clinical research

Preeminent researchers from major medical centers and universities in the US and abroad have published randomized clinical studies regarding the efficacy of guided imagery, hypnosis and meditation on physical and mental well-being. The results show that the use of all three significantly improves the overall quality of life for the participants by reducing symptoms, improving their immune response and shortening their recovery rate. We are providing a sampling of those results and a partial list (menu on left) of peer-reviewed published clinical studies listed per category.

OVERVIEW OF RESEARCH

The Mayo Clinic describes Guided Imagery as learning to listen to someone lead them into relaxed breathing and directing the client to imagine in order to send a guided vivid imagery message to the emotional control center of the brain. From there, the message is passed along to the endocrine, immune and autonomic nervous systems which influence a wide range of bodily functions, including heart, breathing rates and blood pressure. The Mayo Clinic states that they have found that Guided Imagery reduces the negative side effects of cancer treatments; reduces pre-surgery fear and anxiety, reduces need for post surgery medication, and allows clients to be released quicker than those who had not worked with guided imagery; improves the client’s ability to manage stress; and reduces the severity of migraine headaches as effectively as preventative medications.

A review study of over a hundred clinical studies of hypnosis for medical procedures documents that hypnosis is beneficial for allergy, anesthesia for pain, anesthesia for surgery, warts, dermatitis, irritable bowel syndrome, peptic ulcers, abdominal surgery, healing from injury or surgery, hemophilia, hypertension, headaches, childbirth, asthma, smoking cessation, fibromyalgia, impotence, and urinary incontinence.

“Many important trials reviewed here have helped to establish the role of hypnosis in contemporary medicine. These trials have established the utility and efficacy of hypnosis for several medical conditions, either alone or as part of the treatment regimen,”writes Stewart, JH, Department of Internal Medicine and Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Jacksonville, FL, Mayo Clinic Proceedings 2005; 80: 511-524.

At the Menninger Clinic hypnosis was found to be a useful adjunct in the emergency department setting. Its efficacy in various clinical applications has been replicated in controlled studies. Application to burns, pain, pediatric procedures, surgery, psychiatric presentations (e.g., coma, somatoform disorder, anxiety, and post traumatic stress), and obstetric situations (e.g., hyperemesis, labor, and delivery) are described. Emerg Med Clin North Am. 2000 May;18(2):327-38. Peebles-Kleiger MJ, Menninger School of Psychiatry and Mental Health Sciences, Menninger Clinic, Topeka, KS

Hartford Hospital reports that in addition to inducing a relaxation response and reducing chronic pain, guided imagery has been effective by lowering cholesterol, reducing blood pressure and lessening the adverse effects of chemotherapy, etc., giving the patient the ability to enhance their immunologic response to stress, reduce side effects of treatment and diminish anxiety and fear and reduce and often arrest the side effects of nausea and vomiting.

Basic scientific research, much of it done at Harvard University by neuroscientist Steven Kosslyn and colleagues, has shown us that when people imagine things, the part of their brains involved in the senses they are using become active. Using modern technologies like functional MRIs (fMRI) and SPECT scans, brain scientists can see which areas of the brain get activated when mental tasks are performed. The studies show that when people imagine seeing something, the occipital cortex, the part of the brain that processes information from the eyes, becomes activated. When people imagine listening to music, the temporal cortex, where music is processed, becomes active. When people imagine moving, areas of the brain (the prefrontal motor cortex) that instruct the body to move become active. Martin L. Rossman, Guided Imagery for Self-Healing 2000 HJ Kramer/New World Library.

