Agoraphobia-related symptoms were assessed at baseline, after the treatment, and 3 months later in both groups with a clinician rating. The primary hypothesis concerning the difference between groups in the individual percentage symptom reduction could be confirmed in the intention-to-treat, not the per-protocol sample. Additionally, we applied repeated-measures analyses of variance and found a higher symptom decrease in HT compared with WL patients in three of the five imputed datasets. The dropout rate was low, and satisfaction with the treatment was high. HT patients experienced a strong symptom reduction after receiving hypnotherapy. WL patients improved slightly during the waiting period. The COMT Val108/158Met genotype had an effect on the agoraphobia-related symptoms as well as on COMT DNA methylation levels. This is the first study to indicate that hypnotherapy performed better than a waitlist control group regarding the reduction in anxiety symptoms in an RCT. Future studies should confirm the efficacy of hypnotherapy and compare the treatment with a standard treatment for anxiety disorders in a larger trial. Future studies should also investigate whether hypnotic susceptibility is associated with COMT Val108/158Met genotype and could predict treatment success for HT. Clinical trial registration https://classic.clinicaltrials.gov/ct2/show/NCT03684577, identifier: NCT03684577.
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Affiliation(s)
- Kristina Fuhr
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
| | - Annika Bender
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
| | - Ariane Wiegand
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
- Max Planck Fellow Group Precision Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Paul Janouch
- Outpatient Psychotherapy Practice, Bad Salzuflen, Germany
| | - Marta Drujan
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
| | - Barbara Cyrny
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
| | - Cornelie Schweizer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
| | - Benjamin Kreifelts
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
- German Center for Mental Health (Deutsches Zentrum für Psychische Gesundheit), University Hospital of Tübingen, Tübingen, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital of Tübingen, Tübingen, Germany
- German Center for Mental Health (Deutsches Zentrum für Psychische Gesundheit), University Hospital of Tübingen, Tübingen, Germany
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3
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Zhang H, Yuan X, Mohd Zain NB, Gao Y. Analysis of therapeutic effect of subliminal cognition combined with hypnotherapy on anxiety disorder via neural network. Biotechnol Genet Eng Rev 2023:1-18. [PMID: 37129528 DOI: 10.1080/02648725.2023.2204604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Hypnotherapy combined with cognitive therapy is an effective way to intervene anxiety problems, which also responds to the call that using hypnotherapy to treat somatic disorders should become a trend in the future. This paper constructs an evaluation index of the intervention effect of cognitive hypnotherapy on anxiety patients, and then uses neural network to evaluate its effect. At last, we have completed the following work: 1) This paper constructs the theoretical basis related to this topic after searching and sorting out the related literature on anxiety disorders and hypnotherapy at home and abroad. 2) This paper constructs the evaluation index system of the intervention effect of cognitive hypnotherapy on anxiety patients, and then introduces the basic principle and structure of DBN model. 3) Experiments are used to determine the best values for the DBN model's parameters. To accomplish this, you will need to input the experimental data into the trained model and compare the evaluation results from experts with the model's predictions. The experimental findings of this study demonstrate the great accuracy of the DBN model presented in this work for assessing the effectiveness of cognitive combination hypnotherapy for anxiety disorders.
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Affiliation(s)
- Hanyue Zhang
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
| | - Xuejiao Yuan
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
| | | | - Ying Gao
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
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4
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Fernandez A, Urwicz L, Vuilleumier P, Berna C. Impact of hypnosis on psychophysiological measures: A scoping literature review. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2022; 64:36-52. [PMID: 34748461 DOI: 10.1080/00029157.2021.1873099] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Exploring psychophysiological changes during hypnosis can help to better understand the nature and extent of the hypnotic phenomenon by characterizing its influence on the autonomic nervous system (ANS), in addition to its central brain effects. Hypnosis is thought to induce a relaxation response, yet studies using objective psychophysiological measures alongside hypnosis protocols show various results. We review this literature and clarify the effects of hypnosis on psychophysiological indices of ANS activity and more specifically of the stress/relaxation response, such as heart rate variability and electrodermal activity. Studies reporting psychophysical measures during hypnosis were identified by a series of Pubmed searches. Data was extracted with an interest for the influence of hypnotizability and effects of specific suggestions or tasks on the findings. We found 49 studies comprising 1315 participants, 45 concerning healthy volunteers and only 4 on patients. Sixteen compared high vs. low hypnotizable people; 30 measured heart rate, 18 measured heart rate variability, 25 electrodermal activity, and 23 respiratory signals as well as other physiological parameters. Globally, results converge to show reductions in sympathetic responses and/or increases in parasympathetic tone under hypnosis. Several methodological limitations are underscored, such as older studies (N = 16) using manual analyses, small sample sizes (<30, N = 31), as well as uncontrolled multiple comparisons. Nevertheless, we confirm that hypnosis leads to a physiological relaxation response and highlight promising avenues for this research. Suggestions are made for guiding future work in this field.
