Research studies on hypnotherapy for asthma


Published research on hypnotherapy for asthma
Critical reviews and letters

NOTE TO RESEARCHERS AND THERAPISTS
The list is in chronological order of publication rather than in alphabetical order of authors as one of its aims is to provide an indication of the development of research over the years. Text below which set in green indicates links or a downloadable pdf.

Time and effort has been given to trying to ensure information about papers and other publications listed here is accurate and as comprehensive as possible. Therefore if you notice errors – or are aware of additional studies which could be appropriately included within this page – please contact us by emailing info@therapypartnership.com Such help will be appreciated
.


 


The information on this page cataloguing research studies in the use of hypnotherapy for asthma can be downloaded as a PDF file by clicking the logo below

asthma research link

This page was last updated   29th February 2016

1941

Psychosom. Med. Monog. Ser – 1941 2 34
Psychogenic factors in broncial asthma.
French, T. and Alexander, F.  

Psychosomatic Medicine – 1941 3 349 
The emotional settings of some attacks of urticaria.
Saul, L.J., and Bernstein, G., Jr.

1949

B J Med Hypnotism – 1 (2), 14-18.
The hypnotic treatment of bronchial asthma.
Marchesi C.   Citation 

1957

Journal of Psychosomatic Medicine – 1957 19
Sources of tension in bronchial asthma
Knapp, P.H. & Nemetz, S.J

1959

American Journal of Clinical Hypnosis – 1959; 1 124-29
Hypnosis in Children: The Complete Cure of 40 Cases of Asthma. 
Diamond, H.H. 
LINK:
This paper was originally presented by the physician, an instructor at George Washington University Medical School, at the First Annual Meeting of the American Society of Clinical Hypnosis in 1958. He treated 55 cases, beginning in 1954, with 40 having complete remission. He gives 3 case histories where early childhood experiences gave rise to the asthma, and the symptoms were quickly relieved when the repressed material was reviewed by the patient.

1960

May 5, 1960  Paper read before the Pan American Medical Association
Hypnosis in the treatment of asthma
MacLaren, W.R., and Eisenberg, B.C. 

British Medical Journal – 1960 Aug 13; 5197:492-7
Hypnotic treatment of asthma

Edwards, G.     Citation 

Int. J. Clin. Exp. Hypn. 1960 8(2) 121-8
Hypnosis in asthma.
Magonet, A.P.    
Author''s Conclusion & Link:
"Asthma is a symptom in which personality disturbances are due to psychogenic factors, therefore there must be a return to the treatment of the sick patient instead of the symptoms from which he suffers. If we are to carry out treatment effeciently, we cannot afford to neglect any aspect of the patient''s personality. The patient has a mind and the patient has a body, but we must also think of him as a social being in relation to this personal and material environment"

British Medical Journal – 1960 2 1651-2
Treatment of status asthmaticus by hypnosis.  
Sinclair-Gieben, A.H.C. Citation |  Link to full text
SUMMARY & LINK:
A case is described of severe status asthmaticus in a man of 60 who was apparently dying. His condition responded dramatically to hypnosis. Theoretical implications are discussed.
Final Note.-A few days after discharge the patient died suddenly of acute heart failure. At the time there was no wheezing or bronchospasm, and his asthma had been minimal since discharge. Permission for ostmortem examination was not obtained, and the cause of death was not firmly established.  

Br. J. Dis. Chest. – 1960 54 78
The treatment of asthmatic children by hypnotic suggestion.  
Smith, J.M. and Burns, C.L.   
Citation 

1962

British Medical Journal – 1962 Aug 11; 2(5301) 371-6
Controlled trial of hypnosis in the symptomatic treatment of asthma.
Maher-Loughnan GP, Mason AA,  MacDonald N, Lionel Fry
LINK:
This controlled study was conducted at three centres over a 12 month periiod and the results showed a great symptomatic improvement in the hypnotherapy group in that the wheezing was reduced on an average by about half within three months while there was very little alteration in the condition of the control group.  The study concluded: "“Despite the many questions yet to be answered, hypnosis is of value in the symptomatic treatment of asthma as assessed by the reduction in wheezing and in the use of drugs.

