American Journal of Clinical Hypnosis最新文献

Most of the experimental investigations on hypnosis used to compare small samples of individuals with low or high responsiveness to hypnosis by systematically excluding medium responders. The present article underlines the limitations of this methodological approach that may have partially weakened the scientific impact of hypnosis research. In fact, the mediums-neglecting bias might be one of the reasons why some investigations suffer from low replicability and generalizability. Themes such as hypnotizability scales, suggestibility, statistical power, and research design are critically reviewed with the aim of proposing a more rigorous approach that boost up impact and reliability of hypnosis research. In particular, the recruitment of medium hypnotizables and the adoption of a within-instead of a between-subjects design currently seem to be some of the best recommendations for strengthening hypnosis research, as well as to renew the dialogue between clinical and experimental hypnosis.

Exploring psychophysiological changes during hypnosis can help to better understand the nature and extent of the hypnotic phenomenon by characterizing its influence on the autonomic nervous system (ANS), in addition to its central brain effects. Hypnosis is thought to induce a relaxation response, yet studies using objective psychophysiological measures alongside hypnosis protocols show various results. We review this literature and clarify the effects of hypnosis on psychophysiological indices of ANS activity and more specifically of the stress/relaxation response, such as heart rate variability and electrodermal activity. Studies reporting psychophysical measures during hypnosis were identified by a series of Pubmed searches. Data was extracted with an interest for the influence of hypnotizability and effects of specific suggestions or tasks on the findings. We found 49 studies comprising 1315 participants, 45 concerning healthy volunteers and only 4 on patients. Sixteen compared high vs. low hypnotizable people; 30 measured heart rate, 18 measured heart rate variability, 25 electrodermal activity, and 23 respiratory signals as well as other physiological parameters. Globally, results converge to show reductions in sympathetic responses and/or increases in parasympathetic tone under hypnosis. Several methodological limitations are underscored, such as older studies (N = 16) using manual analyses, small sample sizes (<30, N = 31), as well as uncontrolled multiple comparisons. Nevertheless, we confirm that hypnosis leads to a physiological relaxation response and highlight promising avenues for this research. Suggestions are made for guiding future work in this field.

The history of hypnosis has been marked by its effectiveness paralleled by prejudicial refusal, due to its ostensible incompatibility with the ruling Weltbild (picture of the world). Its interpretation has been mainly based on concepts like suggestibility, dissociation, hallucination, impairment of sense of agency, and free will. Nevertheless, little evidence and agreement has been reached so far on the nature of hypnosis and hypnotic ability, an uncertainty enhanced by the wide range of meanings and ambiguities of the used terms. This article analyzes the main epistemological implications involved in the topic.

Hypnosis is a hetero-induced or self-induced altered state of consciousness that involves focused attention and reduced peripheral awareness. It is determined by response to suggestions and can be used in the management of various clinical conditions. Nowadays there is growing attention to the neurobiological correlates of hypnosis because of its future clinical applications. The greater attention is due to the wide range of applications that might stem from its knowledge. Functional neuroimaging studies show that hypnosis affects attention by modulating the activation of the anterior cingulate cortex and other brain areas, modifying the conflict monitoring and cognitive control. During hypnoanalgesia, several changes in brain functions occur in all the areas of the pain network, and other brain areas. Among these, the anterior cingulate cortex is significantly involved in modulating the activity of pain circuits under hypnosis, both in the affective, sensory-cognitive, and behavioral aspects. The study of the functionality of the cingulate cortices, mainly the anterior and medial portions, appears to be crucial for better understanding the hypnotic phenomena, related to both the neurocognitive and somatosensory aspects.

Chronic pain is a complex phenomenon which includes biological, psychological, and socio-professional factors that undermine patients' everyday life. Currently, only few patients significantly benefit from pharmacological treatments and many have to stop them because of negative side effects. Moreover, no medication or treatment addresses all aspects of chronic pain at once (i.e., sensations, emotions, behaviors, and cognitions), positioning chronic pain as an important public health issue and thus contributing to high health-care costs. Consequently, patients and health-care providers are increasingly turning to complementary non-pharmacological techniques such as hypnosis. Clinical research has demonstrated a decrease of pain perception, pain interference, depression and anxiety, and an increase in global quality of life when patients with chronic pain have benefited from hypnosis learning. Neuroimaging studies offer a possible explanation of these results by focusing on neural processes of pain modulation in chronic pain patients' brain. Studies conducted with chronic pain patients showed a modulation of pain matrix activity during hypnosis with a specific involvement of the anterior cingulate cortex (related to emotional and cognitive processing of pain). Therefore, hypnosis seems to act upon regions underlying emotion and cognition, with an influence on pain perception and emotional regulation. In this review, we propose to carry out a review of the recent literature on hypnosis in chronic pain management. A better understanding of the beneficial effects of hypnosis on chronic pain and its neurophysiology should enable more systematic use of this technique in the management of this complex health problem.

Many medical conditions are claimed to benefit when hypnosis is incorporated into their treatment. For some conditions, the claims are largely anecdotal, but the treatment of pain stands out in two ways. First, there is a strong body of evidence that hypnosis can produce clinically useful analgesic effects. Second, since innocuous pain can be induced in the laboratory, the process can be explored rigorously. This idea assumes that experimentally induced pain and clinical pain behave identically. We describe using experimentally induced pain in patients already suffering from temporomandibular disorders. Scanning results indicate that the pain and its amelioration are the same in the two circumstances. Moreover, the absence of any impact upon a nociceptive trigemino-facial reflex implies that the impact of hypnosis is purely cortical. Finally, we address the observation that clinical success correlates poorly with hypnotic susceptibility scores. It is proposed that a painful experimental situation induces anxiety. This, like hypnosis, has been associated with an emphasis on right hemisphere activity. Thus, clinical anxiety may render a person more responsive to hypnosis than would be indicated by a susceptibility test delivered in stress-free circumstances.

As noted by some recent authors, psychotherapy has traditionally focused primarily on how the past affects present functioning. For example, in the hypnosis literature, there is much written about age regression and more recently there has been a focus on the future. In the 1950's there was discussions about embodying expectancy and pseudo-orientation-in-time, but there was not much in the literature again until the 1980's and thereafter about the importance of future focus. Some authors refer to future work as age progression. This article summarizes a "future projection" approach including why this terminology appears more suited for the approach. Techniques and strategies are described. Six case examples are presented covering varied clinical issues in which there was evidence of positive change.