Scientific Method / Science & Exploration
Hypnosis replaces anesthetic in brain surgery—and there’s video
Patients under “hypnosedation” go to their happy place while skull is opened.
by Beth Mole - Jan 5, 2016 4:50pm CST
Just imagine that the whirring noise—from drills and saws cutting into your skull—is the gentle engine-hum of a motorboat, gliding past your canoe as you float in a tranquil lake.
Those may be some of the instructions a cancer patient might hear while in a hypnotic trance during brain surgery.
The technique, which replaces general anesthetics, was used on 37 patients undergoing surgery to remove brain tumors, researchers report in the journal Neurosurgery. Though there's been little science to back up hypnotherapy, the authors conclude that their small study's success suggests hypnosis could be a viable tool to help sedate patients during delicate brain surgery.
Such surgeries are particularly tricky because they often require a patient to be awake to respond to questions or perform certain mental tasks, the authors note. Surgeons use those responses and interactions to help avoid damaging critical brain areas as they carefully extract tumors.
Typically, anesthesiologists put patients to sleep for the start of such a surgery—while the skull is opened—rouse them in the middle, then put them back to sleep for the surgical wrap-up. The technique is referred to simply as the asleep-awake-asleep (AAA) procedure. But, it has two main drawbacks: doctors have to monitor and manage the patient’s breathing during the already-involved surgery; and, it can take some patients (particularly older ones) a while to fully wake up from anesthesia, which lengthens surgery time.
To see if hypnosis could be a viable alternative, researchers led by Ilyess Zemmoura of the Centre Hospitalier Universitaire de Tours, France, pitched the method to brain cancer patients. These patients all needed an awake surgery to remove a certain type of brain tumor that arises in glial cells (support cells in the brain), called glioma. For the hypnosis sedation to work, patients had to meet with a hypnotist a few weeks before the surgery and practice getting into a "trance" state.
Researchers explained the stupor-based surgery to 48 patients. Of those, 11 patients went with AAA—two because they preferred the standard method, three had emergency surgery and couldn’t prepare for hypnosis, and the remaining six patients wanted to try hypnosis but couldn’t get into a trance at the time of surgery and switched to the AAA procedure at the last minute.
The other 37 patients went through surgery with a combination of hypnosis, pain relievers, and local anesthetics, or “hypnosedation." Some of the patients required multiple surgeries for recurring tumors. In all, the researchers conducted 43 surgeries with patients under hypnosis. Below is a video of one of them, but please note that it includes graphic images that may not be suitable for everyone.Video Player
Brain surgery under hypnosedation.
During hypnosedation, the patient is asked to visualize a happy, safe space, plus imagine separating mind from body and “maintain[ing] a distance of 2 cm between them” (PDF). At various points in the surgery, the hypnotist will prompt the patient to hold body and mind farther apart. The hypnotist also instructs patients to visualize different things when sounds and movements arise during the operation. For instance, drill motors could be from a boat engine, vibrations from surgical cutting may be from riding a bicycle with triangular wheels.
For the 37 patients, hypnotists tailored each trance experience to the habits, likings, and personality of the patient, which was worked out in the training session prior to surgery. Thus, hypnosis is not a trivial or easy swap from the standard method, the authors conclude. “It requires intense involvement and long training of the whole team, including the patient,” the authors wrote. “Therefore, the method we describe is limited by the necessity to work with an anesthetic team experienced in both neuro-anesthesiology and hypnotherapy.”
The study also has a big flaw: it didn't include a control group. This makes it impossible to compare the pros and cons of hypnosedation to AAA. The authors acknowledge this and conclude that AAA is still the gold standard and, overall, hypnosedation is not optimal.
But, it may be a useful alternative for some patients, they note. In questionnaires and assessments taken after the surgeries, most patients reported positive experiences and little to no psychological impacts from the generally tough operation. Only two of the 37 patients said they wouldn’t use hypnosis again.
The study isn’t the first to explore hypnosis for surgeries and other medical treatments. The method has been knocked around the medical community for years as a way to focus attention and concentration. It has been considered a way to combat chronic pain, labor pains, and change behaviors such as smoking and overeating. While anecdotes and small studies report success, there is not enough data to support effectiveness and reliability, and researchers have struggled to even define a "trance state," let alone standard methods for inducing one. Overall, strong skepticism has lingered within the medical community, as hypnosis advocates have called for more research.
Neurosurgery, 2015. DOI: 10.1227/NEU.0000000000000993 (About DOIs).
Sleep Problems in Houston"
(Part II – The chemical solutions)
In Part I of SLEEP PROBLEMS IN HOUSTON some of the common symptoms associated with insomnia were examined. It would seem logical at this point to examine the possible causes, but this post will skip the causes for now and go directly to the most common ways insomniacs try to resolve their sleep problems. Why skip the causes? Most of the conventional remedies for insomnia do not treat the cause, but only reduce the symptoms. So, what are those more common “remedies"? 1. Medications. Both, prescription and over the counter. 2. Herbs and other dietary supplements 3. Alternative methods, such as acupuncture, acupressure, yoga, reiki, etc. Although these methods can bring some relief to some of the people some of the time, it is usually temporary relief, because the root cause of the problem remains untreated. What are some of the pros and cons for the use of these "remedies"? Medications: In our drug-oriented society we are trained to believe that for every problem or struggle in life there is a pill, or some other medication, that we can take. If there isn't some pill, cream, or shot for it, than there ought to be one. Pharmaceutical giants should be working hard to find the solution. We have pills to lose weight, to boost the immune system, to help with every kind of pain, mood pills, energy pills, pills for sexual dysfunctions and, of course, sleeping pills. But there are problems with sleep medications besides the fact that they are not always effective.