1964

British Medical Journal 1964 May 2; 1(5391): 1145–1148.6
Effect of Hypnosis on Allergic Skin Responses in Asthma and Hay-fever.
Lionel Fry, A. A. Mason, and R. S. Bruce Pearson.    Citation 
Summary & Link:
Forty-seven subjects with known skin sensitivity to pollen and/or house-dust were divided into five groups and tested with four strengths of allergen. The prick-test method was employed.
In the first part of the investigation a group of unhypnotized subjects were compared with a group who had suggestions made under hypnosis that their skin reactions to the allergen would not occur when tested a second time. A significant diminution
in the size of the weal was obtained in the hypnosis group at the lower two strengths of allerge
n. In the second part of the investigation the subjects were divided into three groups. All were hypnotized, no suggestions regarding skin reactions were given to one group, the second group were given suggestions that only on one arm would the skin reactions be less or not recur, and in the third group the suggestion was made about the reactions on both arms. There was found to be a similar decrease in the response to prick-tests after hypnosis in all three groups.

Med J Malaysia – 1964 Jun;18:232-4.
Treatment of asthma by hypnotherapy
Chong, T.M.  
Citation 

1967


1968

American Journal of Clinical Hypnosis – 1968; 11 6
Hypnotherapy in the management of asthma
Collison, D.R.     
ABSTRACT & LINK::
Following a brief history of the use of hypnosis in the management of asthma, hypnotherapy with 20 ambulant non-hospitalised patients is described. Of 7 females and 13 males, 11 had an excellent response, 5 a good response, and 4 a poor response.

Can Med Assoc J  – 1968 Dec 21; 99(24): 1212
Hypnosis for asthma   
Gilder SS  Citation 

1969

Psychosomatic Medicine – 1969 Mar-Apr; 31(2): 134-143
The mechanism of action of suggestion in the induction of acute asthma attacks
McFadden, Luparello, Lyons, & Bleeker.  
Citation 

Singapore Med J. – 1969 Sep; 10(3) 182-6 
The value of hypnotherapy as an adjunct in the treatment of bronchial asthma
Chong, T.M.  
LINK TO FULL TEXT
"Hypnotherapy is of value as an adjunct in the prevention of future attacks of asthma. It has also been shown to be a useful adjunct in other branches of medicine by the author elsewhere."

Japan J. Hypn. 1969; 12 33
Use and abuse of hypnotherapy for bronchial asthma
Kusano, T., et al.   

1970

International Journal of. Clinical & . Experimental. Hypnosis –. 1970 Jan; 18(1) 1-14  
Hypnosis and autohypnosis for the treatment of asthma
Maher-Loughnan, G.P. 
ABSTRACT: & LINK:
Conducted two controlled studies into the use of hypnosis in 252 asthma patients. Several different control procedures were used. Methods and results were summarized, and the same conclusion was reached: That hypnosis supplemented by autohypnosis was significantly more effective than control procedures. An outline is given of details of treatment methods. A current analysis of Ss involving up to 6 yr. of follow-up, is presented to provide a working guide to the regime in regular practice. To be fully effective hypnosis should be employed before steroids are started. Steroid-dependent asthma is rarely totally relieved by hypnotherapy.