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Affiliation(s)
- Aurore Fernandez
- Center of Complementary and Integrative Medicine, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Pain Center, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Leah Urwicz
- Center of Complementary and Integrative Medicine, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Fundamental Neuroscience, University of Geneva, Geneva, Switzerland
- Swiss Center of Affective Sciences, Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Patrik Vuilleumier
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Fundamental Neuroscience, University of Geneva, Geneva, Switzerland
- Swiss Center of Affective Sciences, Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Chantal Berna
- Center of Complementary and Integrative Medicine, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Pain Center, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
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5
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Occupational Health and Safety Receptivity towards Clinical Innovations That Can Benefit Workplace Mental Health Programs: Anxiety and Hypnotherapy Trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137735. [PMID: 35805401 PMCID: PMC9265652 DOI: 10.3390/ijerph19137735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 12/02/2022]
Abstract
Anxiety is one of the most common mental health conditions experienced by people in Australia during their working years according to the Australian Bureau of Statistics (ABS) and employers recognising that mental health impacts their organisation’s bottom line are increasingly interested in programs to promote better mental health, well-being, and productivity. Beyond management concern for productivity, statutory protection is necessary to safeguard mental health, under the Australian Occupational Health and Safety (OHS) Act, organisations have a duty to eliminate or minimise risks to psychological (mental) health by designing effective workplace systems and Occupational Health and Safety (OHS) practitioners are central to the design and responsibility in managing these systems. Despite literature indicating the benefits of OHS workplace mental health initiatives, such as improved overall health, reduced absenteeism, increased job satisfaction and morale, there remains a lack of empirical research around program measurement, and their effectiveness in this area has been brought into question. The OHS function is interested in improving research around the relationship and connection between work performance and mental health but: there are few studies regarding performance outcomes of mental health OHS services within management journals and insufficient information around the prevalence of psychological morbidity in the workplace and its impact. The purpose of this study was to assess OHS perception regarding anxiety and reveal perceptions and receptivity towards alternative therapies and solutions being used in clinical practice to deal with anxiety such as cognitive behavioural therapy (CBT) with a focus on Hypnotherapy.
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6
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Mohaghegh Toosi F, Sharbaf HA, Fathi M, Kareshki H. The effectiveness of cognitive developmental hypnotherapy on differentiation of self, meaning in life and marital conflicts in married women. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2022; 64:248-262. [PMID: 35007479 DOI: 10.1080/00029157.2021.1964425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of the present study is to investigate the effectiveness of Cognitive Developmental Hypnotherapy (CDH) on Differentiation of Self, Meaning in Life and Marital Conflicts in married women. The method is quasi-experimental pretest and posttest with a control group. The statistical population of this study includes married women who came to FUM Counseling and Psychological Services Center to receive psychological services. The sample of this study included 40 married women who were selected by targeted sampling method and randomly assigned to two experimental and control groups. Participants in the pretest and posttest study answered the Differentiation of Self Inventory, the Marital Conflicts questionnaire by Sanaei, and the Meaning in Life questionnaire. The research data were analyzed using ANCOVA and MANCOVA with SPSS-21. The findings showed CDH led to an increase in Differentiation of Self and Meaning in life, and a reduction in Marital Conflicts in women. Accordingly, CDH through using techniques such as induction and empowerment of the Ego is effective in marital conflicts of married women. Therefore, using it as a means to improve the quality of married women's lives is recommended.
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Affiliation(s)
| | | | - Mehdi Fathi
- Mashhad University of Medical Science, Mashhad, Iran
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7
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Császár N, Scholkmann F, Bókkon I. Implications on hypnotherapy: Neuroplasticity, epigenetics and pain. Neurosci Biobehav Rev 2021; 131:755-764. [PMID: 34619172 DOI: 10.1016/j.neubiorev.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/07/2021] [Accepted: 10/01/2021] [Indexed: 01/11/2023]
Abstract
We provide a brief review about the significance of hypnosis with respect to applications and physiological processes in hypnotherapy. Our review concludes that hypnosis is a promising method to manage acute and chronic pain. In addition, we discuss indications pointing toward the view that hypnosis can induce changes in neuroplasticity possibly involving epigenetic mechanisms.