  • 1995 – National Institutes for Health compiled an official statement entitled “Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia.” The evidence supporting the effectiveness of hypnosis in alleviating chronic pain associated with cancer seems strong. In addition, the panel was presented with other data suggesting the effectiveness of hypnosis in other chronic pain conditions, which include irritable bowel syndrome, oral mucositis (pain and swelling of the mucus membrane), temporomandilbular disorders (jaw pain), and tensions headaches.
  • 1999 – The British Medical Journal (BMJ) published a Clinical Review of current medical research on hypnotherapy and relaxation therapies (Vickers & Zollman; A (1999) “Clinical Review: Hypnosis *& Relaxation Therapies.” British Medical Journal 319(7221); 1346-1349. PMID 10567143) concluded strong evidence from randomized trials of the effectiveness of hypnosis and relaxation for cancer related anxiety, pain, nausea and vomiting particularly in children; effective for panic disorders and insomnia, particularly when integrated into a package of cognitive therapy; enhances the effects of cognitive behavioral therapy for conditions such as phobia, obesity and anxiety; randomized controlled trials support the use of various relaxation techniques for treating both acute and chronic pain as well as asthma and irritable bowel syndrome.
  • 2001 – Professional Affairs Board of the British Psychological Society (BPS) commissioned a working party of expert psychologists to publish a report entitled The Nature of Hypnosis (March 2001). The research is summarized: there is convincing evidence that hypnosis procedures are effective in management and relief of both acute and chronic pain and assisting in the alleviation of pain, discomfort and distress due to medical and dental procedures and childbirth; hypnosis and the practice of self-hypnosis may significantly reduce general anxiety, tension and stress in a manner similar to other relaxation and self-regulation procedures; hypnosis treatment may assist in insomnia in the same was as other relaxation methods; there is encouraging evidence demonstrating the beneficial effect of hypo-therapeutic procedures in alleviating the symptoms of a range of complaints that fall under the heading of stress related illness such as tension headaches and migraine; asthma, gastro-intestinal complaints such as irritable bowel syndrome, warts; and possibly other skin complaints such as eczema, psoriasis and urticaria (hives); there is evidence from several studies that hypnosis inclusion in a weight reduction program may significantly enhance outcome.
  • 2002 – University of Konstanz in Germany. Researchers Flammer and Bongartz examined date of the efficacy of hypnotherapy primarily as if relates to stress related illness, test anxiety, smoking cessation and pain control. Out of 444 studies they narrowed their focus down to 57 of the best quality he selected 44 of the highest quality of control trials. These showed that on average hypnotherapy achieved at least 64% success compared to 37% improvement among untreated control groups. They expanded their analysis to 133 of the top trials which then included 6,000 patients and the findings suggest an average improvement in 27% of the untreated patients over 74% success rate among those receiving hypnosis.
  • 2001 – Psychology Today (“The Power of Hypnosis” Deirdre Barrett, Psych Today, Jan/Feb 2001). Harvard psychologist Dierdre Barrett wrote “A hypnotic trance is not therapeutic in and of itself, but specific suggestions and images fed to clients in a trance can profoundly alter their behavior. As they rehearse the new ways they want to think and feel, they lay the ground work for changes in their future re using specific ways for habit change and amelioration of phobias. In her 1998 book of hypnotherapy case studies (A Pregnant Man: Tales from a Hypnotherapist’s Couch, Deirdre Barrett NY: Times Books/Random House, ISBN 0-8129-2905-5, she reviews the clinical research on hypnosis with smoking cessation and insomnia and described successful treatment of these complaints.

Montgomery, DeHamel and Redd(2000) found that hypnosis has been demonstrated to relieve pain in patients with headache, burn injury, heart disease, cancer, dental problems, eczema and chronic back problems. This study quantified the magnitude of hypnoanalgesic effect. Hypnotic suggestion relieves pain for the majority of people, regardless of the type of pain they are experiencing. Light and medium trance is useful for most purposes, but deep trance is required for hypnotic anesthesia for surgery (Watkins 1987).

Blue Shield of Californiastudy found that guided imagery increased patient satisfaction and cut costs by $2,000 per patient.

ABC News Medical Unit Report – Aug. 28, 2007

It’s something that’s usually associated with stage performances and helping smokers quit, but new research suggests hypnosis may soon be an important tool in helping patients endure common side effects of breast cancer surgery.

Researchers at the Mount Sinai School of Medicine in New York showed that a 15-minute hypnosis session reduced side effects including pain, nausea and emotional distress in patients undergoing breast cancer operations.

