7. Utilizations

Single case studies confirming hypnosis as a beneficial treatment option are about as numerous as there are human diseases. However, only a select few diseases have been empirically proven to consistently benefit from hypnosis, and, in most of them, hypnosis is shown to be most beneficial as an adjunct to more mainstream treatment modalities [Kirsch et al. (1995)].

The utilization of hypnosis in clinical practice may be divided in 4 groups of disorders: (1) physical disorders, (2) psychosomatic disorders, (3) psychological disorders, and (4) psychiatric disorders.





7.1. PHYSICAL DISORDERS
Physical disorders are conditions of the body with clearly definable physical symptoms and clearly definable biologic etiologies.

The physical disorders that have been empirically proven to respond beneficially to hypnosis include: (1) pain, and (2) nausea and vomiting.

7.1.1. Pain
Hypnosis has been conclusively proven to effectively reduce both pain and opioid analgesic drugs use in susceptible patients suffering from pain conditions [Hawkins (2001)]. As to its effectiveness in isolated pain conditions, hypnosis, either alone or as an adjunct to conventional analgesic drugs, has been shown to be particularly useful in cancer palliation [Sellick and Zaza (1998)], obstetric complications and labor [Smith et al. (2006)], and invasive surgical procedures [Patterson and Jensen (2003)]. Hypnosis has also been shown useful in patients suffering from chronic headache and migraine, though to a lesser degree than that of the other pain conditions mentioned above [Patterson and Jensen (2003)].

7.1.2. Nausea and vomiting
Hypnosis has been conclusively proven to effectively reduce both nausea and vomiting in susceptible patients [Richardson et al. (2007)]. As to its effectiveness in isolated conditions, hypnosis has been shown to be particularly useful in nausea and vomiting due to cancer chemotherapy [Marchioro et al. (2000)].


7.2. PSYCHOSOMATIC DISORDERS
Psychosomatic disorders are conditions of the body with clearly identifiable physical symptoms, but without any clearly identifiable biologic etiologies. Instead, psychosomatic disorders show obvious influences of thought patterns on the pathogenesis and exacerbation of these conditions.

The psychosomatic disorders that have been empirically proven to respond beneficially to hypnosis include: (1) irritable bowel syndrome, (2) bronchial asthma, (3) atopic dermatitis, (4) psoriasis, and (5) cutaneous warts.

7.2.1. Irritable bowel syndrome
Hypnosis has been conclusively proven to effectively reduce both abdominal pain, bloating and frequency of bowel movements in susceptible patients suffering from irritable bowel syndrome [Talley et al. (1996)]. As patients suffering from irritable bowel syndrome usually fail to respond to conventional treatment outside the realm of symptomatic measures, hypnosis should be considered much more often as a mainstream treatment option in these patients.

7.2.2. Bronchial asthma
Hypnosis has been conclusively proven to effectively reduce both dyspnea and bronchodilator drug use in susceptible patients suffering from bronchial asthma [Maher-Loughnan et al. (1962)]. Furthermore, hypnosis has also been shown to substantially increase both pulmonary functioning and forced expiratory volume 1, or “FEV1”, in such patients [Ewer and Stewart (1986)].

7.2.3. Atopic dermatitis
Hypnosis has been shown to decrease both itching, scratching and topical glucocorticoid anti-inflammatory drug use in susceptible patients suffering from atopic dermatitis [Stewart and Thomas (1995)]. This finding is in line with similar studies showing the efficacy of hypnosis in related conditions such as bronchial asthma.

7.2.4. Psoriasis
Hypnosis has also been shown to decrease both the size and number of psoriatic plaques in susceptible patients suffering from psoriasis [Tausk and Whitmore (1999)].

7.2.5. Cutaneous warts
Hypnosis has been shown to decrease both the size, amount and number of new eruptions of cutaneous warts in patients suffering from verruca vulgaris [Spanos et al. (1990)]. However, more mainstream treatment modalities such as keratolysis and cryosurgery seem to be more effective than hypnosis alone. As there is yet to be a study on the additive effect on hypnosis to either of these treatment modalities, hypnosis as a means of cutaneous wart removal is still largely ignored within the medical community as a whole.


7.3. PSYCHOLOGICAL DISORDERS
Psychological disorders are conditions of the mind in which the thought patterns are normal, but clearly unbeneficial for the patients suffering from them.