• First, many sleep medications can be habit-forming, especially the stronger ones prescribed by your doctor. Those medications that are effective can lose their effectiveness over time, that is the effectiveness depreciates over time and you need either increase the dosage or replace the medication with another one to get the same effect.
• Second, most medications produce unwanted side effects. You may feel drowsy, tired and worn out, feel “hung over” or even develop headaches. But wait a moment! Aren’t those the same symptoms that you had from lack of restful sleep?
• Third, the ongoing cost can add up to a goodly sum over time. I’m not going to list all the possible problems here but I think you get the picture. Herbs and Dietary Supplements: They can be effective for some people, just like the pharmaceuticals can, but they can also produce unwanted side effects. In some cases the side effects produced by pharmaceuticals and other supplements can be worse than the original sleep problem and may require additional treatments.
And finally, other alternative “remedies’ that do not involve ingesting one substance or another, can also be effective in some cases for some people. The problem is that if you see the improvement produced by one of those alternative methods you will continue spending your money on them because those “remedies” in most cases, can give you only temporary relief. The up side of that is that if after a few sessions you don’t feel any improvement you are likely to stop spending your money on them. So, what else can you do to get a good night of sleep? We will examine another option in the next part of “Sleep Problems in Houston”.
Sleep problems are much more common than most people realize and they affect people of all ages and regardless of gender. Chronic lack of sleep or poor quality sleep can make anyone feel worn out, fatigued, lead to poor memory and concentration. Sleep deprivation can cause serious health problems, depression, hallucinations and even general break down - physical and psychological burnout. However, the symptoms of sleep problems vary significantly, as do the causes. Some people simply can not fall asleep (the most common description of “insomnia”). Others fall asleep, wake up, and cannot go back to sleep or just wake up frequently during the night. Some people cannot stop thinking about something specific and others have, seemingly meaningless, disjointed thoughts racing through their heads, like switching channels on the TV without registering what was being seen or heard on each passing channel. Some worry about something specific, and others experience a different degree of general anxiety. In some cases people are very sensitive to external stimuli. For example, they hear every and any sound around them, in some cases almost to the point of “super hearing” where ticking of the clock, or a soft humming of electric clock in the next room can keep them awake. A dripping faucet in the kitchen at the other end of the house becomes too loud and they lie there waiting for the next drop to fall. Chronic pains or mere discomforts that are barely noticed during the day become so acute during the night that they keep the insomniac awake In some cases the bed becomes too uncomfortable, too hard, too soft or too lumpy. Others become too sensitive to their own bodies, they feel itchy, or twitchy, or too hot, or too cold, or just can’t find a comfortable position in bed. It may become too light in the room, or too dark. Just about anything can keep them awake. These are a few of the more common symptoms. The reader can add his or her own symptoms and be sure that he or she is not alone. But no matter what the cause for not getting a good night of uninterrupted restful sleep, the results are the same. Many people suffer these symptoms for years with little hope of significant lasting relief. In the next part of “SLEEP PROBLEMS IN HOUSTON” some of the more traditional solutions to insomnia will be discussed.
Just as I was about to get back to my writing I came across another interesting article published by The Journal of Neurosurgery, so I quickly copied it and pasted it in it's entirety to make sure that the authors get all the credit. So here it is:
Sleep Problems In Houston
(Part III, The Hypnotic Solution)
We finally come to the alternative solution to insomnia that does not involve ingesting any substances or any unpleasant side effects that most other solutions can produce. I suggest that hypnosis is that solution. First of all we need to understand what hypnosis is. Hypnosis is a very natural state that most people experience, at least twice a day and often more than twice. In fact, some people walk around in a constant state of hypnosis, but that is not the subject we are concerned with here. When we go to sleep and begin to see a dream but still hear the sounds and are aware of things that are around us, we are in a state of hypnosis. Just before we awake and still see the last dream of the night, but are
becoming aware of the sounds and activities around us, we are in a state of hypnosis. When we daydream with our eyes open, but we are somewhere else and hear or see nothing around us, we are in a state of hypnosis. We drive home from work thinking of something else and we realize that we arrived there already, but hardly remember any details of driving, we were in hypnosis. Or we missed our exit on the freeway because we were thinking of something, we were in hypnosis. A form of hypnosis is used in advertisement, in most religions, successful salesmanship and other negotiations, although, we don’t call it hypnosis. Simply stated, hypnosis is a state in which we become more receptive to suggestions. A state, in which we can communicate with our subconscious mind more effectively. In a state of hypnosis we can change our emotions, physical sensations, habitual behaviors and much, much more. Where a particular stimulus evokes an undesirable response, under hypnosis we can attach a different response to the same stimuli, a response that suits us better. For example, where wife’s nagging was irritated her husband, under hypnosis we can change his response to the nagging, where the same nagging evokes physical relaxation, emotional calm and focus in the husband. Now, instead of getting irritated the husband focuses on what his wife actually saying and may be finds out that it is not really nagging but an attempt to communicate (however ineffectively) a legitimate grievance. Now, he can actually hear his wife and respond reasonably instead of getting upset.In short, under hypnosis we can create a new, more desirable
habitual behavior to replace an undesirable one in a relatively short time. Since sleep problems vary in their nature, each problem may require a different approach for its resolution and numerous studies had been conducted to determine applicability and effectiveness of hypnotic intervention for different sleep problems. Here, below I site some of those studies for your scrutiny to help you make an intelligent and more informed decision in seeking solution to your particular variety of sleep problem. These are just short summaries of those studies, but they include links to their sources, so you could read a more detailed report. So now you have it. Yet another possible solution to your sleep problem. But I must add here one more thing. Hypnosis is a very powerful and effective tool that can be used in solving many different problems in our everyday lives, but it is by no means a miraculous one. Although it can be more effective, more expedient and produce more lasting, or permanent results than most other solutions, it does not come with 100% guarantee, or your money back. After all, no doctor, lawyer, or any other professional can give you a guarantee in a positive outcome of his, or her services, no matter how good he is in his particular field. The effectiveness and suitability of hypnotic solution depends on many factors, such as client’s individual motivation to participate, his receptiveness to hypnosis, his suggestibility and, of course, the training and skill of the hypnotist, just to mention a few. So good luck and have a full night of restful, uninterrupted sleep.