The study was published Tuesday in the Journal of the National Cancer Institute. “If this were a drug, it would be very successful,” said lead study author Guy Montgomery, director of the Integrative Behavioral Medicine Program at Mount. Sinai School of Medicine.

Montgomery added that hypnosis carries the added benefit of having no side effects – a quality that makes it an attractive alternative to many drugs used for similar purposes.

Two hundred women who were about to undergo surgeries like a breast biopsy or removal of a suspicious breast lump participated in the study. About half of the women received a 15-minute hypnosis session shortly before their operations. The other women in the study had a consultation with a psychologist before surgery.

The hypnosis session included relaxation exercises that encouraged the women to think of pleasant thoughts, such as a beach on warm day. The women who did not undergo hypnosis talked to a psychologist, who listened and offered supportive comments only.

After their surgeries, the women who had hypnosis experienced less pain, nausea, fatigue, discomfort and emotional upset than their counterparts – and these differences were substantial, the study’s authors reported.

Not only did hypnosis reduce the side effects from surgery, but it also did this while reducing the amount of anesthesia used during the surgery. Additionally, the researchers showed that hypnosis decreased the amount of time spent in the operating room by almost 11 minutes, leading to an overall cost savings of about $770 per patient.

These results were seen despite the fact that treatments involving hypnotism don’t work for everyone; previous studies have shown that about 11 percent of people are resistant to hypnosis. But researchers noted that the tests used to weed out hypnosis-resistant women from the study would have taken longer to perform than the hypnosis itself.

October 11, 2011 – Noetic Sciences launched the most comprehensive, up-to-day bibliography of meditation research to date – for medical professionals, therapist, researchers and academics. Stress, anxiety, sleep problems, hormone imbalance, and heart disease are a few of the many medical issues increasingly treated with meditation as scientific research over the last 80 years progressively revealed more of its health benefits. Additionally, research has shown that people who strive to make significant life changes are more successful when their transformation is supported by meditative practice. As a leading organization advancing the practice of meditation and the science of consciousness research, the Institute of Noetic Sciences (IONS) this week launched the most comprehensive, up-to-date bibliography of meditation research. Available on IONS’ website, noetic.org, to medical professionals, therapists, researchers, and academics, the meditation bibliography offers new features to also ease accessibility and search functions for a growing population of the public incorporating meditation into their lives, work, families, and communities.

With the demand for scientific data on the benefits of meditation continuously increasing, the number of meditation studies published each year has shown steady growth since 1965, when 15 reports were available, according to IONS. IONS’ bibliography now contains nearly 6000 references.

Easing Access to Research. IONS makes its meditation bibliography search engine easy to use, serving important real-world applications and simplifying research efforts. For example, a general practitioner may be interested in the benefits of meditation for patients with hypertension and stress. A prison psychologist might want to investigate the efficacy of meditation for an inmate population.

Believing in Good Results

Hypnosis is believed to work by helping patients expect good results. It also helps take attention away from pain, and some studies have even shown that hypnosis can actually change the way a patient perceives pain.

“When we take an aspirin we expect to have headache relief,” Montgomery said. “One of the things hypnosis is very good at is helping people form expectancy to these outcomes, such as less pain and less nausea.”

While hypnosis is commonly associated with a loss of control, many doctors say it is a powerful tool that patients can use to take charge of their own health.

C. Richard Chapman, professor and director of the Pain Research Center at the University of Utah said “There is a growing body of evidence showing that psychological interventions complement medical interventions. Such interventions empower patients by engaging them in their own care and giving them control over their own pain, nausea and discomfort.”

Montgomery said that even patients who are skeptical about or fearful of hypnosis can take advantage of its benefits if they are properly counseled.

“We’re going to tell you that hypnosis is typically not like hypnosis used in television or seen in movies,” hesaid. “Rather, it’s something that we can do together that can help you reduce side effects and you’re really the person in control.”

