Hypnotic Tape Intervention Ameliorates Stress: A Randomized, Control Study Psychosocial and Immune Effects of Self-Hypnosis Training for Stress Management Throughout the First Semester of Medical School Hypnosis as a modulator of cellular immune dysregulation during acute stress. The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder. A Randomized Controlled Trial of the Effects of Hypnosis With 3-D Virtual Reality Animation on Tiredness, Mood, and Salivary Cortisol Treatment of anxiety: a comparison of the usefulness of self-hypnosis and a meditational relaxation technique. An overview. Cellular and humoral immunity, mood and exam stress: the influences of self-hypnosis and personality predictors. Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: a controlled clinical trial Hypnosis Treatment for Severe Irritable Bowel Syndrome: Investigation of Mechanism and Effects on Symptoms Psychological approaches during conscious sedation. Hypnosis versus stress reducing strategies: a prospective randomized study Effects of relaxation therapy and hypnotizability in chronic urticaria. The impact of self-hypnosis and Johrei on lymphocyte subpopulations at exam time: a controlled study Randomized Trial of Hypnosis as a Pain and Symptom Management Strategy in Adults with Sickle Cell Disease Hypnosis and autogenic training in the treatment of tension headaches: a two-phase constructive design study with follow-up. Hypnosis compared to relaxation in the outpatient management of chronic low back pain. Clinical hypnosis versus cognitive behavioral training for pain management with pediatric cancer patients undergoing bone marrow aspirations. Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer.
Abstract This study ( N = 35 ) used a r and omized control design , and participants were collected from a variety of groups . After evaluating their degree of stress and burnout , coping styles , general well-being , and hypnotizability  , participants were matched by stress level and r and omly assigned to an intervention or wait-list group . The intervention comprised an audio recording of a hypnotic induction accompanied by suggestions for progressive relaxation , imagery , and anchoring to be used for 2 weeks . The results show that , as compared with baseline and wait-list conditions , the hypnotic intervention had a medium-to-large beneficial effect on participants ’ experience of stress , burnout , and well-being . Some participants also decreased their use of the coping strategy escape-avoidance postintervention . Hypnotizability correlated significantly or marginally with some outcomes of the intervention , but only for 1 group This study was a 19-week prospect i ve conducted to determine the effectiveness of a self-hypnosis/relaxation intervention to relieve symptoms of psychological distress and moderate immune system reactivity to examination stress in 35 first-year medical students . Twenty-one subjects were r and omly selected for training in the use of self-hypnosis as a coping skill and were encouraged to practice regularly and to maintain daily diary records related to mood , sleep , physical symptoms , and frequency of relaxation practice . An additional 14 subjects received no explicit training in stress-reduction strategies , but completed similar daily diaries . Self-report psychosocial and symptom measures , as well as blood draws , were obtained at four time points : orientation , late semester , examination period , and postsemester recovery . It was found that significant increases in stress and fatigue occurred during the examination period , paralleled by increases in counts of B lymphocytes and activated T lymphocytes , PHA-induced and PWM-induced blastogenesis , and natural killer cell ( NK ) cytotoxicity . No immune decreases were observed . Subjects in the self-hypnosis condition reported significantly less distress and anxiety than their nonintervention counterparts , but the two groups did not differ with respect to immune function . Nevertheless , within the self-hypnosis group , the quality of the exercises ( ie , relaxation ratings ) predicted both the number of NK cells and NK activity . It was concluded that stress associated with academic dem and s affects immune function , but immune suppression is not inevitable . Practice of self-hypnosis reduces distress , without differential immune effects . However , individual responses to the self-hypnosis intervention appear to predict immune outcomes To assess the influence of a hypnotic intervention on cellular immune function during a commonplace stressful event , the authors selected 33 medical and dental students on the basis of hypnotic susceptibility . Initial blood sample s were obtained during a lower stress period , and a second sample was drawn 3 days before the first major exam of the term . Half of the participants were r and omly assigned to hypnotic-relaxation training in the interval between sample s. Participants in the hypnotic group were , on average , protected from the stress-related