Journal of Asthma – Vol 37, Issue 1 February 2000 , pages 1 - 15 
Hypnosis and Asthma: A Critical Review
Robert M. Hackman; Judith S. Stern; M. Eric Gershwin
ABSTRACT:& LINK:
Asthma is among the most common chrome diseases of the western world and has significant effects on patients' health and quality of life. Asthma is typically treated with pharmaceutical products, but there is interest in finding nonphar-maceutical therapies for this condition. Hypnosis has been used clinically to treat a variety of disorders that are refractive to pharmaceutical-based therapies, including asthma, but relatively little attention has been given recently to the use of clinical hypnosis as a standard treatment for asthma. Significant data suggest that hypnosis may be an effective treatment for asthma, but it is premature to conclude that hypnosis is unequivocally effective. Studies conducted to date have consistently demonstrated an effect of hypnosis with asthma. More and larger randomized, controlled studies are needed.
Existing data suggest that hypnosis efficacy is enhanced in subjects who are susceptible to the treatment modality, with experienced investigators, when administered over several sessions, and when reinforced by patient autohypnosis. Children in particular appear to respond well to hypnosis as a tool for improving asthma symptoms.

Psychosomatic Medicine – 1970 Sep-Oct; 32(5):509-13. 
The interaction of psychologic stimuli and pharmacologic agents on airway reactivity in asthmatic subjects
Luparello, Leist, Lourie, & Sweet.   
ABSTRACT: & LINK:
Two bronchoactive substances, isoproterenol and carbachol were presented by inhalation to 20 asthmatic subjects in a double blind study. Each drug was given under two conditions: in one case, the subject was told the drug was a bronchodilator; in the other, he was told it was a bronchoconstrictor. The bronchodilator effect of isoproterenol was greater when the subject was told it was a bronchodilator than when told it was a bronchoconstrictor. Similarly, the bronchoconstricting effect of carbachol was greater when the subject was told it was a bronchoconstrictor than when told it was a bronchodilator.

1971

American. Journal of. Clinical. Hypnosis –. 1971 13(3) 162-8
The use of hypnosis and behavior therapy in asthma
Moorefield, C.W.  
ABSTRACT & LINK::
Nine patients with asthma were treated with hypnosis and behavior therapy. All of these patients showed subjective improvement to a rather marked degree, except for one patient who has had three slight attacks of asthma since the onset of her treatment. These patients have been followed from eight to approximately 24 months. The results so far have been rather encouraging and the author believes this form of treatment will prove to be of benefit in the treatment of asthma and possibly many other related conditions.

1972

Psychosomatic Medicine – 1972 Sep-Oct; 34(5):388-94.
The immediate effects of systematic relaxation training on peak expiratory flow rates in asthmatic children
Alexander, Miklich, & Hershikoff.  
ABSTRACT & LINK:
Clinical experience has often suggested that having asthmatic patients sit quietly and/or relax during asthma attacks is helpful. The present study was an attempt to provide a controlled experimental demonstration of the effect of systematic relaxation on peak expiratory flow rate in asthmatic children. Eighteen male and 18 female asthmatic children were divided into two groups matched for mean age, sex composition and asthma severity. One group of subjects underwent three sessions of modified Jacobsonian systematic relaxation training, while the second group sat quietly for three sessions. Peak expiratory flow rate measures were obtained prior to and following each session. It was found that relaxation subjects manifested a significant mean increase in peak expiratory flow rate over sessions compared to a nonsignificant mean peak expiratory flow decrease for control subjects. It was suggested that these results have important implications both for the clinical treatment and the understanding of bronchial asthma.

1974

American Journal of Clinical Hypnosis, – Vol 16(4), Apr 1974, 275-279.
Individualized hypnotherapy of asthma
Hanly, F.W. 
Citation 
Describes two cases in which asthma was treated with an individualised hypnotherapeutic approach. 
Asthma is a respiratory disease characterized by an increased irritability of the bronchial tubes leading to bronchospasm and increased secretion of mucus. Emotional states may affect the level of irritability.

1975

Annals of Allergy  – 1975 Jun; 34(6) 356-62
Hypnotherapy in the treatment of bronchial asthma.