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Affiliation(s)
- N Császár
- National University of Public Services, Budapest, Hungary; Psychosomatic Outpatient Clinics, Budapest, Hungary.
| | - F Scholkmann
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, Switzerland.
| | - I Bókkon
- Psychosomatic Outpatient Clinics, Budapest, Hungary; Vision Research Institute, Neuroscience and Consciousness Research Department, Lowell, MA, USA.
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8
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Ramondo N, Gignac GE, Pestell CF, Byrne SM. Clinical Hypnosis as an Adjunct to Cognitive Behavior Therapy: An Updated Meta-Analysis. Int J Clin Exp Hypn 2021; 69:169-202. [PMID: 33646087 DOI: 10.1080/00207144.2021.1877549] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In 1995, Kirsch and colleagues published an influential meta-analysis (k = 20, N = 577) which found that CBT enhanced with hypnosis (CBTH) was superior to CBT alone by at least d = .53. However, a lack of full replication and the emergence of new empirical studies prompted this updated analysis. A total of 48 post- (N = 1,928) and 25 follow-up treatments (N = 1,165) were meta-analyzed. CBTH achieved small to medium but statistically significant advantages over CBT at posttreatment (dIGPP/d = .25 to .41), and specifically in the management of depressed mood and pain. At follow-up, there was a medium sized advantage for CBTH (dIGPP/d = .54 to .59), and specifically for the treatment of obesity. These results further support the adjunctive use of hypnosis as an enhancer of CBT's efficaciousness and endurance as a treatment.
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Affiliation(s)
- Nicolino Ramondo
- School of Psychological Science, University of Western Australia, Perth
| | - Gilles E Gignac
- School of Psychological Science, University of Western Australia, Perth
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth
| | - Susan M Byrne
- School of Psychological Science, University of Western Australia, Perth
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9
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Olendzki N, Elkins GR, Slonena E, Hung J, Rhodes JR. Mindful Hypnotherapy to Reduce Stress and Increase Mindfulness: A Randomized Controlled Pilot Study. Int J Clin Exp Hypn 2020; 68:151-166. [PMID: 32223617 DOI: 10.1080/00207144.2020.1722028] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The feasibility of mindful hypnotherapy (MH) intervention for stress reduction was investigated in a randomized trial. Forty-two college-age participants with elevated stress were randomized into MH intervention or wait-list control condition. MH participants completed an 8-week intervention with 1-hour individual sessions and self-hypnosis audio recordings for daily mindfulness. Results indicated excellent feasibility, determined by participant satisfaction, treatment adherence (84% compliance rate), and low rate of adverse events (4.5%). There were significant differences between the MH and control groups postintervention, with the mindful hypnotherapy intervention resulting in significant and large decrease in perceived distress, p < .001, 15.35 (1.54), Hedge's g = - 1.14, and increase in mindfulness, p < .001, 50.07 (2.04), Hedge's g = 1.36. This study indicates that MH is a feasible intervention for stress reduction and increasing mindfulness.
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Affiliation(s)
- Nicholas Olendzki
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Gary R Elkins
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Elizabeth Slonena
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Julia Hung
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Joshua R Rhodes
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
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Malekzadeh M, Hashemi Mohammadabad N, Kharamin S, Haghighi S. The Effectiveness of Group-based Cognitive Hypnotherapy on the Psychological Well-being of Patients with Multiple Sclerosis: A Randomized Clinical Trial. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2020; 62:364-379. [PMID: 32216621 DOI: 10.1080/00029157.2019.1709149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Multiple sclerosis is a chronic, demyelinating disease of the central nervous system mainly affecting young adults. In addition to physical problems, the patients suffer from many psychological problems affecting their psychological well-being. The aim of the present study was to determine the effectiveness of group-based cognitive hypnotherapy on the psychological well-being of patients suffering from multiple sclerosis. This study was designed as a clinical trial with a pretest-posttest control group. From 60 patients diagnosed with multiple sclerosis referred to Beheshti hospital in Yasuj, Iran, 45 patients who met the inclusion criteria were selected by the convenience sampling method. The patients were randomly assigned to intervention (23 individuals) and control (22 individuals) groups through stratified random allocation. After completing the Ryff Scales of Psychological Well-Being, the intervention group attended eight sessions of group-based cognitive hypnotherapy on a weekly basis. The control group did not attend any intervention sessions. At the end of the eight intervention sessions, both groups completed the Ryff's Scale of Psychological Well-being again. The collected data were analyzed using the SPSS software (Version 23). Analysis of Covariance (ANCOVA) and two-way Analysis of variance (ANOVA) tests were used in order to compare the groups. The results indicated that cognitive hypnotherapy had a significant effect on the total score of psychological well-being (F (45, 1) = 6.07, p = .018, η2 = 0.12) and the dimension of environmental mastery (p < .05). Therefore, it is recommended to use hypnotherapy to promote the psychological well-being of patients suffering from multiple sclerosis.