decrements that were observed in control participants ' proliferative responses to 2 mitogens , percentages of CD3 + and CD4 + T-lymphocytes , and interleukin 1 production by peripheral blood leukocytes . More frequent hypnotic-relaxation practice was associated with higher percentages of CD3 + and CD4 + T-lymphocytes . These data provide encouraging evidence that interventions may reduce the immunological dysregulation associated with acute stressors This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy ( CBT ) of acute stress disorder ( ASD ) . Civilian trauma survivors ( N=87 ) who met criteria for ASD were r and omly allocated to 6 sessions of CBT , CBT combined with hypnosis ( CBT-hypnosis ) , or supportive counseling ( SC ) . CBT comprised exposure , cognitive restructuring , and anxiety management . CBT-hypnosis comprised the CBT components with each imaginal exposure preceded by a hypnotic induction and suggestions to engage fully in the exposure . In terms of treatment completers ( n=69 ) , fewer participants in the CBT and CBT-hypnosis groups met criteria for posttraumatic stress disorder at posttreatment and 6-month follow-up than those in the SC group . CBT-hypnosis result ed in greater reduction in reexperiencing symptoms at posttreatment than CBT . These findings suggest that hypnosis may have use in facilitating the treatment effects of CBT for posttraumatic stress Abstract Case studies suggest hypnosis with a virtual reality ( VR ) component may be an effective intervention ; although few follow-up r and omized , controlled trials have been performed comparing such interventions with st and ard hypnotic treatments .  Thirty-five healthy participants were r and omized to self-hypnosis with VR imagery , st and ard self-hypnosis , or relaxation interventions .  Changes in sleep , cortisol levels , and mood were examined . Self-hypnosis involved 10- to 20-min . sessions visualizing a healthy immune scenario . Trait absorption was also recorded as a possible moderator . Moderated regression indicated that both hypnosis interventions produced significantly lower tiredness ratings than relaxation when trait absorption was high . When trait absorption was low , VR result ed in significantly higher engagement ratings , although this did not translate to demonstrable improvement in outcome . Results suggest that VR imagery may increase engagement relative to traditional methods , but further investigation into its potential to enhance therapeutic efficacy is required We have investigated prospect ively the efficacy of two nonpharmacologic relaxation techniques in the therapy of anxiety . A simple , meditational relaxation technique ( MT ) that elicits the changes of decreased sympathetic nervous system activity was compared to a self-hypnosis technique ( HT ) in which relaxation , with or without altered perceptions , was suggested . 32 patients with anxiety neurosis were divided into 2 groups on the basis of their responsivity to hypnosis : moderate-high and low responsivity . The MT or HT was then r and omly assigned separately to each member of the two responsivity groups . Thus , 4 treatment groups were studied : moderate-high responsivity MT ; low responsivity MT ; moderate-high responsivity HT ; and low responsivity HT . The low responsivity HT group , by definition largely incapable of achieving the altered perceptions essential to hypnosis , was design ed as the control group . Patients were instructed to practice the assigned technique daily for 8 weeks . Change in anxiety was determined by three types of evaluation : psychiatric assessment ; physiologic testing ; and self- assessment . There was essentially no difference between the two techniques in therapeutic efficacy according to these evaluations . Psychiatric assessment revealed overall improvement in 34 % of the patients and the self-rating assessment indicated improvement in 63 % of the population . Patients who had moderate-high hypnotic responsivity , independent of the technique used , significantly improved on psychiatric assessment ( p = 0.05 ) and decreased average systolic blood pressure from 126.1 to 122.5 mm Hg over the 8-week period ( p = 0.048 ) . The responsivity scores at the higher end of the hypnotic responsivity spectrum were proportionately correlated to greater decreases in systolic blood pressure ( p = 0.075 ) and to improvement by psychiatric assessment ( p = 0.003 ) . There was , however , no consistent relation between hypnotic responsivity and the other assessment s made , such as diastolic blood pressure , oxygen consumption , heart rate and the self-rating question naires . The meditational and self-hypnosis techniques employed in this investigation are simple to use and effective in the therapy of anxiety The effects of self-hypnosis training on immune function and mood were examined in medical students at exam time . Hypnosis involved relaxation and imagery directed at improved immune function and increased energy , alertness and concentration . Hypotheses were made about activated and withdrawn personality differences . Eight high and eight low hypnotically susceptible participants were given 10 sessions of hypnosis  , one live and nine tape-recorded , and were compared with control subjects ( N=12 ) .  