“Although humans make sounds with their mouths and occasionally look at each other, there is no solid evidence that they actually communicate among themselves”
DISCLOSURE I have no financial relationships to disclose and will not discuss off label use and/or investigational use of drugs or procedures in this presentation. As I get older and more mellow; I am less ashamed of my past and more accepting of others. Your way of looking at allopathic medicine will change today
“Listen to your patient he is telling you his diagnosis” Sir William Osler
Metanoia May refer to: Theology: a repentance Rhetoric: a correction Psychology: the process of experiencing a "break down" and subsequent, positive re-building or "healing” Medical: a new way to see the same old disease
What is Hypnosis? It is a tool to add to your practice. Hypnosis is a social interaction in which one person responds to suggestions given by another person (the hypnotist) for imaginative experiences involving changes in perception, memory, and the voluntary control of action using trance.
Double Diagnosis RIGHT BRAIN PSYCHODYNAMIC - Conflict, PTSD, Abuse, etc LEFT BRAIN PHYSICAL -Migrane, Asthma, Fibromyalgia, Insomnia, etc., etc
Left Brain Human characteristicsConsciousness …the “Will”
Right Brain Human characteristicsAutonomic Nervous…the “Way”
Hemispheric Characteristics LEFT BRAIN- Thinks in WORDS RIGHT BRAIN- Thinks in SENSES Pictures, Sounds, Motion
LEFT Right • Verbal • Logical • Linear • Temporal • Literal • Analytical • Black & White • Nonverbal • Illogical • Artistic • Timeless • Sensual • Global • Colorful
Left Not negative is a positive. Right No negatives
Our Left Brain Hears the Words That Our Right Brain will make an Image of And the two will confer to make a Judgment
You’re fired • I love you • I’m sorry • You’re right • Its Over • Its cancer • I’m pregnant
Two or Three words can have a profound change in one’s life. Our words have a profound effect. What and How we say our words will impact our ability to heal.
Non-Therapeutic Suggestion is an idea accepted uncritically at a time of great vulnerability
You will have to live with the pain. You will learn to cope with the pain.
“This shot is ‘gonna hurt, hang on!” “I think you will be pleasantly surprised how little discomfort there will be…..”
The Ability to be Hypnotized Varies with Age Very young children relatively unresponsive to hypnosis Hypnotizabilityreaches a peak at the onset of adolescence Hypnotizabilityassessed in college students remains about as stable as IQ over a period of 25 years
The Ability to be Hypnotized Relates to Personality Absorptionis the most reliable personality correlate
How is Hypnotizability Measured? Hypnotizability is measured by standardized psychological tests Stanford Hypnotic Susceptibility Scale Harvard Group Scale of Hypnotic Susceptibility
MILTON H. ERICKSON, M.D • He is generally acknowledged to be the world's leading practitioner of medical hypnosis.
What Happens During Classic Hypnosis? Induction Deepening Suggestions Posthypnotic suggestions Realerting
Trance can be deliberately induced using: prayer, religious rituals, meditation, breathing exercises, exercise, sex, music, Dancing, sweating (sweat lodge), fasting, thirsting, consumption of psychotropic drugs, And do not forget Trauma and the DOCTOR is associated with ….