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Affiliation(s)
- Mohammad Malekzadeh
- Yasuj University of Medical Sciences, Social Determinants of Health Research Center, Yasuj, Iran
| | | | - Shirali Kharamin
- Yasuj University of Medical Sciences, Social Determinants of Health Research Center, Yasuj, Iran
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López-Pinar C, Martínez-Sanchís S, Carbonell-Vayá E, Sánchez-Meca J, Fenollar-Cortés J. Efficacy of Nonpharmacological Treatments on Comorbid Internalizing Symptoms of Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review. J Atten Disord 2020; 24:456-478. [PMID: 31189374 DOI: 10.1177/1087054719855685] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is highly comorbid in adulthood. This meta-analysis was aimed at ascertaining the efficacy of different psychotherapies in improving comorbid internalizing symptoms in adults with ADHD. Method: Twenty randomized controlled trials and 12 uncontrolled pretest-posttest studies were included and combined using the inverse variance method. Risk of bias and heterogeneity assessment and moderator analyses were performed. Results: Cognitive-behavioral therapy (CBT) improved quality of life (QoL), emotional dysregulation (ED), depression, and anxiety symptoms, particularly at follow-up, which was predicted by core symptoms reduction. A significant between-group effect was obtained only on QoL, ED, and self-esteem for dialectical behavior therapy (DBT), mindfulness-based therapies (MBTs), and neurofeedback, respectively. Conclusion: Results support CBT efficacy for treating comorbid internalizing symptoms. More research is needed to determine the effectiveness of DBT, MBT, and neurofeedback. The small number of studies evaluating some therapies and the high risk of bias observed might limit these results.
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12
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Taschereau-Dumouchel V, Liu KY, Lau H. Unconscious Psychological Treatments for Physiological Survival Circuits. Curr Opin Behav Sci 2018; 24:62-68. [PMID: 30480060 PMCID: PMC6251414 DOI: 10.1016/j.cobeha.2018.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The idea of targeting unconscious or implicit processes in psychological treatments is not new, but until recently it has not been easy to manipulate these processes without also engaging consciousness. Here we review how this is possible, using various modern cognitive neuroscience methods including a technique known as Decoded Neural-Reinforcement. We discuss the general advantages of this approach, such as how it can facilitate double-blind placebo-controlled studies, and minimize premature patient dropouts in the treatment of fear. We also speculate how this may generalize to other similar physiological survival processes.
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Affiliation(s)
- Vincent Taschereau-Dumouchel
- Department of Psychology, UCLA, Los Angeles, 90095, USA
- Department of Decoded Neurofeedback, ATR Computational Neuroscience Laboratories, Kyoto, 619-0288, Japan
| | - Ka-yuet Liu
- Departments of Sociology, UCLA, Los Angeles, 90095, USA
- California Center for Population Research, UCLA, Los Angeles, 90095, USA
| | - Hakwan Lau
- Department of Psychology, UCLA, Los Angeles, 90095, USA
- Department of Decoded Neurofeedback, ATR Computational Neuroscience Laboratories, Kyoto, 619-0288, Japan
- Brain Research Institute, UCLA, Los Angeles, 90095, USA
- Department of Psychology, University of Hong Kong, Pokfulam Road, Hong Kong
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13
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Grover MP, Jensen MP, Patterson DR, Gertz KJ, Day MA. The Association Between Mindfulness and Hypnotizability: Clinical and Theoretical Implications. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2018; 61:4-17. [PMID: 29771215 PMCID: PMC6263151 DOI: 10.1080/00029157.2017.1419458] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Mindfulness-based interventions and hypnosis are efficacious treatments for addressing a large number of psychological and physical conditions, including chronic pain. However, there continues to be debate surrounding the relative uniqueness of the theorized mechanisms of these treatments-reflected by measures of mindfulness facets and hypnotizability-with some concern that there may be so much overlap as to make the mechanism constructs (and, therefore, the respective interventions) redundant. Given these considerations, the primary aim of the current study was to examine the degree of unique versus shared variance between two common measures of mindfulness facets and hypnotizability: the Five Facet Mindfulness Questionnaire and the Stanford Hypnotic Clinical Scale. A cross-sectional survey was conducted with a sample of (N = 154) veterans with heterogeneous chronic pain conditions. Bivariate Pearson correlations were used to examine the associations between the target scales. Results showed that the correlations between the Five Facet Mindfulness Questionnaire scales and Stanford Hypnotic Clinical Scale total score were uniformly weak, although significant negative correlations were found between mindfulness facets of observe and nonreact with hypnotizability (ps < 0.05). Thus, not only are the mindfulness and hypnotizability constructs unique, but when significantly associated, hypnotic suggestibility corresponds with a tendency to be less mindful. These findings have important implications for future research aimed toward matching patients to the treatment most likely to be of benefit, and suggest that matching patients on the basis of these theoretically derived "unique" moderators may hold potential.
