Thursday, July 16, 2009

What is Hypnosis?

(from the Canadian Federation of Clinical Hypnosis)

Hypnosis (or trance, relaxation, focusing) has been recognized for thousands of years and used for many purposes. The ability to enter this natural state of heightened and focused attention opens the door to endless possibilities for healing, self-exploration and change.

When we enter into a state of hypnosis, we can utilize thoughts, talents and experiences in ways not usually accessible to us. With the guidance of a trained professional, we can develop our latent abilities that enable making desired changes in our thoughts, feelings and perceptions. "Peak performance" training, as it is called, can be used to help people uncover and overcome “blocks” that underlie their failure to achieve their desired goals.

Although hypnotic trance is a very natural, peaceful state of mind that most of us experience almost daily (e.g., while daydreaming), it has often been portrayed in films and television in ways that have been inaccurate and even alarming. But clinical hypnosis, when practiced by a well-trained, licensed health-care professional, is safe. And it is often speedier than many other forms of treatment--both psychological and medical.

Hypnosis FAQs

What does it feel like to be in a hypnotic state?
This will differ from person to person. Some people say there is very little difference between the hypnotic state and their normal waking state - not at all like the stereotype of being zombie-like. Others say the sensation is that of being extremely calm and relaxed, just as you feel prior to falling asleep. In most cases clients notice that their senses are more alert and aware, quite the opposite of what they had expected. Some can remember everything that happens when they are in trance, and others have less conscious recall of events.

How can a treatment aimed at your mind affect your body?
The body responds physically to thoughts. For example, when we think a frightening thought, we can experience increased heart rate, shortness of breath, "butterflies" in the stomach, muscular rigidity, sweating, shaking, and so on. Similarly, when we think a pleasurable thought, we can experience reduced heart rate, deeper breathing, relaxation of muscles, and so on. These are autonomic nervous system responses that are involuntary, but they can be utilized to promote health. When hypnotized, an individual is very open to suggestions that can enhance positive and diminish negative physical reactions.

Can children be hypnotized?

Many children make excellent hypnotic subjects, and respond well to hypnotic suggestion for a wide variety of problems, e.g., self-esteem issues, anxiety, behaviour problems. It is important that your child's therapist be competent and experienced in dealing with your child's particular issue or problem.

Can anyone be hypnotized?
Some people find it easier to relax than others. By the same token, some people are able to go into trance more quickly and more deeply than others. About 80 to 85% of people can go into at least a light trance. For most hypnotherapeutic goals, light trance is enough to enable almost everyone to benefit from hypnotherapy to some extent.

In a relatively small number of situations, (say, when hypnosis is being used instead of a general anesthetic, e.g., as in labour and childbirth), a deeper level of trance may be needed. For these purposes, it is helpful to determine the trance capability of a given person, before making a decision about the advisability of using hypnosis as an anaesthetic.

Even for those people (maybe 15 to 20%) who do not enter into even a light trance state, hypnosis may still be helpful to assist their relaxation and improve their suggestibility to constructive comments and suggestions.

Will I lose control of myself?
No, there is no loss of control. Hypnotherapy allows clients to be more focused and less distractible. In this way, they can achieve more of their therapeutic goals. If the hypnotherapist's suggestions are acceptable and beneficial to the client, those suggestions are likely to be acted upon by the client. Trained professionals do an assessment to make sure the suggestions they provide are consistent with the value systems of their clients. The 'control' misconception appears to originate from stage hypnosis which, funnily enough, also involves people doing exactly what they want to be doing.

Is hypnotherapy safe?
Yes. The hypnotic state occurs naturally for most people. When you read a book or watch a movie, you suspend your tendency to disbelieve while increasing your ability to believe. That is a form of self-hypnosis. You are making what isn't real, real. So, it makes sense that you need to trust the individual guiding the process. Hypnosis is safe, but it matters that the hypnotist is ethical and competent. That is why we counsel you to see a health care professional for health or psychological problems that might benefit from the use of hypnosis.

Can I get trapped in the hypnotic state?
No. At any time a client can re-alert or choose to ignore suggestions. No one stays hypnotized indefinitely - you will always "come out" of trance within a short time.

