 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
Clinical Hypnosis May Benefit Pediatric Oncology Patients Undergoing Lumbar Punctures
According to an article recently published in The International Journal of Clinical and Experimental Hypnosis, hypnosis
appears effective in reducing pain and anxiety in children undergoing lumbar punctures, especially if a therapist is
present.
Lumbar puncture, also known as spinal tap, involves the removal of cerebral spinal fluid from the spinal canal. This fluid
contains glucose, proteins, white blood cells, and many other substances that are also found in blood. Doctors use lumbar
punctures to diagnose and monitor many different diseases, including cancers of the spinal cord and brain.
As defined by the American Cancer Society, hypnosis “is a state of restful alertness during which a person can be
relatively unaware of, but not completely blind to, their surroundings”. Hypnosis has been approved by an independent
panel from the National Institutes of Health (NIH) for chronic pain. Several studies have suggested that hypnosis may
alleviate stress, anxiety, and pain, although scientists do not understand exactly how hypnosis works.
According to an article recently published in The International Journal of Clinical and Experimental Hypnosis, hypnosis
appears effective in reducing pain and anxiety in children undergoing lumbar punctures, especially if a therapist is
present.
Lumbar puncture, also known as spinal tap, involves the removal of cerebral spinal fluid from the spinal canal. This fluid
contains glucose, proteins, white blood cells, and many other substances that are also found in blood. Doctors use lumbar
punctures to diagnose and monitor many different diseases, including cancers of the spinal cord and brain.
As defined by the American Cancer Society, hypnosis “is a state of restful alertness during which a person can be
relatively unaware of, but not completely blind to, their surroundings”. Hypnosis has been approved by an independent
panel from the National Institutes of Health (NIH) for chronic pain. Several studies have suggested that hypnosis may
alleviate stress, anxiety, and pain, although scientists do not understand exactly how hypnosis works.
A team of researchers in the psychology department at the University of Wales conducted a controlled clinical trial of 80
pediatric cancer patients between the ages of 6 and 16. Each child received one of four different types of treatment: 1)
direct hypnosis with standard medical treatment, 2) indirect hypnosis with standard medical treatment, 3) attention
control with standard medical treatment, or 4) standard medical treatment alone. Standard medical treatment for all
patients consisted of lumbar puncture.
Patients who underwent hypnosis, direct or indirect, reported less anxiety and pain than their unhypnotized counterparts.
In addition, both forms of hypnosis appeared equally effective. Hypnotized patients were also rated by the investigators as
demonstrating less behavioral distress than the control groups. An important factor associated with the efficacy of
hypnosis was the ease with which a patient could become hypnotized. Unfortunately, self-hypnosis failed to achieve high
therapeutic benefit.
These British researchers concluded that hypnosis appears effective in preparing children with cancer for lumbar puncture.
However, the presence of a therapist appears crucial. Pediatric oncology patients and/or their families may wish to speak
with their physician about the risks and benefits of CAM or about participation in a clinical trial further evaluating CAM
therapies. Three sources of information regarding ongoing clinical trials include the National Cancer Institute’s Office
of Cancer Complementary and Alternative Medicine at http://www3.cancer.gov/occam/trials, the National Center for
Complementary and Alternative Medicine at http://nccam.nih.gov, and eCancerTrials.com. Personalized clinical trial
searches on behalf of patients are also provided at eCancerTrials.com.
Reference: Liossi C, Hatira P. Clinical hypnosis in the alleviation of procedure-related pain in pediatric
oncology patients. The International Journal of Clinical and Experimental Hypnosis. 2003;51:4-28.
pediatric cancer patients between the ages of 6 and 16. Each child received one of four different types of treatment: 1)
direct hypnosis with standard medical treatment, 2) indirect hypnosis with standard medical treatment, 3) attention
control with standard medical treatment, or 4) standard medical treatment alone. Standard medical treatment for all
patients consisted of lumbar puncture.
Patients who underwent hypnosis, direct or indirect, reported less anxiety and pain than their unhypnotized counterparts.
In addition, both forms of hypnosis appeared equally effective. Hypnotized patients were also rated by the investigators as
demonstrating less behavioral distress than the control groups. An important factor associated with the efficacy of
hypnosis was the ease with which a patient could become hypnotized. Unfortunately, self-hypnosis failed to achieve high
therapeutic benefit.