Aronoff, G.M., Aronoff, S. & Peck, L.    
ABSTRACT & LINK:
The efficacy of hypnotherapy in aborting acute asthmatic attacks was studied in 17 children ranging in age from six to 17. All had as their primary diagnosis bronchial asthma. Prior to hypnotic induction pulmonary function was assessed, then monitored in the immediate post hypnotic period and at two intervals thereafter. The average improvement for all subjects was greater than 50% above the baseline measurement as documented by spirometry, monitored dyspnea, wheezing and subjective ratings by the subjects.
It is suggested that hypnotherapy may be an important tool in ameliorating asthma, improving ventilatory capacity and promoting relaxation without recourse to pharmacologic agents. One explanation offered is that hypnosis affects an automic response, thereby diminishing bronchospasm.

Med J Aust.  – 1975 Jun 21; 1(25): 776-81.
Which asthmatic patients should be treated by hypnotherapy? 
Collison, D.R. 
ABSTRACT & LINK:
Certain patients with bronchial asthma can benefit, often greatly, from hypnotherapy. This report is based on a retrospective analysis of 121 asthmatic patients who were treated by hypnotherapy. Hypnotic techniques and treatment procedure are described. Of the total number, 21% had an excellent response to treatment, becoming completely free from asthma and requiring no drug therapy. A further 33% had a good response, with worthwhile decrease in frequency and severity of the attacks of asthma, or a decrease in drug requirements. About half of the 46% who had a poor response had a marked subjective improvement in general well-being. Statistical evaluation of the six variables (age, sex, result, trance depth, psychological factors and severity of the asthma) confirmed the clinical impression that the ability to go into a deep trance (closely associated with the youthfulness of the subject) gives the best possibility of improvement, especially if there are significant aetiological psychological factors present and the asthma is not severe. Subjective improvement in well-being and outlood is a potential outcome at all age levels, independent of severity of the illness or entranceability of the patient.

1978

Pediatrics – Vol. 62 No. 2 August 1, 1978 pp. 228 -233
Some Guidelines for Uses of Hypnotherapy in Pediatrics

Karen Olness, G. Gail Gardner    
ABSTRACT:
Hypnotherapy has many uses in pediatrics, and its value, not only as an adjunct but also as a primary therapy for certain conditions, justifies its inclusion in pediatric training programs. Suggestion and expectation have long been related to therapeutic outcomes in medicine, but not all physicians know how to apply them constructively and systematically in communication with patients. In pediatrics there is a tendency to overlook opportunities in which hypnosis might be the treatment of choice.
Because children engage in imagination and fantasy easily without the cognitive inhibitions of adults, they are able to use hypnosis more readily than adults. More research into the imaginative skills of children may facilitate understanding of learning mechanisms and make it possible for professionals to prevent the loss of the natural imaginative capacities in children and, therefore, enhance the ability of mature members of society to use these skills.
In addition to reduction of specific symptoms through hypnotherapy, children benefit by the sense of mastery which they acquire, a sense which is surely needed to overcome the feelings of hopelessness, loss of control, and depression induced by many diagnostic and therapeutic procedures in medicine.


1979

Journal of Abnormal Psychology, Volume 88, issue 5 (October 1979), p. 490-505.
Stress, disease, psychotherapy, and hypnosis.
Bowers, Kenneth S.; Kelly, Paul
LINK
Presents evidence for the importance of suggestion and hypnotic ability in the healing or amelioration of various somatic disorders. It is argued that even in some treatment interventions that are not explicitly hypnotic, suggestion and hypnotic ability may be hidden factors that help to promote successful healing. Consequently, hypnotic ability may be an individual difference variable that influences treatment outcome in a manner not heretofore recognized by many investigators and clinicians involved in helping the psychologically and physically ill.
Refers to growing appreciation of how psychologically produced stress reactions can increase vulnerability to disease, especially via imbalances engendered in immune responsiveness. Also refers to reports in research literature of success in reducing symptoms of asthma by hypnosis.

