Brain Areas Altered During Hypnotic Trances

Brain Activity and Functional Connectivity Associated with Hypnosis

Heidi Jiang Matthew P. White Michael D. Greicius Lynn C. Waelde David Spiegel. Cerebral Cortex, Volume 27, Issue 8, 1 August 2017, Pages 4083–4093

Abstract: Hypnosis has proven clinical utility, yet changes in brain activity underlying the hypnotic state have not yet been fully identified. Previous research suggests that hypnosis is associated with decreased default mode network (DMN) activity and that high hypnotizability is associated with greater functional connectivity between the executive control network (ECN) and the salience network (SN). We used functional magnetic resonance imaging to investigate activity and functional connectivity among these three networks in hypnosis. We selected 57 of 545 healthy subjects with very high or low hypnotizability using two hypnotizability scales. All subjects underwent four conditions in the scanner: rest, memory retrieval, and two different hypnosis experiences guided by standard pre-recorded instructions in counterbalanced order. Seeds for the ECN, SN, and DMN were left and right dorsolateral prefrontal cortex, dorsal anterior cingulate cortex (dACC), and posterior cingulate cortex (PCC), respectively. During hypnosis there was reduced activity in the dACC, increased functional connectivity between the dorsolateral prefrontal cortex (DLPFC;ECN) and the insula in the SN, and reduced connectivity between the ECN (DLPFC) and the DMN (PCC). These changes in neural activity underlie the focused attention, enhanced somatic and emotional control, and lack of self-consciousness that characterizes hypnosis.

Weight Management

Effectiveness of hypnosis as an adjunct to behavioral weight management

David N. Bolocofsky*, Dwayne Spinler and Linda Coulthard-Morris (1985). Journal of Clinical Psychology, 41 (1), 35–41.

Abstract: This study examined the effect of adding hypnosis to a behavioral weight-management program on short- and long-term weight change. One hundred nine subjects, who ranged in age from 17 to 67, completed a behavioral treatment either with or without the addition of hypnosis. At the end of the 9-week program, both interventions resulted in significant weight reduction. However, at the 8-month and 2-year follow-ups, the hypnosis clients showed significant additional weight loss, while those in the behavioral treatment exhibited little further change. More of the subjects who used hypnosis also achieved and maintained their personal weight goals. The utility of employing hypnosis as an adjunct to a behavioral weight-management program is discussed.

Hypnotherapy in weight loss treatment

Gordon Cochrane, John Friesen. Journal of Consulting and Clinical Psychology, Vol 54(4), Aug 1986, 489-492

Abstract: Investigated the effects of hypnosis as a treatment for weight loss among women. The sample consisted of 60 women (aged 20–65 yrs) who were at least 20% overweight and were not in any other treatment program. Six client variables (suggestibility, self-concept, quality of family origin, age of obesity onset, education level, and socioeconomic status [SES]) and 1 process variable (multimodal imagery) were analyzed in relation to the dependent variable (weight loss). Two experimental groups, hypnosis plus audiotapes and hypnosis without audiotapes, and the control group were investigated for weight loss immediately after treatment and again after a 6-mo follow-up. The primary hypothesis that hypnosis is an effective treatment for weight loss was confirmed, but the 7 concomitant variables and the use of audiotapes were not significant contributors to weight loss.

Commentary: The group using hypnosis lost an average of 17 pounds at the 6-month follow up, whereas the group that did not receive hypnosis only lost 0.5 pounds.

Hypnotic Enhancement of Cognitive-Behavioral Weight Loss Treatments—Another Meta-reanalysis

Kirsch, Irving (1996). Journal of Consulting and Clinical Psychology

Abstract: In a 3rd meta-analysis of the effect of adding hypnosis to cognitive-behavioral treatments for weight reduction, additional data were obtained from authors of 2 studies, and computational inaccuracies in both previous meta-analyses were corrected. Averaged across posttreatment and follow-up assessment periods, the mean weight loss was 6.00 lbs (2.72 kg) without hypnosis and 11.83 (5.37 kg) with hypnosis. The mean effect size of this difference was 0.66 SD. At the last assessment period, the mean weight loss was 6.03 lbs (2.74 kg) without hypnosis and 14.88 lbs (6.75 kg) with hypnosis. The effect size for this difference was 0.98 SD. Correlational analyses indicated that the benefits of hypnosis increased substantially over time (r = .74).