These British researchers concluded that hypnosis appears effective in preparing children with cancer for lumbar puncture.
However, the presence of a therapist appears crucial. Pediatric oncology patients and/or their families may wish to speak
with their physician about the risks and benefits of CAM or about participation in a clinical trial further evaluating CAM
therapies. Three sources of information regarding ongoing clinical trials include the National Cancer Institute’s Office
of Cancer Complementary and Alternative Medicine at http://www3.cancer.gov/occam/trials, the National Center for
Complementary and Alternative Medicine at http://nccam.nih.gov, and eCancerTrials.com. Personalized clinical trial
searches on behalf of patients are also provided at eCancerTrials.com.
Reference: Liossi C, Hatira P. Clinical hypnosis in the alleviation of procedure-related pain in pediatric
oncology patients. The International Journal of Clinical and Experimental Hypnosis. 2003;51:4-28.
Excerpted From the Univerisity of Michigan Health System Online Library
What is Pediatric Hypnotherapy?
As currently practiced, hypnotherapy most often involves teaching a child how to self-
hypnotize in order to control bad habits, physical symptoms, and other conditions. The child
learns to use relaxation techniques and mental images—similar to a daydream or fantasy—
to enter an “altered mental state” (in other words, to induce hypnosis).
Once in this altered state, the therapist makes suggestions aimed at producing the desired
change in behavior, anxiety level, or symptom intensity. These may range from recalling
times of feeling happy and well in a child with chronic pain, to thinking of the body as a
“computer” that the child can “program” with his or her mind.
The child may also receive specific teaching about their problem as a means of helping them
learn to exercise control over their body. For example, a child with nocturnal enuresis (bed-
wetting) may be taught the basic anatomy and function of the bladder. Ultimately, the child
is able to induce self-hypnosis when needed to achieve the desired changes.
What is the history of using hypnosis with children?
Hypnosis of children was first described in 1779 by Mesmer, who reportedly used
hypnotherapy to treat a child with visual problems. Historically, hypnotherapy was rarely
practiced with children, because people thought that children could not be hypnotized. In the
1970's, however, observations suggested that children were easier to hypnotize than adults,
and that hypnosis could be used in the treatment of behavioral and physical problems in
children
What are some uses of hypnotherapy in children?
Hypnotherapy has been used to treat hundreds of behavior disorders, chronic diseases, and
pain and discomfort. Here's a partial list:
Behavior problems
What is Pediatric Hypnotherapy?
As currently practiced, hypnotherapy most often involves teaching a child how to self-
hypnotize in order to control bad habits, physical symptoms, and other conditions. The child
learns to use relaxation techniques and mental images—similar to a daydream or fantasy—
to enter an “altered mental state” (in other words, to induce hypnosis).
Once in this altered state, the therapist makes suggestions aimed at producing the desired
change in behavior, anxiety level, or symptom intensity. These may range from recalling
times of feeling happy and well in a child with chronic pain, to thinking of the body as a
“computer” that the child can “program” with his or her mind.
The child may also receive specific teaching about their problem as a means of helping them
learn to exercise control over their body. For example, a child with nocturnal enuresis (bed-
wetting) may be taught the basic anatomy and function of the bladder. Ultimately, the child
is able to induce self-hypnosis when needed to achieve the desired changes.
What is the history of using hypnosis with children?
Hypnosis of children was first described in 1779 by Mesmer, who reportedly used
hypnotherapy to treat a child with visual problems. Historically, hypnotherapy was rarely
practiced with children, because people thought that children could not be hypnotized. In the
1970's, however, observations suggested that children were easier to hypnotize than adults,
and that hypnosis could be used in the treatment of behavioral and physical problems in
children
What are some uses of hypnotherapy in children?
Hypnotherapy has been used to treat hundreds of behavior disorders, chronic diseases, and
pain and discomfort. Here's a partial list:
Behavior problems
- Habit/tic disorders including thumb-sucking 2 , trichotillomania (hair-pulling)
Tourette's Syndrome. (Evidence is currently limited to several small studies and case
reports (reports of successful therapy in a few individuals, without comparison to
another therapy). - Nocturnal enuresis (bedwetting). (Evidence includes case reports as well as one clinical
trial, in which hypnotherapy was shown to be more effective than medication.) - Sleep terrors, nightmares, and other sleep disturbances. (Evidence is limited to case
reports.) - Swallowing problems, food aversions, and choking (not related to anatomic problems or
disease. (Evidence is limited to case reports.) - Anxiety and stress.