Will I be asleep when hypnotized?
You will not be asleep when hypnotized. The word hypnosis comes from the ancient Greek word 'hypnos' meaning sleep, but it is a misnomer. Hypnosis is generally a very relaxed state, but it is not sleep. Many people, after a session of hypnosis, don't believe that they were hypnotized at all. That likely comes from misconceptions about just what a 'trance' in fact is. There are differences between the brain waves of people who are asleep and those who are in trance. In practice, people who are hypnotized often talk with the hypnotist, and can both answer and ask questions.

Will hypnosis make you remember things accurately?
No. Hypnosis can improve your recall of events that you believe happened to you. But hypnosis is not a way to find out the truth (whatever that may be) about events that are in dispute. That is, under hypnosis you may re-experience events, but there is no guarantee that you are remembering them correctly. Hypnosis only assists the subject in recalling perceptions, not truths.

Courts recognize this, and sometimes take the position that being hypnotized influences your ability to later testify in court on those matters. You should get legal advice before attempting to use hypnosis to improve your recall of events when there are, or might be, court matters involved.

Successful Treatments

Uses of Hypnosis in Medicine and Psychotherapy

This is a list of conditions/situations that have been successfully treated by hypnosis, according to documented case studies. The list is not exhaustive and we don't claim that everyone will benefit from hypnosis. The choice of whether hypnotherapy is the correct choice for you is a matter requiring discussion between you and your health care provider.

  • Gastrointestinal Disorders (Irritable Bowel Syndrome, Colitis, Crohn's Disease)
  • Anxiety and stress management: Posttraumatic Stress Disorder, Phobias, Test Anxiety, Travel Anxiety (including finding unconscious factors involved in the cause; use of self-hypnosis for relaxation; and increasing resistance to stress)
  • Depression (with and without medications)
  • Dermatologic Disorders (Eczema, Herpes, Neurodermatitis, Pruritus [itching], Psoriasis, Warts)
  • Surgery/Anesthesiology (in unusual circumstances where the usual chemical anesthesia is not recommended, or when the patient needs to be conscious during a procedure)
  • Pain (back pain, cancer pain, dental anesthesia, headaches and migraines, arthritis or rheumatism, injuries from motor vehicle accidents). Some maintain that hypnosis can “cure” the source of some of these painful conditions, but this has not been definitively demonstrated in the literature. There is good evidence that some people can use hypnosis to mask and alleviate pain.
  • Childbirth: the American Society of Clinical Hypnosis claims that, based upon members' anecdotal evidence, approximately two thirds of women have been found capable of using hypnosis as the sole analgesic for labour.
  • Sports and athletic performance enhancement. Hypnosis has been found effective by many athletes as a way to deal with improving concentration and alertness, improving adaptiveness in the incorporation of new techniques.
  • Smoking cessation. For some people hypnosis can be an effective sole agent, but for most, it will be part of a program used to assist in smoking cessation.
  • Weight control. This is another complex problem in which hypnosis can be one of the treatment choices.
  • Habit modification: nail biting, hair-pulling (trichotillomania), teeth grinding (bruxism).

The above is a partial list taken both from the American Society of Clinical Hypnosis and a recent literature search.

Wednesday, April 1, 2009

Are You Depressed?

About one in 10 North Americans suffers some form of depression, according to the National Institute of Mental Health. Women experience depression twice as often as men. Depression has devastating effects on a person's relationships with family and friends, on the ability to do productive work and, of course, on the ability to enjoy life.

Are You Depressed?
You may think this is an easy question to answer, but it's not wise to make your own diagnosis of depression — leave that to a professional. However, you may want to ask yourself a few basic questions first:
  • Do you feel unhappy, irritable or anxious?
  • Have you stopped enjoying the activities that always made you happy? Or have you always had trouble enjoying yourself?
  • Are you no longer able to do the things you need to do to keep things going at home or at work?
  • Are you less hopeful about the future?
  • Do find that it is hard to make important decisions without too much anxiety or distress?
  • Are you sleeping poorly, too little or too much? Do you have trouble getting to sleep or do you wake too early?
  • Has your appetite changed? Have you lost or gained weight as a result?
  • Do you have less energy than you need?
  • Do you think about hurting yourself? Do you wish for death or think about suicide?
If you can answer yes to any of these questions, especially if your answer has been yes for more than a few weeks or months, you may have a depression that needs help. It may make you anxious to seek assistance, but you may also have a lot to gain.

