Hypnosis side effects

Ladell, R. M. “HYPNOTISM AND SUGGESTION.” British medical journal, vol. 2, no. 3128, 1920., pp. 918 ProQuest Central, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/1775928271?accountid=1 4767.doi:http://dx.doi.org/10.1136/bmj.2.3128.918. “Hypnotism Part of Recovery.” Daily Examiner, Jan 19 2017, pp. 15. ProQuest Central, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/1859388173?accountid=1 4767. Margolick, David. “STATE COURT LIMITS HYPNOTISM AS TOOL.” Hypnosis side effects

New York Times, Jul 06 1983, ProQuest Central, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/424678812?accountid=14 767. “High Court Allows use of Hypnotism in Trials.” St.Petersburg Times, Jun 23 1987, pp. 3A. ProQuest Central, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/262504329?accountid=14 767. “TIME OFF: Hidden Side of Stage Hypnotism.” Liverpool Echo, Sep 23 2003, pp. 23. ProQuest Central, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/340126974?accountid=14 767. GRANT, DANIEL H. The Use Of Hypnosis And Suggestions To Improve Study Habits, Study Attitudes, Self-concept, And Reduction Of Test Anxiety, University of Georgia, Ann Arbor, 1982. ProQuest Dissertations & Theses A&I; ProQuest Dissertations & Theses Global, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/303070308?accountid=14 767. “Natural Hypnosis Launches Manifestation Success Promotion for their Hypnosis Programs; Natural Hypnosis Promotes their Hypnosis Programs that Assists the Public in Making Positive Life Changes.” M2 Presswire, Aug 13 2013, ProQuest Central, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/1419626547?accountid=1 4767. Turner, Tracy. “More Turn to Hypnosis to Address Concerns, Cure Ills.” Knight Ridder Tribune Business News, Jan 15 2005, pp. 1. ProQuest Central, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/461713488?accountid=14 767. Anbar, Ran D., and Kim E. Hummell. “Teamwork Approach to Clinical Hypnosis at a Pediatric Pulmonary Center.” American Journal of Clinical Hypnosis 48.1 (2005): 459. ProQuest. Web. 26 Jan. 2017. http://search.proquest.com/central/docview/218778655/2F7AADA840E94FBAPQ/2?accountid= 14767 Thomson, Linda. “A Project to Change the Attitudes, Beliefs and Practices of Health Professionals Concerning Hypnosis.” American Journal of Clinical Hypnosis, vol. 46, no. 1, 2003., pp. 31-44 ProQuest Central, https://proxy.lib.utc.edu/login?url=http://search.proquest.com/docview/218785897? accountid=14767. Upshaw, William N. “Hypnosis: Medicine’s Dirty Word.” American Journal of Clinical Hypnosis, vol. 49, no. 2, 2006., pp. 113-22 ProQuest Central, https://proxy.lib.utc.edu/login? Hypnosis side effectsurl=http://search.proquest.com/docview/218779972? accountid=14767. DEPRESSION AND ANXIETY 30:342–352 (2013) Special Article TRANCEFORMATIONS: HYPNOSIS IN BRAIN AND BODY David Spiegel, M.D.∗ In this review, the role of hypnosis and related psychotherapeutic techniques are discussed in relation to the anxiety disorders. In particular, anxiety is addressed as a special form of mind/body problem involving reverberating interaction between mental and physical distress. The history of hypnosis as a therapeutic discipline is reviewed, after which neurobiological evidence of the effect of hypnosis on modulation of perception in the brain. Specific brain regions involved in hypnosis are reviewed, notably the dorsal anterior cingulate gyrus and the dorsolateral prefrontal cortex. The importance of hypnotizability as a trait, stable variability in hypnotic responsiveness, is discussed. Analogies between the hypnotic state and dissociative reactions to trauma are presented, and the uses of hypnosis in treating posttraumatic stress disorder, stressful situations, and phobias as well as outcome data are reviewed. Effects of hypnosis on control of somatic processes are discussed, and then effects of psychosocial support involving Supportive–Expressive Group Therapy and hypnosis on survival time for cancer patients are evaluated. The evidence indicates an important role for hypnosis in managing anxiety disorders and anxiety related to medical illness. Depression and Anxiety 30:342–352,  C 2013 Wiley Periodicals, Inc. 2013. Key words: anxiety/anxiety disorders; dissociation; trauma; agoraphobia; PTSD/posttraumatic stress disorder H HYPNOTIC HISTORY ypnosis is the first Western conception of a psychotherapy, the first time a talking interaction between a doctor and a patient was thought to have therapeutic potential.[1] Hypnosis has been used as an adjunctive tool in the treatment of traumatic experiences, pain, and anxiety for more than 200 years. Initial uses involved hypnotic analgesia to help patients through traumatic surgical procedures before the advent of inhalation Stanford University School of Medicine, Stanford, California This paper was presented as an invited keynote address to the 32nd Annual Conference of the Anxiety Disorders Association of America on April 12, 2012. ∗ Correspondence to: David Spiegel, Room C231 401 Quarry Road, Palo Alto, CA 94305-5718. E-mail: dspiegel@stanford.edu Received for publication 12 September 2012; Revised 27 November 2012; Accepted 1 December 2012 DOI 10.1002/da.22046 Published online 19 February 2013 in Wiley Online Library (wileyonlinelibrary.com).

