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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

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Daniel Lee/Flickr

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).

www.youtube.com/watch?v=zp-9CvaGq18

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”.

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MasterHypnotherapist
 

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.

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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.

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Sleep Problems in Houston and Hypnosis

(Part IV)

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.

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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.

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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.

Hypnosis Script
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.
Case 1
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.
Case 2
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.
Case 3
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.

Study  2: Hypnosis and Trichotillomania – Children Hypnotherapy: An Effective  Treatment Modality For Trichotillomania http://www.  ncbi.nlm.nih.gov/pubmed/10342539 http://lib.bioinfo.pl/paper: 10342539

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
http://www.asch.net/portals/0/journallibrary/articles/ajch-44/zalsman.pdf

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.

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JUST A LITTLE DISTRACTION,

I was browsing the net today and I came across an interesting image. This image:

https://www.groupon.com/deals/hypnosis-for-better?utm_medium=cpc&utm_source=ggl&utm_campaign=US_DT_DIS_GGL_JPG_TTT_AP_CBP_CHA_NBR_x*US-Dynx-Text-TTT_g*5501_c*eprst.net&gclid=CKPbhPuYjMkCFRCpaQodC4gNog

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. :-)

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