CD3 , CD4 , CD8 , CD19 and CD56 NK cells and blood cortisol were assayed . Life-style , activated vs. withdrawn temperament , arousal and anxiety question naires were administered . Self-hypnosis buffered the decline found in controls in NK ( P<0.002 ) and CD8 cells ( P<0.0.07 ) and CD8/CD4 % ( P<0.06 ) ( 45 - 35 % order of magnitude differences ) while there was an increase in cortisol ( P<0.05 ) . The change in NK cell counts correlated positively with changes in both CD8 cells and cortisol . Results were independent of changes in life-style . Energy ratings were higher after hypnosis ( P<0.01 ) , and increased calmness with hypnosis correlated with an increase in CD4 counts ( P<0.01 ) . The activated temperament , notably the cognitive subscale ( speaking and thinking quickly ) , was predictive of exam levels of T and B lymphocytes ( P&z . Lt;0.08-P<0.02 ) , and reaching r=0.72 ( P<0.001 ) in the non-intervention control group . The sizeable influences on cell-mediated immunity achieved by a relatively brief , low cost psychological intervention in the face of a compelling , but routine , stress in young , healthy adults have implication s for illness prevention and for patients with compromised immunity & NA ; Few controlled clinical trials have tested the efficacy of psychological techniques for reducing cancer pain or post‐chemotherapy nausea and emesis . In this study , 67 bone marrow transplant patients with hematological malignancies were r and omly assigned to one of four groups prior to beginning transplantation conditioning : hypnosis training (HYP);cognitive behavioral coping skills training (CB);therapist contact control ( TC ) ; ortreatment as usual ( TAU ; no treatment control ) . Patients completed measures of physical functioning ( Sickness Impact Profile ; SIP ) and psychological functioning ( Brief Symptom Inventory ; BSI ) , which were used as covariates in the analyses . Biodemographic variables included gender , age and a risk variable based on diagnosis and number of remissions or relapses . Patients in the HYP , CB and TC groups met with a clinical psychologist for two pre‐transplant training sessions and ten in‐hospital “ booster ” sessions during the course of transplantation . Forty‐five patients completed the study and provided all covariate data , and 80 % of the time series outcome data . Analyses of the principal study variables indicated that hypnosis was effective in reducing reported oral pain for patients undergoing marrow transplantation . Risk , SIP , and BSI pre‐transplant were found to be effective predictors of inpatient physical symptoms . Nausea , emesis and opioid use did not differ significantly between the treatment groups . The cognitive behavioral intervention , as applied in this study , was not effective in reducing the symptoms measured Hypnosis improves  irritable bowel syndrome ( IBS ) , but the mechanism is unknown . Possible physiological and psychological mechanisms were investigated in two studies . Patients with severe irritable bowel syndrome received seven biweekly hypnosis sessions and used hypnosis audiotapes at home . Rectal pain thresholds and smooth muscle tone were measured with a barostat before and after treatment in 18 patients ( study I ) , and treatment changes in heart rate , blood pressure , skin conductance , finger temperature , and forehead electromyographic activity were assessed in 24 patients ( study II ) .  Somatization , anxiety , and depression were also measured . All central IBS symptoms improved substantially from treatment in both studies . Rectal pain thresholds , rectal smooth muscle tone , and autonomic functioning ( except sweat gl and reactivity ) were unaffected by hypnosis treatment . However , somatization and psychological distress showed large decreases . In conclusion , hypnosis improves IBS symptoms through reductions in psychological distress and somatization . Improvements were unrelated to changes in the physiological parameters measured & NA ; Stress reducing strategies are useful in patients undergoing surgery .  