- Asthma. (Case reports suggest that hypnotherapy may reduce episodes of wheezing or
shortness of breath, and may decrease reliance on asthma medications.) - Cystic Fibrosis (CF. (A study in adults and children with CF suggests that
hypnotherapy can reduce symptoms of cough, shortness of breath, anxiety, and other
problems commonly faced by these patients.) - Control of pain, treatment and medical procedure discomfort and other symptoms:
Chronic pain in cancer patients. (Initial results from small studies showing that
hypnotherapy can be used to manage chronic pain in children with cancer; larger studies
are likely underway.)
- Nausea and vomiting in chemotherapy. (Several studies comparing hypnotherapy to
anti-nausea medications and simple relaxation techniques show that hypnotherapy plus
medications was more effective than medications alone in reducing nausea and
vomiting. Children treated with hypnotherapy had less pre- and post-chemotherapy
nausea and vomiting.) - Treatments: pill-swallowing, injections, and medical procedures. (Hypnosis has been
shown to be very effective in helping children through painful procedures like shots, IV
pokes, even spinal taps and bone marrow studies.)
| Pediatric Hypnosis Utilized at Pediatric Pulmonary Center Instruction in self-hypnosis is helpful in the management of pediatric patients with respiratory problems such as asthma, chest pain, cystic fibrosis, dyspnea, end-stage lung disease, habit cough, hyperventilation, sighing, and vocal cord dysfunction (Anbar, 2000; Anbar, 2001; Anbar, 2002; Anbar & Hall, 2004; Anbar & Hehir, 2000; Hackman, Stern, & Gershwin, 2000). Further, it has been shown that over half of adolescents referred to Pediatric Pulmonary Centers may benefit from psychological intervention (Anbar, 2005). Therefore, referral to individuals specializing in clinical hypnosis (such as developmental-behavioral pediatricians, psychiatrists, psychologists, or social workers) can be useful. One disadvantage of such a referral to individuals outside of Pulmonary Centers is that they may have little experience with respiratory problems that could be amenable to clinical hypnosis. Also, patients may resist referral to mental health providers because they may not believe they have issues amenable to psychologically oriented therapy. Patients referred for clinical hypnosis included those thought to have pulmonary symptoms attributable to psychological problems or concerns, (e.g., habit cough or anxiety-induced dyspnea as described by Anbar (2005), or fear of medical procedures). Patients were instructed in self-hypnosis by the social worker in 30-60 minute sessions. A typical session consisted of the following: (I) A pre-hypnotic interview about the presenting complaints. (II) An explanation regarding the nature and utility of hypnosis, and concerns or misconceptions regarding hypnosis were addressed. (III) A hypnotic induction and deepening based on patients' aptitude and preferences. For example, an induction might have included imagery of helium balloons levitating an arm, imagining inhalation of air that was the patients' favorite color, imagining a favorite place, or relaxation of muscle groups progressively from head to toes or toes to head. Indications that patients were in hypnosis included observation of eyelid fluttering, catalepsy, and slowed respiration. (IV) Teaching patients to relax with the aid of hypnosis. For example, this was accomplished by asking some of the patients to focus on what they might perceive with each of their senses in their favorite place. Some were instructed in how to employ imagery specific to their symptom with methods such as changing the appearance of their airways from abnormal to healthy. Generally, patients were taught a triggering gesture that would cue their relaxation response, (e.g., touching an index finger to their thumb on one hand after that had been paired with relaxation). (V) Following hypnosis sessions, the experience was discussed with the patients, and validated by encouraging them to use their triggering gesture to cue relief after the session. Typically, patients were encouraged to practice their self-hypnosis techniques on a nightly basis for at least two weeks. They were reminded that improvements with hypnosis can take time and that with practice further improvement could be expected (Anbar, 2000; Anbar, 2001; Anbar, 2002; Anbar & Hall, 2004). American Journal of Clinical Hypnosis, Jul 2005 by Anbar, Ran D, Hummell, Kim E |
For specific questions regarding pediatric hypnotherapy, please call me (734) 693-5794, or use the Informational Packet link here to request specific information about the uses of pediatric hypnosis. Please note someplace on the form you are seeking information regarding pediatric hypnosis so the information you are seeking can be promptly sent to you. Pediatric cancer patients: I have worked with pediatric cancer patients for pain management and healing visualization. If this is the type of information you are seeking, the preferred method of contact in this case is by telephone. Referrals from your child's physician or mental health provider will be required at the Initial Consultation and ongoing communication with your child's physician and/or mental health provider or social worker is necessary for the duration of pediatric hypnosis programs. |
| Advocates of Hypnosis Association (AMA) Association (ADA) Health, 1996: Hypnosis is an effective intervention for alleviating pain from cancer and other chronic conditions. Complimentary and Alternative Medicine (NCCAM) Stanford School of Medicine Harvard University Medical Center |
ADDITIONAL RECOMMENDED READING
- Abbot NC, Stead LF, White AR, et al. Hypnotherapy for smoking cessation. Cochrane Database Syst Rev 2000;
(2):CD001008. - Anbar RD. Self-hypnosis for anxiety associated with severe asthma: a case report. BMC Pediatr 2003;3(1):7.