Depression and Anxiety

Cognitive Hypnotherapy for Depression: An Empirical Investigation

Assen Alladin and Alisha Alibhai

Abstract: To investigate the effectiveness of cognitive hypnotherapy (CH), hypnosis combined with cognitive behavior therapy (CBT), on depression, 84 depressives were randomly assigned to 16 weeks of treatment of either CH or CBT alone. At the end of treatment, patients from both groups significantly improved compared to baseline scores. However, the CH group produced significantly larger changes in Beck Depression Inventory, Beck Anxiety Inventory, and Beck Hopelessness Scale. Effect size calculations showed that the CH group produced 6%, 5%, and 8% greater reduction in depression, anxiety, and hopelessness, respectively, over and above the CBT group. The effect size was maintained at 6-month and 12-month follow-ups. This study represents the first controlled comparison of hypnotherapy with a well-established psychotherapy for depression, meeting the APA criteria for a “probably efficacious” treatment for depression.

Treating anxiety with self-hypnosis and relaxation

Lucy M. O’Neill, Amanda J. Barnier andProfessor Kevin McConkey*

Abstract: The outcome and process of treating subclinical anxiety with self-hypnosis and relaxation were compared. Twenty individuals who presented for treatment for ‘stress, anxiety, and worry’ were assessed (for anxiety and self-hypnotizability), exposed to a 28-day treatment programme (which involved daily measures of outcome and process variables), and re-assessed (for anxiety). It was found that both self-hypnosis and relaxation alleviated anxiety pre- to post-treatment. Although there was no difference in the outcome data, throughout treatment self-hypnosis rather than relaxation was associated with a greater sense of treatment efficacy and expectation and with a greater sense of cognitive and physical change. The findings are discussed in terms of the expectational and experiential aspects of self-hypnosis, and their potential role in the perception, progress and impact of using self-hypnosis in therapy. Copyright © 1999 British Society of Experimental and Clinical Hypnosis

Sleep Disorders

Deepening Sleep with Hypnotic Suggestion

Maren J. Cordi, Dipl Psych; Angelika A. Schlarb, PhD; Björn Rasch, PhD

Slow wave sleep (SWS) plays a critical role in body restoration and promotes brain plasticity; however, it markedly declines across the lifespan. Despite its importance, effective tools to increase SWS are rare. Here we tested whether a hypnotic suggestion to “sleep deeper” extends the amount of SWS. Our results demonstrate the effectiveness of hypnotic suggestions to specifically increase the amount and duration of slow wave sleep (SWS) in a midday nap using objective measures of sleep in young, healthy, suggestible females. Hypnotic suggestions might be a successful tool with a lower risk of adverse side effects than pharmacological treatments to extend SWS also in clinical and elderly populations.

Hypnotherapy in the Treatment of Chronic Combat-Related PTSD Patients Suffering from Insomnia: A Randomized, Zolpidem-Controlled Clinical Trial

EITAN G. ABRAMOWITZ, YORAM BARAK, IRIT BEN-AVI, AND HAIM Y. KNOBLER

Abstract: This study evaluated the benefits of add-on hypnotherapy in patients with chronic PTSD. Thirty-two PTSD patients treated by SSRI antidepressants and supportive psychotherapy were randomized to 2 groups: 15 patients in the first group received Zolpidem 10 mg nightly for 14 nights, and 17 patient in the hypnotherapy group were treated by symptom-oriented hypnotherapy, twice-a-week 1.5-hour sessions for 2 weeks. All patients completed the Stanford Hypnotic Susceptibility Scale, Form C, Beck Depression Inventory, Impact of Event Scale, and Visual Subjective Sleep Quality Questionnaire before and after treatment. There was a significant main effect of the hypnotherapy treatment with PTSD symptoms as measured by the Posttraumatic Disorder Scale. This effect was preserved at follow-up 1 month later. Additional benefits for the hypnotherapy group were decrease in intrusion and avoidance reactions and improvement in all sleep variables assessed.