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Affiliation(s)
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, The University of Washington, Seattle, USA
| | - David R. Patterson
- Department of Rehabilitation Medicine, The University of Washington, Seattle, USA
| | - Kevin J. Gertz
- Department of Rehabilitation Medicine, The University of Washington, Seattle, USA
| | - Melissa A. Day
- School of Psychology, The University of Queensland, Brisbane, Australia
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14
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Daitch C. Cognitive Behavioral Therapy, Mindfulness, and Hypnosis as Treatment Methods for Generalized Anxiety Disorder. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2018; 61:57-69. [PMID: 29771217 DOI: 10.1080/00029157.2018.1458594] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Individuals suffering from generalized anxiety disorder (GAD) experience a broad range of physical, emotional, and cognitive distress. A hallmark of GAD is anxiety around making decisions. Many clinicians notice improvements in patients through specific modalities, such as mindfulness, hypnosis, and cognitive behavioral therapy (CBT); however, these individual methods sometimes fall short. Clinicians and researchers alike note that it can be more effective to combine these three methods into an integrative treatment protocol. This article demonstrates the efficacy of an integrative model through the case study of a client who suffers from GAD and acute fear of decision making. Competent use of mindfulness, hypnosis, and CBT helps the client build the skills necessary to self-soothe, diminish worry, access resources, and enhance hope for the future. Through the article, clinicians interested in integrated treatment models will gain insight into how to apply these methods.
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Affiliation(s)
- Carolyn Daitch
- Center for the Treatment of Anxiety Disorders, Farmington Hills, Michigan, USA
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Pinto PR, Paredes AC, Costa P, Carvalho M, Lopes M, Fernandes S, Pedras S, Almeida A. Effectiveness of two psychological interventions for pain management, emotional regulation and promotion of quality of life among adult Portuguese men with haemophilia (PSY-HaEMOPEQ): study protocol for a single-centre prospective randomised controlled trial. BMJ Open 2017; 7:e016973. [PMID: 28871021 PMCID: PMC5588949 DOI: 10.1136/bmjopen-2017-016973] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/24/2017] [Accepted: 06/12/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Haemophilia is a bleeding disorder associated with significant pain, emotional distress, quality of life (QoL) impairment and considerable healthcare costs. Psychosocial health and effective pain management are considered essential end points for optimal haemophilia care, but there is a significant gap in evidence-based treatments targeting these outcomes in people with haemophilia (PWH). Psychological interventions are cost-effective in promoting emotional well-being, QoL and pain control, although these have been scarcely used in haemophilia field. This investigation aims to evaluate the effectiveness of two psychological interventions for pain management, emotional regulation and promotion of QoL in PWH. METHODS AND ANALYSIS This is a single-centre parallel randomised controlled trial conducted at a European Haemophilia Comprehensive Care Centre in Portugal, with five assessment points: baseline (T0), postintervention (T1), 3 (T2), 6 (T3) and 12 (T4) months follow-up. Eligible adult males, with moderate or severe haemophilia A or B will be randomised to experimental (EG) or control (CG) group. Intervention is either cognitive-behavioural therapy (EG1) or hypnosis (EG2), both consisting of four weekly sessions following standardised scripts delivered by trained psychologists. Randomisation will be computer generated, allocation concealment will be guaranteed and outcome assessors will be blind to EG/CG allocation. Main outcomes are pain and haemophilia-related QoL and secondary outcomes include clinical (clotting factor replacement consumption, joint bleeding episodes, analgesic intake) and psychological (pain coping strategies, anxiety, depression, illness perceptions) variables, functional assessment of the joints, inflammatory biomarkers (cytokines, high-sensitivity C reactive protein) and white blood cell count. ETHICS AND DISSEMINATION This study was approved by the competent authorities and all procedures will comply with international ethical guidelines for clinical studies involving humans. Written informed consent will be obtained from all participants. The dissemination plan includes peer-reviewed scientific publications, conference participation and web and media coverage. TRIAL REGISTRATION NUMBER NCT02870452.