Sleep Problems in Houston and Hypnosis
And here are some of the studies in support of hypnotic solution:
Study 1: Hypnosis for Children (Approximately 12 Years Old) Sleep Onset Delay, Nighttime Awakenings and Other Issues Impeding Sleep (Pain, Cough, etc.) Hypnosis for treatment of insomnia in school-age children: a retrospective chart review http://www.biomedcentral.com/1471-2431/6/23
Results: By the end of the study 87% of the children reported that hypnosis had helped them either significantly improve or completely resolve their sleep problems. Insomnia was resolved in the majority of the children after one or two hypnosis instruction sessions. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings after hypnosis and 38% reported improvement after hypnosis. 87% of those who had body issues impeding sleep – such as chest pain, habit cough, and headaches – reported improvement or resolution of those issues following hypnosis. Instruction in self-hypnosis appears to help resolve insomnia in children as young as 7 years old.
Notes: A retrospective chart review was performed for 84 children and adolescents with insomnia at SUNY Upstate Medical University Pediatric Pulmonary Center between 1998 and 2005. Patients were offered instruction in self-hypnosis and returned for follow-up after one or more hypnosis sessions. Mean age was 12 years old. The average duration of insomnia prior to hypnosis was 3 years. Information was obtained from the children’s self reports before and after hypnosis. Sessions included demonstration of 2 or 3 self-hypnosis induction techniques, employment of a favorite place imagery and progressive relaxation while in hypnosis to achieve relaxation, and development of imagery intended to resolve the insomnia. If insomnia did not resolve after the first session, patients were offered a second session during which they were taught how to use hypnosis in order to gain insight into potential stressors – including dream analysis. BMC Pediatrics. 2006, Vol. 6 (23). Published Aug. 16, 2006 By: Ran D. Anbar and Molly P. Slothower, Dept. of Pediatrics, University Hospital, State University of New York Upstate Medical University, Syracuse, NY
Study 2: Hypnosis for Adult Insomnia – Sleeping Longer and Getting “Normal Night’s Sleep” Insomnia and Hypnotherapy http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1437/pdf/jrsocmed00280-0030.pdf
Results: Patients slept significantly longer with hypnosis alone than when they received a placebo. Significantly more patients had a normal night’s sleep when on autohypnosis alone than when they received a placebo or Mogadon/Nitrazepam – a benzodiazepine drug. There was a tendency for autohypnosis to reduce the time taken to go to sleep.
Note: 18 patients were between 29 and 60 years old and had suffered from insomnia for at least 3 months prior to the study. Patients were issued diary cards and every morning they classified their sleep based on: average time to go to sleep, average sleep duration, quality of sleep, and waking state (bright, average or tired). Hypnosis techniques included a simple prolonged relaxation technique, guided imagery so the patient pictured himself in a warm safe place (possibly on vacation), and imagining the patient was in a warm, dark room, feeling at ease and
comfortable. Self-hypnosis was taught and patients were told they could give themselves suggestions that would lead to a deep, refreshing sleep, waking up at their usual time in the morning, feeling wide awake. Journal of the Royal Society of Medicine Volume 72 October 1979. By: Professor J. A. D. Anderson, E. R. Dalton BSC DipMathStats, Department of Community Medicine, Guy's Hospital Medical School, London SEL 9RT M. A. Basker MRCS MRCGP, 95 The Ridgeway, Westcliffon Sea, Essex SSO 8PX
Study 3: Hypnosis and Sleep Onset InsomniaHypnotic relaxation and the reduction of sleep onset insomnia http://www.ncbi.nlm.nih.gov/pubmed/2689375
Results: Data generated by the study suggested that the particular hypnotic relaxation treatment
used was effective in helping subjects go to sleep more quickly. Neither stimulus control nor placebo groups recorded similar improvement.
Notes: A hypnotic relaxation technique was compared to stimulus control and placebo conditions as a means of reducing sleep onset latency (SOL). Forty-five subjects were matched on their baseline SOL as measured through sleep diaries. They were randomly assigned to one of three groups: hypnotic relaxation; stimulus control; and placebo. These groups experienced four weekly sessions of 30-minutes duration with demand effects being controlled through the use of counter-demand instructions. Int J Psychosom. 1989;36(1-4):64-8 By: Harry E. Stanton, Ph.D., University of Tasmania, Australia.
Study 4: Hypnosis and Specific Visualization for Slow Sleep Onset, Waking During the Night, and Difficulty Sleeping During the Day
Hypnotic Relaxation and Insomnia: A Simple Solution? http://www. sleepandhypnosis.org/pdf/1_1_12.pdf
Results: Conclusions – The success of the hypnotic visualization technique with all three cases suggests it might well be used more widely in treatment of insomnia. Case study #1: Time to fall asleep decreased from 47 minutes on average to 15 minutes on average nightly. Case study #2: Time to fall back asleep (after waking during the night) decreased from over one hour on average
to approximately 11 minutes. Case study 3: A night shift worker who previously had trouble falling and staying asleep during the day found after hypnosis he was able to fall asleep within 10 minutes and sleep uninterrupted for 7 hours usually unbothered by noises that previously would awaken him.