Potential Roadblocks
One difficulty in facing the problem of depression is stigma. People resist labeling their problems as depression. The term depression may sound too clinical, objective or cold-hearted. People tend to describe their problems with everyday words, such as unhappiness, stress, disappointment, irritation or anger.

For some people, to be depressed means to be weak, flawed or morally tainted. The danger of this point of view is that you can become self-critical or embarrassed. You may avoid help or feel you don't deserve it. Instead of seeing depression as a problem (medical or otherwise) with a solution, it becomes a source of shame. So you may dismiss your ups and downs as a normal part of life not worthy of any special attention.

The Bottom Line
Depression is a clinical diagnosis. This means that no laboratory test or X-ray can tell you whether you are depressed or not.

Depression is not just feeling a little down. It is diagnosed by a set of symptoms. Some symptoms indicate mild depression while other symptoms, such as considering suicide, suggest a more severe depression that requires immediate action.

Take the most honest measure you can of your feelings and experiences, and tell a health-care provider about them. Together you can discuss what would be helpful. Labeling your problems is not always so important. More important is describing your feelings and experiences in detail so helpful plans can be made, so you can feel better, enjoy life more, and be more productive in the ways that matter to you.

Harvard Medicine, July 2007

Monday, February 23, 2009

An angry heart is an at-risk heart

How the heart reacts to anger seems to predict who's at risk for a life-threatening irregular heartbeat.

Negative emotions like hostility and depression have long been considered risk factors for developing heart disease.

But research released Monday goes a step farther, uncovering a telltale pattern in the electrocardiograms (known as ECGs or EKGs) of certain heart patients when they merely remember a maddening event.

"Anger causes electrical changes in the heart," of already vulnerable people, said Dr. Rachel Lampert, a Yale University cardiologist who led the research. "That means those people are more likely to have irregular heartbeats when they go out in real life."

Anger's adrenalin rush

To track anger's effect, the researcher gave EKGs to 62 patients who had defibrillators implanted in their chests because of pre-existing heart disease.

When they recounted something that had made them angry, some patients experienced beat-to-beat EKG alterations. In other words, the emotional stress was producing a red flag like physical stress can. But it did so without causing the jump in heart rate that exercise does, suggesting anger's adrenalin rush might act directly on heart cells.

The result: people whose EKGs showed a big anger spike were 10 times more likely to have their defibrillators fire a lifesaving shock in the next three years than similarly ill patients whose hearts didn't react to anger, Lampert reported in the Journal of the American College of Cardiology.

Next she's studying whether anger-reducing techniques might help those high-risk patients avoid irregular heartbeats. There's a clear connection between the heart and the head: chronic negative emotions are somehow heart-damaging. "But we haven't been able to explain why that happens," said Goldberg, a cardiologist at New York University School of Medicine. "This is a step in the right direction."

© The Canadian Press, 2009

Tuesday, February 10, 2009

Innovative Therapy Helps Complicated Grief

A new type of psychotherapy created specifically to target symptoms of complicated grief appears to be more effective at helping patients recover after the death of a loved one.

Complicated grief occurs after the death of a loved one, and symptoms (which persist for more than six months after the death) include a sense of disbelief about the loved one's death, anger and bitterness over the death, yearning for the deceased person, and preoccupation with thoughts of the loved one, including distressing intrusive thoughts related to the death itself.

According to Katherine Shear, M.D., who is lead author of a study published in the June 1 Journal of the American Medical Association, complicated grief shares elements of major depression (sadness, guilt, and social withdrawal) and post-traumatic stress disorder (disbelief, intrusive images, and avoidance behaviors), but treatments typically used for these disorders don't work well for people with complicated grief.

In addition, since complicated grief isn't yet recognized as a disorder in the Diagnostic and Statistical Manual, many clinicians may misdiagnose patients who are experiencing traumatic grief with depression, Shear added. "Helping clinicians to identify complicated grief is crucial to successful treatment."