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Affiliation(s)
- Patrícia Ribeiro Pinto
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS / 3B's, PT Government Associate Laboratory, Braga / Guimarães, Portugal
| | - Ana Cristina Paredes
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS / 3B's, PT Government Associate Laboratory, Braga / Guimarães, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS / 3B's, PT Government Associate Laboratory, Braga / Guimarães, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Manuela Carvalho
- Centre of Hemophilia, Department of Transfusion Medicine and Blood Bank, Centro Hospitalar São João, Porto, Portugal
| | - Manuela Lopes
- Centre of Hemophilia, Department of Transfusion Medicine and Blood Bank, Centro Hospitalar São João, Porto, Portugal
| | - Susana Fernandes
- Centre of Hemophilia, Department of Transfusion Medicine and Blood Bank, Centro Hospitalar São João, Porto, Portugal
| | - Susana Pedras
- School of Psychology, University of Minho, Braga, Portugal
| | - Armando Almeida
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS / 3B's, PT Government Associate Laboratory, Braga / Guimarães, Portugal
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Sawni A, Breuner CC. Clinical Hypnosis, an Effective Mind-Body Modality for Adolescents with Behavioral and Physical Complaints. CHILDREN (BASEL, SWITZERLAND) 2017; 4:E19. [PMID: 28338644 PMCID: PMC5406678 DOI: 10.3390/children4040019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/07/2017] [Accepted: 03/20/2017] [Indexed: 02/03/2023]
Abstract
Mind-body medicine is a system of health practices that includes meditation/relaxation training, guided imagery, hypnosis, biofeedback, yoga, art/music therapy, prayer, t'ai chi, and psychological therapies such as cognitive behavioral therapy. Clinical hypnosis is an important mind-body tool that serves as an adjunct to conventional medical care for the adolescent patient. Clinical hypnosis specifically uses self-directed therapeutic suggestions to cultivate the imagination and facilitate the mind-body connection, leading to positive emotional and physical well-being. There are many similarities between clinical hypnosis and other mind-body/self-regulatory modalities such as visual imagery, mindfulness meditation, yoga, and biofeedback that incorporate experiential learning and mechanisms for change. They may be viewed as subtypes of the hypnotic experience and share the common experience of trance as the entrée into self-empowered change in physiologic and psychological states. Clinical hypnosis can be used by health care providers to teach adolescents coping skills to deal with a wide variety of conditions such as chronic headaches, recurrent abdominal pain, anxiety, depression, grief and bereavement, phobias, anger, family stressors, sleep disorders, or enuresis. Clinical vignettes are given to help illustrate the effectiveness of hypnosis in adolescents.
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Affiliation(s)
- Anju Sawni
- Department of Pediatrics, Hurley Children's Hospital/Hurley Medical Center, Michigan State University College of Human Medicine, Flint, MI 48503, USA.
| | - Cora Collette Breuner
- Department of Pediatrics, Adolescent Medicine Division and Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA 98105, USA.
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Alladin A. Cognitive Hypnotherapy for Accessing and Healing Emotional Injuries for Anxiety Disorders. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2016; 59:24-46. [PMID: 27196009 DOI: 10.1080/00029157.2016.1163662] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Although anxiety disorders on the surface may appear simple, they often represent complex problems that are compounded by underlying factors. For these reasons, treatment of anxiety disorders should be individualized. This article describes cognitive hypnotherapy, an individual comprehensive treatment protocol that integrates cognitive, behavioral, mindfulness, psychodynamic, and hypnotic strategies in the management of anxiety disorders. The treatment approach is based on the self-wounds model of anxiety disorders, which provides the rationale for integrating diverse strategies in the psychotherapy for anxiety disorders. Due to its evidence-based and integrated nature, the psychotherapy described here provides accuracy, efficacy, and sophistication in the formulation and treatment of anxiety disorders. This model can be easily adapted to the understanding and treatment of other emotional disorders.