The psychological disorders that have been empirically proven to respond beneficially to hypnosis include: (1) smoking, and (2) overeating and obesity.

7.3.1. Smoking
Hypnosis has been shown to increase the probability of smoking cessation in susceptible patients [Green and Lynn (2000)]. However, more mainstream treatment modalities such as behavioral therapy and trans-dermal nicotine patches seem to be more effective than hypnosis alone. As there is yet to be a study on the additive effect on hypnosis to either of these treatment modalities, hypnosis as a means of smoking cessation is still highly debated within the medical community as a whole.

7.3.2. Overeating and obesity
Hypnosis, as an adjunct to mainstream treatment modalities such as behavioral therapy and cognitive-behavioral therapy, has been proven superior to either of these treatment modalities alone in the treatment of susceptible patients suffering from obesity [Kirsch (1996)]. The addition of hypnosis to these regiments have shown to provide both increased weight loss and more sustained weight loss over time compared to either of these regiments in isolation [Bolocofsky et al. (1985)].


7.4. PSYCHIATRIC DISORDERS
Psychiatric disorders are conditions of the mind in which the thought patterns are clearly diseased.

The psychiatric disorders that have been empirically proven to respond beneficially to hypnosis include: (1) anxiety disorders, (2) somatoform disorders, (3) depressive disorders, (4) eating disorders, and (5) sleep disorders.

7.4.1. Anxiety disorders
Hypnosis, as an adjunct to cognitive-behavioral therapy, has been proven superior to cognitive-behavioral therapy alone in the treatment of susceptible patients suffering from anxiety and anxiety disorders. As to its effectiveness in isolated anxiety disorders, hypnosis has been shown to be particularly useful in social phobias [Schoenberger et al. (1997)], specific phobias [Somer (1995)], acute stress disorder [Bryant et al. (2005)], and post-traumatic stress disorder [Brown and Fromm (1986)]. Of particular interest here is post-traumatic stress disorder, in which dissociation is both one of the proposed mechanisms of hypnosis as well as one of the proposed pathomechanisms of post-traumatic stress disorder.

7.4.2. Somatoform disorders
Hypnosis, as an adjunct to cognitive-behavioral therapy, has been proven superior to cognitive-behavioral therapy alone in the treatment of susceptible patients suffering from somatoform disorders. As to its effectiveness in isolated somatoform disorders, hypnosis has been shown to be particularly useful in conversion disorder [Moene et al. (2003)]. Hypnosis has also been shown useful in somatization disorder, though to a lesser degree than that of conversion disorder [Moene et al. (2003)].

7.4.3. Depressive disorders
Hypnosis, as an adjunct to cognitive-behavioral therapy, has been proven superior to cognitive-behavioral therapy alone in the treatment of susceptible patients suffering from depression and depressive disorders [Alladin and Alibhai (2007)]. However, due to the relative neglect of hypnosis as a viable treatment modality for depressive disorders, there are still a lot of questions in need of answering before hypnosis can be instated as a valid treatment choice for these patients.

7.4.4. Eating disorders
Hypnosis, as an adjunct to cognitive-behavioral therapy, has been proven superior to cognitive-behavioral therapy alone in the treatment of susceptible patients suffering from eating disorders. As to its effectiveness in isolated eating disorders, hypnosis has been shown to be particularly useful in bulimia nervosa [Vanderlinden and Vandereycken (1990)]. Hypnosis has also been shown useful in anorexia nervosa, though to a lesser degree than that of bulimia nervosa [Moene et al. (2003)]. However, this should not come as a surprise as anorexia nervosa is notoriously hard to treat even with mainstream treatment modalities.

7.4.5. Sleep disorders
Hypnosis has been conclusively proven to increase both the quality and duration of sleep in susceptible subjects suffering from sleep disorders. As to its effectiveness in isolated sleep disorders, hypnosis has been shown to be particularly useful in insomnia [Silber (2001)] and parasomnias, including both sleep walking disorder and sleep terror disorder [Hurwitz et al. (1991)]. In the case of insomnia, hypnosis alone has been shown to even be more efficacious than conventional treatment modalities such as benzodiazepine hypnotic drugs [Anderson et al. (1979)].





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