Headaches, Migraines and Pain

Review of the Efficacy of Clinical Hypnosis with Headaches and Migraines

D. Corydon Hammond

Abstract: The 12-member National Institute of Health Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia (1996) reviewed outcome studies on hypnosis with cancer pain and concluded that research evidence was strong and that other evidence suggested hypnosis may be effective with some chronic pain, including tension headaches. This paper provides an updated review of the literature on the effectiveness of hypnosis in the treatment of headaches and migraines, concluding that it meets the clinical psychology research criteria for being a well-established and efficacious treatment and is virtually free of the side effects, risks of adverse reactions, and ongoing expense associated with medication treatments.

Virtual reality hypnosis for pain associated with recovery from physical trauma

DAVID R. PATTERSON, MARK P. JENSEN, SHELLEY WIECHMAN ASKAY, AND SAM R. SHARAR

Abstract: Pain following traumatic injuries is common, can impair injury recovery, and is often inadequately treated. In particular, the role of adjunctive nonpharmacologic analgesic techniques is unclear. The authors report a randomized, controlled study of 21 hospitalized trauma patients to assess the analgesic efficacy of virtual reality hypnosis (VRH)—hypnotic induction and analgesic suggestion delivered by customized virtual reality (VR) hardware/software. Subjective pain ratings were obtained immediately and 8 hours after VRH (used as an adjunct to standard analgesic care) and compared to both adjunctive VR without hypnosis and standard care alone. VRH patients reported less pain intensity and less pain unpleasantness compared to control groups. These preliminary findings suggest that VRH analgesia is a novel technology worthy of further study, both to improve pain management and to increase availability of hypnotic analgesia to populations without access to therapist-provided hypnosis and suggestion.

Effects of Hypnosis as an Adjunct to Intravenous Sedation for Third Molar Extraction: A Randomized, Blind, and Controlled Study

EDWARD F. MACKEY

Abstract: The effects of hypnosis/therapeutic suggestion in connection with intravenous sedation and surgery have been described in many clinical publications; however, few randomized, controlled, and blind studies have been performed in the outpatient area. This study aimed to evaluate the use of hypnosis/therapeutic suggestion as an adjunct to intravenous (IV) sedation in patients having 3rd molar removal in an outpatient setting. The patients were randomly assigned to a treatment (n = 46) or control (n = 54) group. The treatment group listened to a rapid conversational induction and therapeutic suggestions via headphones throughout the entire surgical procedure along with standard sedation dose of intravenous anesthetic. The control group listened to only music without any hypnotic intervention. Intraoperative Propofol administration, patient postoperative pain ratings, and postoperative prescription pain reliever consumption were all significantly reduced in the treatment, compared to the control group. Implications of these results are discussed.

Hypnotherapy in the Management of Chronic Pain

Gary Elkins, Mark Jensen, and David Patterson

Abstract: This article reviews controlled prospective trials of hypnosis for the treatment of chronic pain. Thirteen studies, excluding studies of headaches, were identified that compared outcomes from hypnosis for the treatment of chronic pain to either baseline data or a control condition. The findings indicate that hypnosis interventions consistently produce significant decreases in pain associated with a variety of chronic pain problems. Also, hypnosis was generally found to be more effective than nonhypnotic interventions such as attention, physical therapy, and education. Most of the hypnosis interventions for chronic pain include instructions in self-hypnosis. However, there is a lack of standardization of the hypnotic interventions examined in clinical trials, and the number of patients enrolled in the studies has tended to be low and lacking long-term follow-up. Implications of the findings for future clinical research and applications are discussed.

Fears & Phobias

Hypnosis in the treatment of phobias: a review of the literature

Thomas P. McGuinness

Abstract: The literature on the use of hypnosis in the treatment of phobias was reviewed. Case reports and controlled studies indicated mixed results, which were discussed in terms of methodological considerations, the overlap between hypnotherapy and behavior therapy, and hypnotic susceptibility and phobic behavior. It was concluded that hypnosis is an effective and efficient adjunct in the treatment of phobias.

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