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Abstract
This article describes cognitive hypnotherapy (CH), an integrative treatment that provides an evidence-based framework for synthesizing clinical practice and research. CH combines hypnotherapy with cognitive-behavior therapy in the management of emotional disorders. This blended version of clinical practice meets criteria for an assimilative model of integrative psychotherapy, which incorporates both theory and empirical findings. Issues related to (a) additive effect of hypnosis in treatment, (b) transdiagnostic consideration, and
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Jensen MP, Adachi T, Tomé-Pires C, Lee J, Osman ZJ, Miró J. Mechanisms of hypnosis: toward the development of a biopsychosocial model. Int J Clin Exp Hypn 2015; 63:34-75. [PMID: 25365127 PMCID: PMC4220267 DOI: 10.1080/00207144.2014.961875] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Evidence supports the efficacy of hypnotic treatments, but there remain many unresolved questions regarding how hypnosis produces its beneficial effects. Most theoretical models focus more or less on biological, psychological, and social factors. This scoping review summarizes the empirical findings regarding the associations between specific factors in each of these domains and response to hypnosis. The findings indicate that (a) no single factor appears primary, (b) different factors may contribute more or less to outcomes in different subsets of individuals or for different conditions, and (c) comprehensive models of hypnosis that incorporate factors from all 3 domains may ultimately prove to be more useful than more restrictive models that focus on just 1 or a very few factors.
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Kohen DP, Kaiser P. Clinical Hypnosis with Children and Adolescents-What? Why? How?: Origins, Applications, and Efficacy. CHILDREN-BASEL 2014; 1:74-98. [PMID: 27417468 PMCID: PMC4928724 DOI: 10.3390/children1020074] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/13/2014] [Accepted: 07/21/2014] [Indexed: 12/03/2022]
Abstract
This review article addresses the process, intention, and therapeutic value of clinical hypnosis with children and adolescents. A brief historical perspective is followed by a digest of the published laboratory and clinical research that has accelerated substantially over the past two decades. This review lends appropriate credence to the benefits and integration to clinical practice of this powerful tool for teaching young people self-regulation skills. The breadth of application is described, and several clinical vignettes are provided as examples of what is possible. In addition to the provision of the most relevant citations in the pediatric, psychological, and neuroscience literature, this synopsis concludes with information regarding availability of skill development training in pediatric clinical hypnosis.
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Affiliation(s)
- Daniel P Kohen
- National Pediatric Hypnosis Training Institute (NPHTI), Developmental-Behavioral Pediatrics, Partners-in-Healing of Minneapolis, 10505 Wayzata Boulevard, Suite #200, Minnetonka, MN 55305, USA.
| | - Pamela Kaiser
- National Pediatric Hypnosis Training Institute (NPHTI), Private Practice, 1220 University Drive, Suite #104, Menlo Park, CA 94025, USA.
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Kaiser P. Childhood anxiety and psychophysiological reactivity: hypnosis to build discrimination and self-regulation skills. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2014; 56:343-67. [PMID: 24938076 DOI: 10.1080/00029157.2014.884487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Clinically anxious, worried, and fearful children and teens need clinicians' assistance in reducing their exaggerated psychophysiological stress reactivity. Affective neuroscience finds that chronic activation of the body's emergency response system inhibits neurogenesis, disrupts neuronal plasticity, and is detrimental to physical and mental health. Patterns of faulty discrimination skills, for example, over-estimation of threat and danger and under-estimation of their coping capacity, fuel this over-arousal. Similarly, contributory patterns of reduced self-regulation skills are shown by "stuck" attention to and poor control of their exaggerated psychophysiological reactivity and somatization. This article considers the literature and focuses on cognitive hypnotherapy to enhance these under-developed capacities. A case illustration highlights various hypnotic phenomena and techniques, psychoeducation, and relaxation training that address the goals of interrupting these unproductive, interconnected patterns and fostering new patterns of more realistic and accurate discrimination capacities and sturdier psychophysiological self-regulation skills.
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Alladin A. The wounded self: new approach to understanding and treating anxiety disorders. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2014; 56:368-88. [PMID: 24938077 DOI: 10.1080/00029157.2014.880045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article synthesizes the concept of "wounded self" in the understanding and psychological treatment of anxiety disorders. The focal point of this concept is the notion of self-wounds or early unresolved emotional injuries. According to this conceptualization, anxiety represents an unconscious fear of unbearable insult to the wounded self, which is protected by maladaptive conscious strategies such as avoidance, cognitive distortions, or emotional constriction. This perspective provides a theoretical basis for blending elements of psychodynamic, behavioral, cognitive, and experiential therapies in the psychological management of anxiety disorders. As cognitive hypnotherapy embodies all of these therapeutic elements, its application to anxiety disorders is described in this article. Various hypnotherapeutic techniques for symptomatic relief and for eliciting and healing the wounded self are discussed and exemplified by a case. This case illustrates that symptom-focused treatment is necessary, but not sufficient. A more durable treatment requires resolution of underlying conflicts that drive the anxiety.