Hypnosis is also known to alleviate acute and chronic pain . We therefore compared the effectiveness of these two psychological approaches for reducing perioperative discomfort during conscious sedation for plastic surgery . Sixty patients scheduled for elective plastic surgery under local anesthesia and intravenous sedation ( midazolam and alfentanil upon request ) were included in the study after providing informed consent . They were r and omly allocated to either stress reducing strategies ( control : CONT ) or hypnosis ( HYP ) during the entire surgical procedure . Both techniques were performed by the same anesthesiologist ( MEF ) . Patient behavior was noted during surgery by a psychologist , the patient noted anxiety , pain , perceived control before , during and after surgery , and postoperative nausea and vomiting ( PONV ) . Patient satisfaction and surgical conditions were also recorded . Peri‐ and postoperative anxiety and pain were significantly lower in the HYP group . This reduction in anxiety and pain were achieved despite a significant reduction in intraoperative requirements for midazolam and alfentanil in the HYP group ( alfentanil : 8.7±0.9 & mgr;g kg−1/h−1 vs. 19.4±2 & mgr;g kg−1/h−1 , P<0.001 ; midazolam : 0.04±0.003 mg kg−1/h−1 vs. 0.09±0.01 mg kg−1/h−1 , P<0.001 ) . Patients in the HYP group reported an impression of more intraoperative control than those in the CONT group ( P<0.01 ) . PONV were significantly reduced in the HYP group ( 6.5 % vs. 30.8 % , P<0.001 ) . Surgical conditions were better in the HYP group . Less signs of patient discomfort and pain were observed by the psychologist in the HYP group ( P<0.001 ) . Vital signs were significantly more stable in the HYP group . Patient satisfaction score was significantly higher in the HYP group ( P<0.004 ) . This study suggests that hypnosis provides better perioperative pain and anxiety relief , allows for significant reductions in alfentanil and midazolam requirements , and improves patient satisfaction and surgical conditions as compared with conventional stress reducing strategies support in patients receiving conscious sedation for plastic surgery The therapeutic results of hypnosis with relaxation therapy were evaluated in 15 patients with chronic urticaria of 7.8 years ' average duration . Compared with baseline and control session values , the hypnosis session provided relief of pruritus as measured by three self-report parameters . There was no change in the number of hives . All subjects were given a st and ard test for hypnotizability . Assuming that the results were not biased by their preceding relaxation sessions , we determined that six subjects were hypnotizable and nine were nonhypnotizable . Subjects in both groups improved symptomatically , but hypnotizable subjects had fewer hives and became more symptomatic during the control ( testing and history taking ) session . Hypnotizable subjects also more frequently related stress as a causative factor . At a follow-up examination five to 14 months after the completion of the experimental sessions , six patients were free of hives and an additional seven reported improvement In a prospect i ve r and omised controlled trial , 48 students were r and omly assigned to stress reduction training before exams with self-hypnosis , Johrei or a mock neurofeedback relaxation control .  Peripheral blood lymphocyte sub population s and self-reported stress ( Perceived Stress Scale ) were measured before training and 1 - 2 months later as exams approached . Absolute number and percentages of CD3(+)CD4(+ ) and CD3(+)CD8(+ ) T lymphocytes , CD3(-)CD56(+ ) Natural Killer cells ( NK cells ) and NK cell cytotoxic activity was measured from venous blood . Stressed participants showed small but significant declines in both CD3(-)CD56(+ ) NK cell percentages and NK cell cytotoxic activity levels while CD3(+)CD4(+ ) T cell percentages increased , changes supported by correlations with perceived stress . The effects of stress were moderated in those who learned Johrei at exam time ; 11/12 showed increases in CD3(-)CD56(+ ) NK cell percentages with decreased percentages of CD3(+)CD4(+ ) T cells , effects not seen in the relaxation control group . Stress was also buffered in those who learned and practised self-hypnosis in whom CD3(-)CD56(+ ) NK cell and CD3(+)CD4(+ ) T cell levels were maintained , and whose CD3(+)CD8(+ ) T cell percentages , shown previously to decline with exams , increased . The results compliment beneficial effects on mood of self-hypnosis and Johrei . The results are in keeping with beneficial influences of self-hypnosis and provide the first evidence of the suggestive value of the Japanese Johrei procedure for stress reduction , which clearly warrants further investigation Sickle cell disease ( SCD ) is the most common genetic disease in African-Americans , characterized by recurrent painful vaso-occlusive crises . Medical therapies for controlling or preventing crises are limited because of efficacy and /or toxicity . This is a r and omized , controlled , single-crossover protocol of hypnosis for managing pain in SCD patients . Participants receive hypnosis from a trained hypnosis therapist followed by six weeks of self-hypnosis using digital media .  Those in the control arm receive SCD education followed by a six-week waiting period before crossing over to the hypnosis arm of the study . Outcome measures include assessment s of pain ( frequency , intensity and quality ) , anxiety , coping strategies , sleep , depression , and health care utilization . To date , there are no published r and omized , controlled trials evaluating the efficacy of hypnosis on SCD pain modulation in adults .  