- Anbar RD, Hall HR. Childhood habit cough treated with self-hypnosis. J Pediatr 2004;144(2):213-217.
- Baglini R, Sesana M, Capuano C. Effect of hypnotic sedation during percutaneous transluminal coronary
angioplasty on myocardial ischemia and cardiac sympathetic drive. Am J Cardiol 2004;93(8)1035-1038. - Brodie EA. A hypnotherapeutic approach to obesity. Am J Clin Hypnosis 2002;164(3):211-215.
- Bryant RA, Moulds ML, Guthrie RM. The additive benefit of hypnosis and cognitive-behavioral therapy in
treating acute stress disorder. J Consult Clin Psychol 2005;73(2):334-340. - Bryant RA, Somerville E. Hypnotic induction of an epileptic seizure: a brief communication. Int J Clin Exp
Hypn 1995;43(3):274-283. - Butler LD, Symons BK, Henderson SL, et al. Hypnosis reduces distress and duration of an invasive medical
procedure for children. Pediatrics 2005;115(1):77-85. - Calvert EL, Houghton LA, Cooper P, et al. Long-term improvement in functional dyspepsia using
hypnotherapy. Gastroenterol 2002;123(6):1778-1785. - Cyna AM. Hypno-analgesia for a labouring parturient with contra-indications to central neuraxial block.
Anaesthesia 2003;58(1):101-102. - Cyna AM, McAuliffe GL, Andrew MI. Hypnosis for pain relief in labour and childbirth: a systematic review. Br
J Anaesth 2004;93(4):505-511. - Davoli M, Minozzi S. Summary of systematic revisions of the efficacy of smoking cessation therapy [Article
in Italian]. Epidemiol Prev 2002;Nov-Dec, 26(6):287-292. - Gay MC, Philippot P, Luminet O. Differential effectiveness of psychological interventions for reducing
osteoarthritis pain: a comparison of Erikson [correction of Erickson] hypnosis and Jacobson relaxation. Eur
J Pain 2002;6(1):1-16. - Ginandes C, Brooks P, Sando W, et al. Can medical hypnosis accelerate post-surgical wound healing?
Results of a clinical trial. Am J Clin Hypn 2003;Apr, 45(4):333-351. - Gonsalkorale WM, Houghton LA, Whorwell PJ. Hypnotherapy in irritable bowel syndrome: a large-scale audit
of a clinical service with examination of factors influencing responsiveness. Am J Gastroenterol 2002;97(4):
954-961. - Green JP, Lynn SJ. Hypnosis and suggestion-based approaches to smoking cessation: an examination of
the evidence. Int J Clin Exp Hypn 2000;48(2):195-224. - Houghton LA, Calvert EL, Jackson NA, et al. Visceral sensation and emotion: a study using hypnosis. Gut
2002;Nov, 51(5):701-704. - Kircher T, Teutsch E, Wormstall H, et al. Effects of autogenic training in elderly patients. [Article in German].