Notes: A specific technique embracing visualization of a garden scene, letting go of problems, and a special place, is described by means of case studies. Patients are told that it is irrelevant whether they fall asleep or not – because their minds and bodies will be repaired during their relaxed hypnotic visualization to the same extent as if they were actually asleep: 1. Visualization of a scene in which subjects imagine themselves on the patio of a lovely house which has 10 steps leading down to a beautiful garden below – descending into relaxing, allowing self to let go more and more, attention drawn to the colors, flowers, drifting clouds, birds singing, rustle of tree leaves and sun’s warmth. 2. Lying on grass enjoying warmth of sun, watching leaves fall – serving as a reminder of how it is possible to let go of old problems and worries. 3. After letting go of problems, subjects are able to remain in the garden or – if they prefer – go away to a special place where they are able to feel peaceful. Three case studies are described using this technique with three different types of insomnia: 1. Slow sleep onset; 2. Waking during the night; 3. Difficulty sleeping during the day. Sleep and Hypnosis 1:1, 1999 By: Harry E. Stanton, Ph.D., University of Tasmania, Australia.
Study 5: Hypnosis And Chronic Insomnia
Chronic Insomnia: Outcome of Hypnotherapeutic Intervention in Six Caseshttp://www.tandfonline. com/doi/abs/10.1080/00029157.1993.10403051
Results: 50% of the patients (3 out of 6) responded to two sessions of structured hypnotherapy. The three responders remained improved at 16-month follow-up.
Notes: A group of patients was evaluated at a sleep disorders center for a sleep disorder that occurred on at least 3 nights per week for 6 months or more. Six patients accepted hypnotherapy for their persistent insomnia and other sleep disorder diagnoses. Three patients responded to two sessions of structured hypnotherapy. Factors that seemed to contribute to long-term response in this small group of patients included a report of sleeping at least half of the time while in bed, increased hypnotic susceptibility, no history of major depression, and a lack of secondary gain. American Journal of Clinical Hypnosis, Vol. 36, Issue 2, 1993 By: Phillip M. Becker, University of Texas Southwestern Medical Center at Dallas.
Study 6: Hypnosis And Combat-Related Post Traumatic Stress Insomnia (Hypnosis As Efffective Or Better Than Ambien For All Sleep Variables)
Hypnotherapy in the Treatment of Chronic Combat-Related PTSD Patients Suffering From Insomnia: A Randomized, Zolpidem-Controlled Clinical Trial http://www.medecine.ups-tlse.fr/du_diu/fichiers/ametepe/1212/PTSD_et_ Insomnie.pdf http://www.tandfonline.com/doi/abs/10.1080/00207140802039 672
Results: Those in the study given hypnotherapy had improvement in all sleep variables assessed: quality of sleep, total sleep time, number of awakenings during the night, ability to concentrate upon awakening and morning sleepiness. The hypnotherapy group had better quality of sleep, better concentration, and lower sleepinesss than the group that received Zolpidem (a prescription insomnia medication sold under brand names such as Ambien). The hypnotherapy group and the group given Zolpidem had equal levels of improvement for total sleep time and number of awakenings.
Notes: This study evaluated the benefits of add-on hypnotherapy in patients with chronic PTSD who were suffering with chronic difficulties in initiating and maintaining sleep, night terrors, and nightmares. Thirty-two PTSD combat veteran 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 patients in the hypnotherapy group were treated by symptom-oriented hypnotherapy, twice-a-week 1.5-hour sessions for 2 weeks. The hypnotherapy included age regression where participants imagined returning to earlier periods in which normal restorative sleep was present (for example, an exhausting day of games with friends during childhood). 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. International Journal of Clinical and Experimental Hypnosis, Vol. 56, Issue 3, 2008 By: Eitan Abramowitz, Yoram Borak, Irit Ben-Avit et Haim Y. Knobler, Israel Defense Forces, Mental Health Department, Israel.
Study 7: Self-Hypnosis and Sleep-Terror in Children Sleep-Terror Disorder in Children: The role of self-hypnosis in management http://www.ncbi.nlm. nih.gov/pubmed/1580230
Results: Four children, ages 8 to 12, all responded to a short course of imipramine, 20 to 60 mg at bedtime, followed by and in conjunction with training in relaxation and mental imagery (self-hypnosis). Also reported are seven additional children who were treated equally successfully with hypnosis without the use of medication.
Notes: This paper describes four children, ages 8 to 12 years, with frequent, prolonged, or dangerous disorders of arousal. None had any significant psychological or behavioral problems. Each showed sudden arousals out of slow-wave sleep associated with complex behavior Once the correct diagnosis was made, the treatment strategy was to (1) demystify the symptom complex through education, (2) establish prompt control of the symptoms with the use of imipramine, (3) train the children in self-regulation with self-hypnosis, and (4) discontinue the medication while maintaining control of the arousals. Over a 2-3 year follow-up all children remain asymptomatic. Am. J. Clin. Hypn. 1992 Apr. 34(4); 233-44 D. P. Kohen, M. W. Mahowald, G. M. Rosen, University of Minnesota
Study 8: Hypnosis for Adults who Sleepwalk or have Sleep Terrors A retrospective outcome study and review of hypnosis as treatment of adults with sleepwalking and sleep terror. http://www.ncbi.nlm.nih.gov/pubmed/2007894
Results: A total of 74% of these individuals reported much or very much improvement when followed over substantial periods after instruction in self-hypnotic exercises that were practiced in the home. Hypnosis, often preferred over pharmacotherapy by patients, required one to six office visits (mean = 1.6). This represents a very cost-effective and noninvasive means of treatment, especially when contrasted with lengthy psychotherapy and pharmacotherapy.