Cocaine that can be abused or used for procedures. Hypnosis can be abused for fun, frolics and profits or it can be a useful tool to help others. Stage Shows CLINICAL HYPNOSIS
PET Scan of 11 volunteers. Scans while stimulated with hot noxious stimuli to right thumb with and without hypnosis. Hypnosis decreased both pain sensation and the unpleasantness of noxious stimuli. Noxious stimuli caused an increase in blood flow in thalamic nuclei and anterior cingulate cortex. The hypnotic state induced a significant activation of the anterior cingulate cortex. Neural Mechanisms Of Antinociceptive Effects Of Hypnosis Marie Elisabeth Faymonville MD Phd et al Anesthesiology 2000: 92: 1257-67 p 1257
Functional MRI Scan Clinical hypnosis may prevent nociceptive inputs from reaching the higher cortical structures responsible for pain perception. The effects of hypnosis can be explained by increased activation of the anterior cingulate cortex (ACC) and the basal ganglia. Clinical Hypnosis Modulates Functional Magnetic Resonance Imaging Signal Intensities and Pain Perception in a Thermal Stimulation Paradigm Sebastian Schulz-Stiibner. M.D., Ph.D., TimoKrings, M.D. Ingo G. Meister, M.D., Stefen Rex, M.D., Armin Thron, M.D., Ph.D., and Rolf Rossaint, M.D., Ph.D. Regional Anesthesia and Pain Medicine, Vol 29, No 6 (November-December, 2004: pp 549-556
Functional MRI data revealed that under posthypnotic suggestion, both ACC and visual areas presented reduced activity in highly hypnotizable persons compared with either no-suggestion or less-hypnotizable controls. Raz'sneuroimaging findings show that a specific brain area which regulates automatic processes, the anterior cingulate cortex (ACC), "lights up" when individuals perform the Stroop task without suggestion. However, the ACC tends to turn off when highly hypnotizable individuals perform the task under the suggestion that these English words should be perceived as gibberish. Hypnotic suggestion reduces conflict in the human brain Amir Raz , Jin Fan , and Michael I. Posner Sackler Institute for Developmental Psychobiology Weill Medical College of Cornell University, New York, NY PNAS (Proceedings of the National Academy of Sciences) July 12, 2005, vol. 102, no. 28:p. 9978-9983
"At least for highly suggestible people, words framed as part of a carefully-crafted suggestion can change focal brain activity in a way no drug we have can do" Hypnotic suggestion reduces conflict in the human brain Amir Raz , Jin Fan , and Michael I. Posner Sackler Institute for Developmental Psychobiology Weill Medical College of Cornell University, New York, NY PNAS (Proceedings of the National Academy of Sciences) July 12, 2005, vol. 102, no. 28:p. 9978-9983
Constantin von Economo discovery in 1929 The anterior cingulate cortex (ACC) The fronto-insular cortex (FI) The dorsolateral prefrontal cortex (DLPC) Humpback, Fin. Killer, Beluga and Sperm Whales Bottlenose and Risso’s dolphins African and Asian Elephants Normal SPINDLE
Uses for Clinical Hypnosis IBS Psychosomatic Illness Pain modification Anesthesia Phobias (needle, procedure, traumatic stress) Anxiety Habit control (smoking, nail biting, bedwetting weight reduction) Nausea for Chemo
Worwell Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. The Lancet 1984 placebo-controlled The hypnotherapy patients showed a dramatic improvement in all central symptom. The hypnotherapy group showed no relapses during the 3-month follow-up period. Whorwell PJ; Prior A; Faragher EB. Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. The Lancet 1984, 2: 1232-4.
Whorwell PJ; Prior A; Faragher EB. Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. The Lancet 1984, 2: 1232-4.
Kwan Abnormal forebrain activity in functional bowel disorder patients with chronic pain. NEUROLOGY 2005 fMRIrevealed abnormal urge and pain related forebrain activity during rectal distension in patients with irritable bowel syndrome (IBS). C.L. Kwan, MSc; N.E. Diamant, MD*; G. Pope, BSc; K. Mikula, BSc; D.J. Mikulis, MD; and K.D. Davis, PhD* Abnormal forebrain activity in functional bowel disorder patients with chronic pain. NEUROLOGY 2005;65:1268–1277
IBS Control The control group shows prominent pain related activations within the dorsal anterior insula and anterior cingulate cortex but not in the IBS group. C.L. Kwan, MSc; N.E. Diamant, MD*; G. Pope, BSc; K. Mikula, BSc; D.J. Mikulis, MD; and K.D. Davis, PhD* Abnormal forebrain activity in functional bowel disorder patients with chronic pain. NEUROLOGY 2005;65:1268–1277