Self-hypnosis for pain management may be helpful in modulating chronic pain , improving sleep quality , and decreasing use of narcotics in patients with SCD . TRIAL REGISTRATION Clinical Trials.gov : Tension  headaches  can form a chronic ( very long duration ) condition . EMG biofeedback , relaxation training and analgesia by hypnotic suggestion can reduce the pain . So far , no differences have been demonstrated between the effects of various psychological treatments . In a constructively design ed study , we firstly compared an abbreviated form of autogenic training to a form of hypnotherapy ( future oriented hypnotic imagery ) which was not presented as hypnosis and secondly we compared both treatments to the same future oriented hypnotic imagery , but this time explicitly presented as hypnosis . The three treatments were equally effective at post-treatment , but after a 6-month follow-up period , the future oriented hypnotic imagery which had been explicitly presented as hypnosis was superior to autogenic training . Contrary to common belief , it could be demonstrated that the therapists were as effective with the treatment modality they preferred as with the treatment modality they felt to be less remedial Chronic low back pain ( CLBP ) presents a problem of massive dimensions . While inpatient approaches have been evaluated , outpatient treatment programs have received relatively little examination . Hypnosis and relaxation are two powerful techniques amenable to outpatient use . Seventeen outpatient subjects suffering from CLBP were assigned to either Self-Hypnosis ( n = 9 ) or Relaxation ( n = 8) treatments . Following pretreatment assessment , all subjects attended a single placebo session in which they received minimal EMG feedback . One week later the subjects began eight individual weekly treatment sessions . Subjects were assessed on a number of dependent variables at pretreatment , following the placebo phase , one week after the completion of treatment , and three months after treatment ended . Subjects in both groups showed significant decrements in such measures as average pain rating , pain as measured by derivations from the McGill Pain Question naire , level of depression , and length of pain analog line . Self-Hypnosis subjects reported less time to sleep onset , and physicians rated their use of medication as less problematic after treatment . While both treatments were effective , neither proved superior to the other . The placebo treatment produced nonsignificant improvement A r and omized controlled trial was conducted to compare the efficacy of clinical hypnosis versus cognitive behavioral ( CB ) coping skills training in alleviating the pain and distress of 30 pediatric cancer patients ( age 5 to 15 years ) undergoing bone marrow aspirations . Patients were r and omized to one of three groups : hypnosis , a package of CB coping skills , and no intervention . Patients who received either hypnosis or CB reported less pain and pain-related anxiety than did control patients and less pain and anxiety than at their own baseline . Hypnosis and CB were similarly effective in the relief of pain . Results also indicated that children reported more anxiety and exhibited more behavioral distress in the CB group than in the hypnosis group . It is concluded that hypnosis and CB coping skills are effective in preparing pediatric oncology patients for bone marrow aspiration Hypnosis was compared with nonhypnotic behavioral techniques for efficacy in reducing pain and anxiety in 27 children and adolescents during bone marrow aspiration and in 22 children and adolescents during lumbar puncture . The patients and independent observers each rated ( scale of 1 to 5 ) pain and anxiety during one to three procedures prior to intervention and one to three procedures with intervention . Prior to intervention for both groups , pain during bone marrow aspiration was rated as more severe ( P less than 0.01 ) than pain during lumbar puncture . During bone marrow aspiration pain was reduced to a large extent by hypnosis ( P less than 0.001 ) and to a smaller but significant extent by nonhypnotic techniques ( P less than 0.01 ) , and anxiety was significantly reduced by hypnosis alone ( P less than 0.001 ) . During lumbar puncture only hypnosis significantly reduced pain ( P less than 0.001 ) ; anxiety was reduced to a large degree by hypnosis ( P less than 0.001 ) and to a smaller degree by nonhypnotic techniques ( P less than 0.05 ) . Thus hypnosis was shown to be more effective than nonhypnotic techniques for reducing procedural distress in children and adolescents with cancer
Conclusions Due to exploratory design s and high risk of bias , the effectiveness of hypnosis or hypnotherapy in stress reduction remains still unclear .
Background Although hypnosis and hypnotherapy have become more popular in recent years , the evidence for hypnosis to influence perceived stress is unclear .
In this systematic review we search ed and evaluated r and omized clinical studies investigating the effect of hypnosis on perceived stress reduction and coping .