 C 2013 Wiley Periodicals, Inc. anesthesia.[2] Hypnosis was used to good effect to control pain during surgery, prior to the introduction of chemical anesthesia.[2] Freud began his exploration of the unconscious through the use of hypnosis at a time when he thought of hysterical reactions as the aftermath of traumatic experiences in childhood.[3] He abandoned its use when a patient exited a trance state and embraced him. Freud, noting that “I was modest enough not to attribute this event to my own irresistible personal attractiveness. Hypnosis side effects

” Freud[4] decided that hypnosis represented a mobilization of tranceference phenomena, and so gave it up in favor of free association and psychoanalysis, though later in his career he opined that “The pure gold of analysis might have to alloyed with the copper of suggestion.”[5] Hypnotic techniques were then used during World War II to treat what were then called “traumatic neuroses.” Despite the growing acceptance of psychoanalysis as the model for psychotherapy in that era, hypnotic techniques were found to be efficient and effective in helping soldiers with acute combat reactions to work through, control, or put aside the effects of traumatic experiences.[6] With the recognition of posttraumatic stress disorder (PTSD) as a diagnosis[7] has come increased interest in hypnosis as a tool in psychotherapy. 343 Special Article: Hypnosis in the Treatment of Anxiety-related Problems CLINICAL APPLICATIONS OF HYPNOSIS Hypnosis is a state of highly focused attention, coupled with dissociation of competing thoughts and sensations toward the periphery of awareness, and enhanced response to social cues.[8] Hypnosis is analogous in consciousness to what a telephoto lens does to a camera. What you see, you see with great detail, but disconnected from its visual context. In the say way, hypnosis helps you to focus attention and put aside distraction. It is comprised of three components: absorption, dissociation, and suggestibility. Hypnosis has been referred to as “self-altering attention,” the capacity to lose oneself effortlessly in what one is concentrating on. Indeed, people who have more spontaneous experiences of losing themselves in a movie or a sunset are likely on formal testing to be more highly hypnotizable.[9, 10] This capacity to lose oneself implies dissociating, processing potentially distracting information outside of conscious awareness. The third component is suggestibility. This does not mean that the hypnotized person is unable to exert control over what they think and do, but rather that they are inclined to go along with hypnotic suggestions because they are less likely to consider alternatives and analyze the context of the suggestions: who is this person and why is he/she asking me to do this? We have all had the “it seemed like a good idea at the time” experience. In hypnosis, people focus more on “what” than “why,” so compliance is more likely. This can actually be useful in getting patients to step away from old maladaptive ways of dealing with problems such as anxiety. HYPNOTIZABILITY AS A TRAIT The capacity to exert this top-down processing control involving hypnosis varies considerably among adults.