Notes: The authors report the use of hypnosis in the treatment of 27 adult patients who sleepwalk or have sleep terrors. J. Nerv Ment Dis. 1991 April 179(4); 228-33 T. D. Hurwitz, M. W. Mahowald, C. H. Schenck, J. L. Schluter, S. R. Bundlie, Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, Department of Psychiatry, Minneapolis, Minnesota 55415
Study 9: Hypnosis for Various Sleep Disorders, including Bed-Wetting, Sleep Walking, Night Terrors and Chronic Movements The Treatment of Parasomnia Disorders with Hypnosis: A 5-year follow-up study. http://www.ncbi.nlm.nih. gov/pmc/articles/PMC1978312/
Results: This study replicated a previous one that demonstrated that hypnosis could help those who were suffering from parasomnia (sleep disorders that include bed-wetting, sleep walking, night terrors and chronic movements). The authors found that one month after the hypnosis treatment 45.4% of them were free of all symptoms. Eighteen months after treatment this had dropped to 42.2% and five years later it was down to 40.5%.
Notes: Thirty-six patients ranging from 6 to 71 years of age who all had "functionally autonomous" parasomnia (where the condition was self -sustaining) were treated with hypnosis. The authors suggest that in light of these significant results, parasomnia should first be treatedwith hypnosis, before other remedies are tried. The hypnotic techniques used included patients imagining seeing themselves in a movie, depicting how they were experiencing a good, parasomnia-free night of sleep at home. That is, they would see themselves going to bed, close their eyes, enter first a light, then a deeper stage of sleep, then REM, etc., throughout the night. This was laced with suggestions that they were safe now and that the previously necessary parasomnias simply were no longer needed and could be abandoned. They were also told that if they ever found themselves starting their parasomnias during sleep, they could simply tell themselves “that it is no longer necessary.” Clin Sleep Med 2007; 3(4):369-373. By: P. J. Hauri, M. H. Silber, B. F. Boeve
Study 10: Hypnosis for Older Adult Addicted to Sleeping Pills for Insomnia Hypnotic Dependent Insomnia in an Older Adult With Addiction-Prone Personality. http://ccs.sagepub.com/content/2/4/247.abstract
Results: Not only were the authors able to use hypnosis to help him successfully break free from this addiction, but they were also able to help him overcome his insomnia and improve thequality of his sleep.
Notes: This paper reports on the case study of an older man who had a history of engaging in addictive behavior. When the authors of this paper saw him, he was addicted to heavy sleepinpills. Clinical Case Studies, Vol. 2, No. 4, 247-258 (2003) By: Theodore V. Cooper, University of Mississippi Medical Center G. V. (Sonny) Montgomery, Veterans Affairs Medical Center Kenneth L. Lichstein, University of Memphis R. Neal Aguillard, Methodist Healthcare Sleep Problems and Hypnosis docx Displaying Sleep Problems and Hypnosis. docx.
Test Anxiety In Houston ( Part I )
Of course test anxiety is not exclusive to Houston, but it is a relatively common problem that can seriously affect person’s whole life. When we think of test anxiety we usually are thinking of teens and SATs. Getting a low score on SAT can do a lot of harm to a student who wants to get in a good college, get scholarship, or enter some valued training program. What if you finished law school and actually graduated? You are not a lawyer until you pass your State bar exam and that’s where you are unable to complete this last and most important step in becoming an attorney? Or you are finishing your second or third year of medical school (I actually had an occasion to work with a young man like that) and you failed an exam that will decide if you go on or drop out? Or you are already a licensed professional and you are required to retake the test to continue in your chosen profession? You have so much invested already and this pesky anxiety is standing in your way.
So what is this Test Anxiety?
You paid attention in class, took detailed notes, read every chapter and even attended extra study sessions after class, so you should do great on that big exam, right? When the test is presented, however, you find yourself so nervous that you blank out the answers to even the easiest questions. If this experience is familiar, than you might be suffering from what is known as test anxiety.
, Test anxiety is a psychological condition in which people experience extreme distress and anxiety in testing situations. While many people experience some degree of stress and anxiety before and during exams, test anxiety can actually impair learning and hurt test performance.
A little bit of nervousness can actually be helpful, making you feel mentally alert and ready to tackle the challenges presented in an exam. Excessive fear, on the other hand, can make it difficult to concentrate and you might struggle to recall things that you have studied.Test anxiety is a type of performance anxiety. In situations where the pressure is on and a good performance counts, people can become so anxious that they are actually unable to do their best.
While people have the skills and knowledge to do very well in these situations, their excessive anxiety impairs their performance.
So how do you know if what you suffer from is a test anxiety?
The severity of test anxiety can vary considerably from one person to another. Some people might feel like they have "butterflies" in their stomach and while others might find it difficult to concentrate on the exam. Others might experience a racing heartbeat and a sense of shakiness. In the most severe cases, people can feel nauseous and short of breath or might even experience a full-blown panic attack.
The symptoms of test anxiety can vary considerably and range from mild to severe. Some students experience only mild symptoms of test anxiety and are still able to do fairly well on exams. Other students are nearly incapacitated by their anxiety, performing dismally on tests or even experiencing panic attacks before or during exams.
Physical symptoms of test anxiety include sweating, shaking, rapid heart beat, dry mouth, fainting and nausea. Milder cases of test anxiety can cause a sense of "butterflies" in the stomach, while more severe cases can actually cause students to become physically ill.