Not Just for Breast Cancer Surgery

In addition to being effective, hypnosis may also prove to be a versatile tool. The benefits of hypnosis have been shown in previous research to extend to other procedures as well, including gynecological surgery and coronary artery bypass.

Montgomery said he is hopeful that doctors continue to expand the use of hypnosis in other medical applications.

“This could become part of standard care,” he said. However, he added, “it’s not a panacea for everything, but rather a tool in the toolbox that we can use to address specific problems.” Copyright © 2011 ABC News

Other general studies:

  • Astin JA, Shapiro SL, Eisenberg, DM, Forys KL. Mind-body medicine: state of the science, implications for practice. J Am Board Fam Pract. 2003 Mar-Apr;16(2):131-47.
  • Barrows KA, Jacobs BP. Mind-body medicine. An introduction and review of the literature. Med Clin North Am. 2002 Jan;86(1): 11-31.
  • Bertisch SM, Wee CC, Phillips, RS et al. Alternative mind-body therapies used by adults with medical conditions. J Pscyhosom Res 2009 Jn; 66(6):511-9. Epub 2009 Mar 3.
  • Bryant RA, Moulds ML, Guthrie RM, Nixon RD. The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder. J Consult Clin Psychol. 2005 Apr;73(2):334-40.
  • Hellman CJ, Budd M, Borysenko J et all. Used guided imagery with patients who visited health care professionals twice as often as average patients and cut their medical visits 40%. 1990. The Study of the Effectiveness of Two Group Behavioral Medicine Interventions; Behavioral Medicine 1990 (16):165–73.
  • Houghton LA, Calvert EL, Jackson NA, Cooper P, Whorwell PJ. Visceral sensation and emotion: a study using hypnosis. Gut. 2002 Nov;51(5):701-4.
  • Lorig KR, Sobel DS, Stewart AL, Brown Jr BW, Ritter PL, Gonzalez VM, Laurent DD, Holman HR. Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization and costs: A randomized trial. Medical Care, 1999 37(1): 5-14.
  • Lynn, SJ, Kirsch I, et al. Hypnosis as an empirically supported clinical intervention: the state of the evidence and look to the future. Int J Clin Exper Hypnosis 2000. 48:239-259.
  • Mamtani R, Cimino A. A primer of complementary and alternative medicine and its relevance in the treatment of mental health problems. Psychiatr Q. 2002 Winter;73(4): 367-81.
  • McKinney CH, Antoni MH, Kumar M, Tims FC, McCabe PM. Effects of guided imagery and music (GIM) therapy on mood and cortisol in healthy adults. Health Psychol. 1997 Jul;16(4):390-400.
  • Ornish D. (1998) Love & Survival: The Scientific Basis for the Healing Power of Intimacy. New York, NY: HarperCollins.
  • Reibel DK, Greeson JM, Brainard GC, Rosenzweig J. Mindfulness-based stress reduction and health-related qualify of life in a heterogeneous patient population. Gen Hosp Psychiatry, 2001 Jul-Aug;23(4):183-92.
  • Stanford Patient Education Research Center. The Chronic Disease Self-Management Workshop Leaders Manual. Stanford University. 1999.
  • Stetter F, Kupper S. Autogenic training: a meta-analysis of clinical outcome studies. Appl Psychophysiol Biofeedback. 2002 Mar;27(1):45-98.
  • Stewart JH. Hypnosis in contemporary medicine. Mayo Clin Proc. 2005 Apr;80(4):511-24.
  • Toth M, Wolsko PM, et al. A pilot study for a randomized controlled trial on effect of guided imagery on hospitalized medical patients. J Altern Complement Med 2007; 13(20): 194-197.
  • Utay J, Miller m. Guided imagery as an effective therapeutic technique: a brief review of its history and efficacy research. J. Instr Psych. 2006; 33(1): 40-44.
  • Whorwell PJ, Houghton LA, Taylor EE, Maxton DG. Physiological effects of emotion: assessment via hypnosis. Lancet. 1991 Aug 15;340(8816):434.