While most children are highly hypnotizable, substantial variation in responsiveness to hypnosis develops in adult life and persists. Hypnotizability becomes a stable trait, with a test–retest correlation of .7 over a 25-year interval, which is greater stability than is found with intelligence over a similar interval.[11] Despite this reliability, few meaningful correlates of this trait, either psychological or neurobiological, have been identified, despite many efforts to find them.[10, 12–14] It has been established that a tendency for self-altering attention, called “absorption,” is moderately but significantly correlated with hypnotizability.[9, 10] This means that people who have hypnotic capacity tend to use it spontaneously, even without any formal training or exposure to hypnotic techniques. One especially useful way of introducing hypnosis into the therapy is through the use of a clinical hypnotizability scale, such as the Hypnotic Induction Profile.[8] This is a good way to initiate experience with hypnosis in treatment for several reasons: (1) It provides useful information about the patient’s degree of hypnotizability, which provides empirical guidance for the choice of treatment. The presence and degree of a patient’s hypnotizability can help in designing treatment with hypnosis. The absence of hypnotic responsiveness, if identified, can lead to a choice of other more effective treatments, ranging from progressive muscle relaxation to medication. (2) It enables the clinician to turn the hypnotic induction into a deduction about the patient’s ability to respond. Hypnosis side effects

Thus reduces performance pressure on both the patient and the clinician. Such an atmosphere can enhance the treatment alliance and defuse anxieties about loss of control. It also helps to demystify hypnosis. (3) All hypnosis is really self-hypnosis. Testing provides a framework for teaching patients how to use their capacity for self-hypnosis as part of their ongoing treatment and symptom management. HYPNOTIC MODULATION OF PERCEPTION Hypnosis is a powerful means of altering pain, anxiety, and various somatic functions, even under highly stressful circumstances such as interventional radiology procedures and surgery for breast cancer.[15–19] Hypnotic alteration of perception, best studied in the somatosensory and visual systems, involves a top-down resetting of the intensity of perceptual response itself, rather than just an alteration in postperception processing. This has been through reduction in early (p100) as well as late (p300) components of somatosensory event-related potentials during hypnotic analgesia instructions.[20] In addition, the nature of the hypnotic instruction influences the part of the brain involved in producing hypnotic analgesia. If subjects are told that the pain is there but will not bother them, there is reduced activity of dorsal anterior cingulate cortex (dACC), while if they are told they can reduce perception of the pain itself through a competing sensation such as tingling numbness, the analgesia is accomplished through reduced activity in somatosensory cortex.[21–23] Several studies have examined the idea that endogenous opiates account for hypnotic analgesia. However, with one partial exception,[24] studies with both volunteers[25] and patients with chronic pain[26] have shown that hypnotic analgesia is not blocked and reversed by a substantial dose of naloxone, an opiate receptor blocker. In contrast, placebo analgesia is mediated by endogenous opiates.[27] Therefore, the cortical mechanisms of hypnotic analgesia described above are a more plausible explanation for hypnotic reduction of pain. With the use of hypnosis, believing is seeing: hypnotic alteration of color vision results in congruent changes in blood flow in the lingual and fusiform gyri.[28] An instruction to drain color from a grid like a Mondrian painting results in decreased blood flow in the color-processing regions, whereas hypnotic illusion that Depression and Anxiety 344 Spiegel a black and white grid is filled with color results in perception of the color and increased blood flow in those regions. Hypnotic suggestion that words are written in an unknown language can reduce or eliminate the well-known Stroop color–word interference phenomenon, with concomitant reduction in activation of the dACC.[13, 14, 29] The amount of time delay in naming a color–word presented in a different color is mediated by interaction between the dorsolateral prefrontal cortex (DLPFC) and ACC.[30] These are examples of how hypnosis can provide a model system for brain control over perception and behavior. Such hypnotic reduction of interference tasks has been shown in some studies to occur especially when the hypnotic state is induced, so the phenomenon is more than a trait difference—it requires entry into the hypnotic state among people capable of it. Hypnosis side effects