Z Gerontol Geriatr 2002;Apr, 35(2):157-165. - Kirsch I, Montgomery G, Sapirstein G. Hypnosis as an adjunct to cognitive-behavioral psychotherapy: a
meta-analysis. J Consult Clin Psychol 1995;63(2):214-220. - Lang EV, Laser E, Anderson B, et al. Shaping the experience of behavior: construct of an electronic
teaching module in nonpharmacologic analgesia and anxiolysis. Acad Radiol 2002;Oct, 9(10):1185-1193. - Langenfeld MC, Cipani E, Borckardt JJ. Hypnosis for the control of HIV/AIDS-related pain. Int J Clin Exp Hypn
2002;50(2):170-188. - Langlade A, Jussiau C, Lamonerie L, et al. Hypnosis increases heat detection and heat pain thresholds in
healthy volunteers. Reg Anesth Pain Med 2002;Jan-Feb, 27(1):43-46. - Liossi C, Hatira P. Clinical hypnosis in the alleviation of procedure-related pain in pediatric oncology
patients. Int J Clin Exp Hypn 2003;Jan, 51(1):4-28. - Mehl-Madrona LE. Hypnosis to facilitate uncomplicated birth. Am J Clin Hypn 2004;46(4):299-312.
- Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A randomized controlled clinical trial of a hypnosis-
based treatment for patients with conversion disorder, motor type. Int J Clin Exp Hypn 2003;Jan, 51(1):29-50. - Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A randomized controlled clinical trial on the additional
effect of hypnosis in a comprehensive treatment programme for in-patients with conversion disorder of the
motor type. Psychother Psychosom 2002;Mar-Apr, 71(2):66-76. - Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A randomized controlled clinical trial of a hypnosis-
based treatment for patients with conversion disorder, motor type. Int J Clin Exp Hypn 2003;51(1):29-50. - Montgomery GH, David D, Winkel G, et al. The effectiveness of adjunctive hypnosis with surgical patients: a
meta-analysis. Anesth Analg 2002;94(6):1639-1645. - Montgomery GH, DuHamel KN, Redd WH. A meta-analysis of hypnotically induced analgesia: how effective is
hypnosis? Int J Clin Exp Hypn 2000;48(2):138-151. - Montgomery GH, Weltz CR, Seltz M, Bovbjerg DH. Brief presurgery hypnosis reduces distress and pain in
excisional breast biopsy patients. Int J Clin Exp Hypn 2002;Jan, 50(1):17-32. - Moore R, Brodsgaard I, Abrahamsen R. A 3-year comparison of dental anxiety treatment outcomes:
hypnosis, group therapy and individual desensitization vs. no specialist treatment. Eur J Oral Sci 2002;110
(4):287-295. - National Institutes of Health Consensus Development Program. Integration of behavioral and relaxation
approaches into the treatment of chronic pain and insomnia. NIH Technol Statement Online 1995;Oct 16-18:1-
34. - Page RA, Handley GW, Carey JC. Can devices facilitate a hypnotic induction? Am J Clin Hypn 2002;Oct, 45(2):
137-141. - Palsson OS, Turner MJ, Johnson DA, et al. Hypnosis treatment for severe irritable bowel syndrome:
investigation of mechanism and effects on symptoms. Dig Dis Sci 2002;Nov, 47(11):2605-2614. - Simren M, Ringstrom G, Bjornsson ES, et al. Treatment with hypnotherapy reduces the sensory and motor
component of the gastrocolonic response in irritable bowel syndrome. Psychosom Med 2004;66(2):233-238. - Staplers LJ, da Costa HC, Merbis MA, et al. Hypnotherapy in radiotherapy patients: a randomized trial. Int J
Radiat Oncol Biol Phys 2005;61(2):499-506. - Tal M, Sharav Y. Jaw clenching modulates sensory perception in high- but not in low-hypnotizable subjects.
J Orofac Pain 2005;19(1):76-81. - Younus J, Simpson I, Collins A, Wang X. Mind control of menopause. Womens Health Issues 2003;Mar-Apr,
13(2):74-78. - Zeltzer LK, Tsao JC, Stelling C, et al. A phase I study on the feasibility and acceptability of an
acupuncture/hypnosis intervention for chronic pediatric pain. J Pain Symptom Manage 2002;Oct, 24(4):437-
446. - Zsombok T, Juhasz G, Budavari A, et al. Effect of autogenic training on drug consumption in patients with
primary headache: an 8-month follow-up study. Headache 2003;Mar, 43(3):251-257.
| Ann Catherine Pawelczyk, C.Ht. Farmington Hills, Michigan Location Serving SE Michigan & Surrounding Areas Business (734) 693-5794 |
| Business Hours 7 days by Appointment |