Cognitive and behavioral symptoms can include fidgeting or outright avoidance of testing situations. In some cases, test anxiety can become so severe that students will drop out of school in order to avoid the source of their fear. Substance abuse can also occur, since many students attempt to self-treat their anxiety by taking "downers" such as prescription medications and alcohol. Many people with test anxiety report "blanking out" answers to the test, even though they thoroughly studied the information and were sure that they know the answers to the questions. Negative self-talk, trouble concentrating on the test and racing thoughts are also common cognitive symptoms of test anxiety.
Emotional symptoms of test anxiety can include depression, low self-esteem, anger and a feeling of hopelessness. Students often feel helpless to change their situation, or belittle and berate themselves about their symptoms and poor test performance.
Fortunately, there are steps that students can take to alleviate these unpleasant and oftentimes harmful symptoms. By learning more about the possible causes of their test anxiety, students can begin to look for helpful solutions.
Test Anxiety In Houston II (The Hypnotic Solution)
Of course, you all knew that I was leading to this, but before I suggest the hypnotic solution I would like to mention a few more things about the test anxiety.
Things are not always what they appear to be. In some cases anxiety is not due to the fear of failing the test but due to passing it. That’s right, due to tear of succeeding. How could that be you will say?
I will describe a couple of cases I had that are right on point.
A very bright young man was finishing second year of medical school and already failed the most important test that would decide if he would remain in school and eventually become a doctor, or not. He failed it more than once already and was about to have his last chance to retake this test. He contacted me to help him with test anxiety less than a month before the test and we got right to it. I was sure that he knew the material because he reported that studied between the attempts and before each attempt he successfully passed a trial test with scores well above the minimum required. The test anxiety was the only reason for the failed attempts and in each failure he scored only one or two points below the passing score. In addition to anxiety reducing sessions we had, I also thought him self-hypnosis and appropriate self suggestions. He reported to be calm and relaxed during the test and was confident that his score would be well above the required minimum. It was two more weeks before the test results would be posted. But when the results were posted we were all in shock. Failed again with one point below the required minimum. Anxiety was not at fault because I did my job removing the anxiety. But for some reason his subconscious failed the test for him with very high precision. Precisely one point below the passing grade. I know that by now you are curious to know why he failed the test if his subconscious knew all the right answers to the degree that it could calculate exactly how many to answer wrong to fail by just one.
I don’t like my clients’ failures because they are also my failures, so this case presented a personal challenge to me and I dug in to get the answers. Here is what it turned out to be. This young man’s father is a doctor and since he was a small boy he wanted to be a doctor to help people. His whole life he was preparing himself for that, but in his mid teens he met a wonderful teacher and decided that he wanted to become a teacher just like this teacher because he decided that he could help young people even more effectively that way than by becoming a doctor. Shortly after his family moved to a different State and the thought of becoming a teacher kind of retreated and was forgotten. Or was it? As I continued my investigation I found that he really did want to be a doctor and the teacher idea was just the result of temporary infatuation with this wonderful teacher he had met. But moving away from the teacher and the idea of becoming one, not to mention leaving all the friends behind, built quite a resentment and actually reinforced the subconscious, even if not entirely reasonable, desire to become a teacher. So this unresolved conflict between conscious and subconscious lied in wait and sabotaged every attempt to extinguish its chance for survival. In this kind of contest the subconscious will win every time because it is actually more powerful than conscious and because it is working unbeknown to the logical part of mind, the conscious.
And here is another case of test anxiety that is not. I will make it very short just to show how radically different these cases can be when on the surface they appear as simple test anxiety due to fear of failing the test.
A woman was failing professional licensure exams that would help her become successful in her chosen occupation. Without a license she was limited in how much she was allowed to do and what fees she could receive for her services. She was doing it for years and knows the material in and out but she fails that important exam or sabotages it when passing it would open the doors of success for her. So, without going into many details, lest I bore you to tears, I will simply tell you what her subconscious problem was.
This lady subconsciously believed herself to be responsible for something (I’m not going to say what it was) that happened to her loved one and, thus she was not deserving to be successful and prosperous. So, no matter how much she consciously wanted to be successful her subconscious made sure that she was not. You see, the subconscious will win every time, unless we give it a new believe – the one that suits our conscious intelligent choice. A well trained hypnotherapist has numerous ways to achieve the desired outcome, depending on specificity of the problem and the individual. Hypnosis is the best, most effective and most expedient means to achieve that task because hypnosis allows us to communicate with subconscious more effectively than any other means we know thus far. So there you go again. Hypnosis may be just the way to deal with your test anxiety.
Trichotillomania and Hypnosis (Part I)
Trichotillomania (TTM) is an impulse disorder which urges people to pull their hair out. Hair from the scalp, eyelashes, eyebrows, or other parts of the body are all fair game. The noticeable bald patches inspire an additional layer of emotion; fear of being caught, shame of being unable to stop. Some describe the compulsive hair-pulling as a self-soothing behavior comparable to thumb-sucking.
Although there are still questions it is for the moment defined as an impulse-control disorder. An estimated two percent of Americans wrestle with this urge to pluck hair. The urge is not just a simple habit or learned behavior but is experienced as an urge more like a yawn or sneeze that emerges from the subconscious.
This disorder most frequently emerges in the early adolescent years, near age twelve. Researchers suggest that of those with trichotillomania ninety percent are women. But this may only indicate that women are more likely to seek treatment. Some experts note that 50 to 70 percent of people who pull out their hair bite or chew the root of, or examine the hair.