Shear and her colleagues developed complicated grief treatment (CGT), in which professional therapists guide clients to recall stories of their loved one's death while they tape-record the client's recollections. Periodically, the therapist asks clients to report their levels of distress. Therapists tried to reduce distress levels during each session by "promoting a sense of connection" to the loved one. Between sessions clients listened to their tapes.

These connections included imagined conversations with the deceased and a discussion of positive and negative memories about him or her. Therapists using CGT also asked clients to discuss what their plans and goals would be if their grief wasn't so intense.

All patients were independently rated before and after receiving CGT using the Clinical Global Improvement (CGI) scale. This scale measures clinical improvement from before therapy on a scale of 0 to 7. Shear found that 51 percent of those who received CGT reported "very much improvement" (CGI score of 1) or "much improvement" (CGI score of 2) after therapy, whereas just 28 percent of those receiving standard interpersonal psychotherapy did.

Researchers also found that 55 percent of the CGT group experienced a 20-point improvement on the CGI compared with 25 percent of the other group.

Shear also noted that "people who were on antidepressants" at the time of therapy "had the same mean CGI score as those who weren't on medications,"... "so the medications didn't seem to relieve symptoms of complicated grief".

Adapted from
Psychiatric News July 15, 2005 Volume 40 Number 14 © 2005 American Psychiatric Association
p. 16

Saturday, January 31, 2009

Chronic Pain Harms Brain

January 30, 2009

A Report from Northwestern University
This illustration shows the brain from the left side, demonstrating the differences in brain function between patients with chronic pain and patients with no chronic pain.

In a new study, investigators at Northwestern University’s Feinberg School of Medicine have identified a clue that may explain how suffering long-term pain could trigger other pain-related symptoms, such as sleeplessness, anxiety and depression.

Researchers found that in a healthy brain all the regions exist in a state of equilibrium. When one region is active, the others quiet down. But this balance does not exist in people with chronic pain. For these people, the front region of the cortex mostly associated with emotion “never shuts up,” said Dante Chialvo, lead author and associate research professor of physiology at the Feinberg School. The region is stuck on full throttle, wearing out neurons and altering their connections to each other.

“The areas that are affected fail to deactivate when they should,” Chialvo said.

This is the first demonstration of brain disturbances in chronic pain patients not directly
related to the sensation of pain. The study will be published Feb. 6 in The Journal of Neuroscience.

Chialvo and colleagues used functional magnetic resonance imaging (fMRI) to scan the brains of people with chronic low back pain and a group of pain-free volunteers while both groups were tracking a moving bar on a computer screen. The study showed the pain sufferers performed the task well but “at the expense of using their brain differently than the pain-free group,” Chialvo said.

When certain parts of the cortex were activated in the pain-free group, some others were deactivated, maintaining a cooperative equilibrium between the regions. This equilibrium also is known as the resting state network of the brain. In the chronic pain group, however, one of the nodes of this network did not quiet down as it did in the pain-free subjects.

This constant firing of neurons in these regions of the brain could cause permanent damage, Chialvo said. “We know when neurons fire too much they may change their connections with other neurons and or even die because they can’t sustain high activity for so long,” he explained.

‘If you are a chronic pain patient, you have pain 24 hours a day, seven days a week, every minute of your life,” Chialvo said. “That permanent perception of pain in your brain makes these areas in your brain continuously active. This continuous dysfunction in the equilibrium of the brain can change the wiring forever and could hurt the brain.”

Chialvo hypothesized the subsequent changes in wiring “may make it harder for you to make a decision or be in a good mood to get up in the morning. It could be that pain produces depression and the other reported abnormalities because it disturbs the balance of the brain as a whole.”

He said his findings show it is essential to study new approaches to treat patients not just to control their pain but also to evaluate and prevent the dysfunction that may be generated in the brain by the chronic pain.

Chialvo’s collaborators in this project are Marwan Baliki, a graduate student; Paul Geha, a post-doctoral fellow, and Vania Apkarian, professor of physiology and of anesthesiology, all at the Feinberg School.

The study was supported by the National Institute of Neurological Disorders and Stroke.

From Tri City Psychology Services