[31] BRAIN REGIONS INVOLVED IN HYPNOSIS The dACC and DLPFC contribute in important ways to both hypnotizability and sensory control. These regions are involved in the executive network of attention including selective attention and conflict resolution.[32] The dACC and lateral PFC are also part of the mesocortical dopamine system[13] and hypnotizability has been found to be correlated with levels of homovanillic acid, a dopamine metabolite, in the cerebrospinal fluid.55 Highhypnotizable individuals, in contrast to low hypnotizables, have altered activation of the dACC[14, 21–23, 33–38] and PFC[13, 21, 34, 35] when they are modulating pain perception, reducing Stroop interference, and during rest when they are in versus out of hypnotic states.[39] These findings suggest that these two brain regions are involved in top-down modulation of perception during hypnosis. We have recent evidence that there are detectable differences in functional connectivity between these regions between high- and low-hypnotizable individuals.[40] In a resting-state functional magnetic resonance imaging (fMRI) study, high- compared to low-hypnotizable individuals showed greater functional connectivity between left DLPFC, an executive-control region of the brain, and the salience network, which composed of the dACC, anterior insula, amygdala, and ventral striatum. This region is involved in detecting, integrating, and filtering relevant somatic, autonomic, and emotional information. These functional differences were not due to differences in brain anatomy in these regions. These results are similar to but not identical to observations that there are increases in left frontal activation during mindfulness practice,[41, 42] Our findings differ in emphasizing co-activation of dACC along with DLPFC. Mindfulness is considered a practice that must be developed with considerable time and effort. Unlike hypnosis, it is not targeted at specific symptoms, but rather is a practice involving developing a sense of open presence, scanning of the body, and compassion. Both, however, involve deDepression and Anxiety veloping the ability to shift among mental states, which seems to provide benefit in dealing with stress and anxiety. ANXIETY: MIND AND BODY Anxiety disorders are the most common of psychiatric problems, with a 12-month prevalence of 18.1% and a lifetime prevalence of 28.8%.[43] They are also archetypal mind–body problems, since an interaction between psychological and somatic distress is a hallmark feature of all of the disorders: generalized anxiety disorder, panic disorder, agoraphobia, specific phobias, acute stress disorder (ASD), and PTSD.

All of these disorders involve a reciprocating cycle of mental and physical distress. This makes techniques such as hypnosis that involve enhanced control by the mind over the body especially salient to treatment. Most people with anxiety disorders understand that, at some level, their fears are exaggerated or irrational. Yet, oddly enough this is rarely reassuring. The very lack of definition of the source of the discomfort can exaggerate the fear, enhancing the patient’s sense of helplessness and desire for avoidance. And yet the more they avoid the source of the fear, the more they cement an associational network that reinforces the strength of the threat. The challenge is to convert anxiety into fear, to give it a focus, so something can be done about it, in the same sense that converting depression into sadness can help depressed individuals work through the sources of their sadness so that the erosion of their self-worth and feelings of hopelessness and helplessness are reduced. Yet to do this, one has to offer patients tools that enable them to face their fears or sadness without a downward cycle of mental and physical distress. Hypnosis side effects

The ability to provide physical comfort in the fact of fear is a potentially valuable therapeutic took. From the point of view of therapeutic strategy, anxiety involves pathological distraction of attention from necessary day-to-day functions, and a negative feedback cycle between psychological preoccupation and somatic discomfort, a kind of “snowball effect,” in which subjective anxiety and somatic tension reinforce one another. When someone notices an increase in heart rate, sweating, or tension in their abdomen, they are likely to respond with increased anxiety, reading the somatic signals as an indication of what a tight spot they are in. This can in turn trigger further somatic response, and on it goes. Hypnosis can be especially helpful not only because of its ability to reduce anxiety and induce relaxation,[44] but because of the dissociative element of hypnosis which facilitates separation of the psychological and somatic components of anxiety.

There is evidence that hypnosis is as effective at reducing anxiety as 1 mg of alprazolam, at least among college student populations.[45] Hypnosis has also been found to have as consistent antianxiety effects in such populations as does autogenic training and quiet rest.[46] It is particularly important to employ the dissociative capacity of the patient, to help Special Article: Hypnosis in the Treatment of Anxiety-related Problems them separate their focal attention, even that devoted to anxiety-related issues, from somatic sensations of discomfort and restlessness. STRESS AND TRAUMA PTSD is, unfortunately, a common disorder, with a 12-month prevalence in the United States of 3.5%, a third of these severe cases.[47] There is much that is naturally dissociative in both the immediate and the long-term response to trauma.[48–51] There are a substantial number of dissociative features in the symptoms of PTSD, especially flashbacks, numbing, and amnesia. The role of dissociation was most recently recognized in the proposal to include a dissociative subtype of PTSD in the DSM-5.[52] This change is based on new evidence that a sizeable subgroup of those with PTSD suffer additional dissociative features, notably depersonalization and derealization.[53] A recent major epidemiological study involving 25,018 people from 16 countries in a World Mental Health Survey found that 14.4% of those with PTSD also had the dissociative symptoms of depersonalization and derealization. They were characterized as well by higher levels of re-experiencing symptoms, the onset o … Hypnosis side effects