Symptoms range widely. Each individual is unique in severity, location on the body, and response to treatment. The unifying factor is all people with TTM will go to great lengths to cover up their handy work. That includes changing hairstyles, using scarves, or camouflage clothing, or makeup to hide bald patches or skin irritation. The tenacity of this disorder is also subjective. Some people, at some times can eliminate their urge to pull by focusing their awareness on it. For other people, or at other times the urge to pull may be so urgent that normal functioning becomes nearly impossible.
Trichotillomania and Hypnosis (Part II)
A 2004 article in the "Journal of Counseling and Development" states that "hypnotherapy has been effective in treating habit disorders, such as tics and thumb sucking, as well as trichotillomania. During hypnosis clients can significantly increase awareness of their urge to pull hair. Two small studies reported moderate success in treating trichotillomania with hypnotherapy.
Among other things hypnosis can arm trichotillomania client with the skills to recognize or identify 'parts' of the self that are urging their need to pull hair. Parts therapy is a method of healing feelings, thoughts, behaviors, and responses that are counterproductive or uncomfortable. This trichotillomania hypnosis guides clients to journey within the self to invite change.
No personal issues are too big or too small to be approached through this parts method. The object of trichotillomania hypnosis is to successfully transform limitations not through confrontation but from the inside out. The clear and easy steps of this hypnosis script invite change to develop naturally from within. This hypnosis approach can resolve trichotillomania by opening the individual to the wholeness that resides at the centre of their being. The process transforms self-defeating beliefs that keep them trapped without getting even more deeply ensnared in self-critical thinking. Without turmoil, without nagging hypnosis addresses trichotillomania and opens the opportunity to live from a profoundly meaningful true self.
Functioning from the centre of the self allows us to feel an unshakable sense of well-being no matter what kind of waves and ripples shake our day to day experience. This trichotillomania hypnosis helps clients' connect with the inner self to gain access to a sense of inner-knowing that provides all the resources necessary to overcome any obstacles.
Helping clients to learn and deal with the cause of their symptom can empower them to function in alignment with their true values. Hypnosis can help to eliminate Compulsive Hair Pulling provides clients with a clear perception of their world not a subjective version colored by their individual biases, fears, or prejudices.
Trichotillomania and Hypnosis (Part III)
Here are some studies that were conducted in order to determine the effectiveness of hypnosis in helping clients with trichotillomania.
Study 1: Hypnosis And Trichotillomania – Children Hypnosis as a Vehicle for Choice and Self-agency in the Treatment of Children with Trichotillomania http://the-medical-dictionary.com/trichotillomania_article_5.htm
Results: The technique of direct suggestion under hypnosis, aimed at alerting the patients to impending scalp hair pulling behaviors, was combined with forming contracts with the parents to relinquish their authority over matters regarding the patients' hair. This combination provided an effective treatment that extinguished the scalp hair pulling in 7 visits or less. These cases received follow-up at intervals up to 6 months and no evidence of relapse was found.
Notes: Three pediatric cases of Trichotillomania were treated with direct hypnotic suggestion with exclusive emphasis on sensitizing and alerting the patients to impending scalp hair pulling behaviors. These children had presented with total lack of awareness of their scalp hair pulling behaviors until they had actually twisted and pulled off clumps of hair. It was also suggested, under hypnosis, that upon learning to recognize impending scalp hair pulling behaviors, the patients would become free to choose to willfully pull their hair or to resist the impulse and not pull. At no point was the explicit suggestion given that they stop pulling their hair. A preliminary condition was agreed to by the parents that redefined the patients' hair as their own property and affirmed their sole responsibility for its care and maintenance. An element of secondary gain was identified in each of these cases. Scalp hair pulling was hypothesized to provide these particular patients with a vehicle with which to oppose their overbearing and over-involved parents.
The hypnotic sessions were 30 minutes long and included only the child. The accompanying parent was included during the last 15 minutes of each visit in order to provide a general overview of the child's progress and to reinforce the contract. An eye fixation with progressive relaxation hypnotic induction was utilized in each of the cases. Moreover, imagery of the child playing his/her favorite sport, non-competitively and for fun was employed for deepening. The following non-adversarial, direct suggestions under hypnosis were given.
You will hear a bell ringing and will be acutely aware whenever your hand makes the slightest effort to move up to your head. Knowing, ahead of time, that your hand is intending to move up to your head gives you the power and the control to decide if you want to pull your hair or if you choose not to. Never again will your hair get pulled without your awareness and your permission. Your hair is your property and it is your choice how to care for it.
An 8-year-old boy presented with pure Trichotillomania of about 6 month's onset that coincided with his dad's recent remarriage. Direct suggestions under hypnosis were made for the child to become immediately aware at the earliest movement of the hand towards his head. Suggestions were further provided that since he was a "big kid," he could decide like a "big kid" whether to pull or not. Ego strengthening suggestions were also provided at each visit. They were aimed at enhancing the child's self-confidence, autonomy and empowering the child with suggestions that he was in control of his life. After 5 visits the Trichotillomania behavior stopped. Follow-up visits at 3 and 6 months demonstrated no relapse.
This 10-year-old boy already had a 2- 1/2 year history of "seasonal" hair pulling. He was an avid swimmer and swam competitively for a community swim club. Since he cut his hair off during the swimming season, there was no hair pulling during these months. He pulled his hair the rest of the year. The patient was treated with direct suggestions under hypnosis to sensitize him and make him immediately aware, at the earliest movement of the hand towards his head. He was also treated with guided imagery of swimming and given suggestions that swimming did not always have to involve competition; that one could also swim for fun. He was also told, under hypnosis, that once he became aware of impending hair pulling behaviors that it was his choice to proceed and pull his hair or stop and not pull it. He was also reminded that his hair belonged to him and he was responsible for its care and management. Ego strengthening suggestions were also provided at each visit. They were aimed at enhancing the child's self-confidence, autonomy and empowering the child with suggestions that he was in control of his life. After 7 visits, the hair pulling behaviors stopped. A follow-up visit 6 months later, after the swimming season and after he again let his hair grow, demonstrated no evidence of relapse.