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Rominger C, Weiss EM, Nagl S, Niederstätter H, Parson W, Papousek I. Carriers of the COMT Met/Met allele have higher degrees of hypnotizability, provided that they have good attentional control: a case of gene-trait interaction. Int J Clin Exp Hypn 2014; 62:455-82. [PMID: 25084618 DOI: 10.1080/00207144.2014.931177] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Genetic factors may explain part of the interindividual variability in hypnotizability. A new avenue that may provide more comprehensive understanding of the phenotypic effects of genetic variations is the study of gene-trait interaction. In this study, the authors investigate the relationship of the dopamine-related COMT and the serotonin-related 5-HTTLPR polymorphisms to hypnotizability by taking individual differences in executive attention into account. Homozygosity for the COMT Met allele, putatively linked to the capability or proneness to dissociate from reality, was associated with high hypnotizability only if paired with high-attention ability. The finding can be integrated into hypnosis theory and represents a case of gene-trait interaction suggesting that investigating the effects of a gene in the context of relevant psychological traits may further elucidate gene-brain-behavior relationships.
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Enck P, Hefner J, Herbert BM, Mazurak N, Weimer K, Muth ER, Zipfel S, Martens U. Sensitivity and specificity of hypnosis effects on gastric myoelectrical activity. PLoS One 2013; 8:e83486. [PMID: 24358287 PMCID: PMC3865216 DOI: 10.1371/journal.pone.0083486] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 11/11/2013] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The effects of hypnosis on physiological (gastrointestinal) functions are incompletely understood, and it is unknown whether they are hypnosis-specific and gut-specific, or simply unspecific effects of relaxation. DESIGN Sixty-two healthy female volunteers were randomly assigned to either a single session of hypnotic suggestion of ingesting an appetizing meal and an unappetizing meal, or to relax and concentrate on having an appetizing or unappetizing meal, while the electrogastrogram (EGG) was recorded. At the end of the session, participants drank water until they felt full, in order to detect EGG-signal changes after ingestion of a true gastric load. During both conditions participants reported their subjective well-being, hunger and disgust at several time points. RESULTS Imagining eating food induced subjective feelings of hunger and disgust as well as changes in the EGG similar to, but more pronounced than those seen with a real gastric water load during both hypnosis and relaxation conditions. These effects were more pronounced when imagining an appetizing meal than with an unappetizing meal. There was no significant difference between the hypnosis and relaxation conditions. CONCLUSION Imagination with and without hypnosis exhibits similar changes in subjective and objective measures in response to imagining an appetizing and an unappetizing food, indicating high sensitivity but low specificity.
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Affiliation(s)
- Paul Enck
- Department of Psychosomatic Medicine, University Hospital, Tübingen, Germany
| | - Jochen Hefner
- Department of Internal Medicine II, University Hospital, Würzburg, Germany
| | - Beate M. Herbert
- Department of Health Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Nazar Mazurak
- Central Research Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Katja Weimer
- Department of Psychosomatic Medicine, University Hospital, Tübingen, Germany
| | - Eric R. Muth
- Department of Psychology, Clemson University, Clemson, South Carolina, United States of America
| | - Stephan Zipfel
- Department of Psychosomatic Medicine, University Hospital, Tübingen, Germany
| | - Ute Martens
- Department of Psychosomatic Medicine, University Hospital, Tübingen, Germany
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Alladin A. Healing the wounded self: combining hypnotherapy with ego state therapy. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2013; 56:3-22. [PMID: 24660336 DOI: 10.1080/00029157.2013.796282] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this article is to formulate a theoretical conceptualization for utilizing ego state therapy (EST) as an adjunct with cognitive hypnotherapy (CH) for depression. As the relationship between life events and onset of depression is very complex, it is not clear from current literature how stressors cause depressive symptoms. The notion of "wounded self," derived from the work of Wolfe (2005, 2006), is examined as a potential unifying concept for binding the role of risk factors in the precipitation of depression. By incorporating wounded self, the circular feedback model of depression, on which CH for depression is based, is expanded. This revised version provides conceptual and empirical underpinnings for integrating EST with CH in the management of depression.
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