This eleven-year-old girl presented with a well-established case of Trichotillomania. She had been pulling her hair for about a year. She was treated with direct hypnotic suggestion with an emphasis on making her aware of impending efforts to bring her hand towards her head. It was suggested, under hypnosis, that it was entirely her choice to pull her hair or stop. It was also suggested, under hypnosis, that there was going to be less stress associated with her performance in sports and that they would become more enjoyable. After six visits the hair pulling stopped. Ego strengthening suggestions were also provided at each visit. They were aimed at enhancing the child's self-confidence, autonomy and empowering the child with suggestions that she was in control of her life. Follow-up one month, two months, and six months later demonstrated no evidence of relapse. American Journal of Clinical Hypnosis, October 1, 2003 By: Alex Iglesias, Ph.D., Psychologist.
Results: Three children with trichotillomania were treated with hypnotherapy. Two of the children reported complete resolution after 7-8 weeks and 1 patient after 16 weeks The latter, reporting recurrence of the complaint after 4 weeks due to stressful school problems, was resolved after successful retreatment with hypnosis after 3 weeks. During a follow-up period of 16 months, there were no recurrences.
Notes: Three children with trichotillomania were treated with hypnotherapy and observed in an outpatient clinic for 8 consecutive weeks and subsequently followed for 12-18 months. Relaxation and mental imagery were used. Acta Paediatr, 1999 Apr. 88 (4); 407-10 By: H. A. Cohen, Pediatric Ambulatory Center, Assaf Harofeh Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel), Barzilai (Petach Tikva, Pediatric Infectious Disease Unit, Assaf Harofeh Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel), A, Laha (Sheba Medical Center, Tel Hashomer and Pediatric Neurology Unit, Assaf Harofeh Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel.
Study 3: Hypnosis and Trichotillomania – Adolescents
Hypnotherapeutic Management of Pediatric and Adolescent Trichotillomania http://www.ncbi.nlm.nih.gov/pubmed/8897221
Results: This report presents five cases of trichotillomania in which self-monitoring, dissociative hypnotic techniques, and self-hypnosis (relaxation/mental imagery) practice were used in teaching children successful management of this vexing problem. Specific emphasis is placed on the nature and importance of modifying the described techniques for the personal and specific developmental needs of individual patients.
Notes: Specific emphasis is placed on the nature and importance of modifying the described techniques for the personal and specific developmental needs of individual patients. J. Dev. Behav. Pediatr. 1996, Oct. 17(5); 238-34 By: D. P. Kohen, M.D., Dept. of Pediatrics, University of Minnesota.
Study 4: Hypnosis and Trichotillomania – Adolescents
Hypnotherapy in Adolescents with Trichotillomania: Three Cases
Results: This paper reports on three adolescents with pure trichotillomania who responded to the imaginative hypnotherapy technique with Ericksonian suggestions. Hair pulling was significantly reduced, and the improvement was sustained throughout the 6-month follow-up.
Notes: The patients described their hair as weak and vulnerable and needy of protection. In therapy, the patient was assigned the role of “patron of the hair” thereby giving him/her control of the situation. After induction, during the hypnotic state, the following text was used: “Imagine yourself wearing special binoculars that give you the ability to see the hair of your eyebrows (or scalp, chest, etc.) very, very closely. Each hair looks very big, and you can observe it carefully. You may even look under the skin to the hair root and watch the hair as it starts to grow. The hair starts off tiny and thin, like you were as a child and tries to grow up and out to reach its full size. You feel that you want to protect and guard the tiny hair and prevent outside forces from harming it.” At this point sometimes a “cue” is added which “allows” the impulse of pulling to disappear. For example, patients may be instructed to press the first and second fingers of their hands together every time they have an urge to pull. This served to discharge the tension, like two electric wires that short circuit. American Journal of Clinical Hypnosis, Vol. 44, Issue 1, 2001, p. 63-68 By: Dr. Gil Zalsman MDa, Haggai Hermesha and Jonathon Severa, Geha Psychiatric Hospital, Tel Aviv University, USA
Study 5: Hypnosis and Trichotillomania – Adults Hypnotic treatment of five adult cases of Trichotillomaniahttp://psycnet. apa. org/psycinfo/1983-30885-001
Results: The author presents 5 cases of female trichotillomania patients (aged 14-35 yrs), 3 of whom were successfully treated using modified behavior therapy in hypnosis along with age regression and autohypnosis. Australian Journal of Clinical & Experimental Hypnosis, Vol 10(2), Nov 1982, 109-116By: James V. Hynes.
JUST A LITTLE DISTRACTION,
I was browsing the net today and I came across an interesting image. This image:
It was not so much the image of the swinging pendelum pocket watch, as it was the fact that identical image was on a big poster in my office. Because I happened to be a hypnotherapist myself I felt that the image is so well suited to a, what I would consider, a misleading hypnosis stereotype. Most people expect something similar to a pendelum-watch when they think about HYPNOSIS. Or may be they expect a sinister, vampire looking individual, like Boris Karloff saying - "look into my eyes!!!" When I looked what it was, it turned out an ad for a hypnotherapy sessoin. Whoever came up with that ad was good at selling the product or service. I'm not, in any way, attempting to harm a valid marketing effort. I have my services advertised as well. I just fell a sense of comradery with whoever picked that particular image. My compliments to you! And now let us go to the next discussion, if that is what we are doing here. :-)