1981

Journal of the Royal Society of Medicine – 1981 July; 74(7): 525–530
Hypnotherapy in the psychosomatic approach to illness: a review
J B Wilkinson
Full text is available as a scanned copy of the original print version.
Click here for printable copy (PDF file)
of the complete article.

1982

American review of respiratory disease – 1982 Apr;125(4):392-5 
Hypnosis for exercise-induced asthma.
Ben-Zvi Z, Spohn WA, Young SH, Kattan M. 
ABSTRACT & LINK:
Hypnosis has been used for many years in the treatment of asthma, but studies of its usefulness have been controversial. We assessed the efficacy of hypnosis in attenuating exercise-induced asthma (EIA) in 10 stable asthmatics. The subjects ran on a treadmill while mouth breathing for 6 min on 5 different days. Pulmonary mechanics were measured before and after each challenge. Two control exercise challenges resulted in a reproducible decrease in forced expiratory volume in one second (FEV1). On 2 other days, saline or cromolyn by nebulization was given in a double-blind manner with the suggestion that these agents would prevent EIA. Hypnosis prior to exercise resulted in a 15.9% decrease in FEV1 compared with a 31.8% decrease on the control days (p less than 0.001). Pretreatment with cromolyn resulted in a 7.6% decrease in FEV1.
We conclude that hypnosis can alter the magnitude of a pathophysiologic process, namely, the bronchospasm after exercise in patients with asthma.

Journal of adolescent health care – 1982 Aug;3(1):45-8. 
Hypnosis as an adjunct therapy for asthma: case report.
Neinstein LS, Dash J. 
ABSTRACT & LINK:
This study reports the effect of hypnotherapy in an asthmatic. The patient had moderately severe asthma with frequent attacks despite multiple medications. He received four weekly hypnosis sessions, and was then followed bimonthly for a year. The patient's course was followed by subjective daily scoring of wheezing severity, daily recording of peak expiratory flow rate by a Wright minispirometer, and once a month recording of his Forced Vital Capacity (FVC), Forced Expiratory Volume in one second/Forced Rate (MMRF). The severity rating showed improvement at one year when the start of therapy was compared to pretherapy (P less than .005). The daily peak flow rate averaged 486 liter/min before starting hypnotherapy and 502 liter/min after one year. There was no charge in the FEV1/FVC and MMFR before and after therapy. School attendance and academic performance may be a helpful adjunct in asthma therapy during adolescence

Psychological Bulletin – Vol 91(2), Mar 1982, 215-243. doi: 10.1037/0033-2909.91.2.215
The clinical use of hypnosis.
Wadden, Thomas A.; Anderton, Charles H.
Abstract and Link:
Reviews recent experimental evidence on the hypnotic treatment of obesity, cigarette smoking, alcoholism, clinical pain, warts, and asthma. It is concluded that although hypnosis may be effective with addictive behavior, the therapeutic success is attributable to nonhypnotic factors. In contrast, hypnosis appears to be of unique value in the treatment of clinical pain, warts, and asthma. Differential effectiveness may be attributable to the nature of the disorders or to the manner in which hypnosis is used in treating them. The relevance of hypnotizability to treatment is discussed, as is the need to distinguish between genuine and placebo-based hypnotic effects. It is concluded that future research must be more attentive to the (a) nature of the disorders and patient populations, (b) adequate implementation of therapeutic techniques, (c) context in which treatment is delivered, and (d) influence of hypnotic susceptibility and other S factors on outcome.

1984

Psychotherapy, 1984 21,  452-455.
Resolving intractable medical problems through psychological intervention: A clinical report
Brown, Erick L.; Kinsman, Robert A.   
ABSTRACT & LINK:
Treatment of chronic physical illness is often complicated by psychological factors that maintain and exacerbate the illness. Hypnotic techniques, coupled with insight-oriented psychotherapy comprised an effective strategy for favorably influencing medical outcome. A clinical report illustrates how psychological intervention initiated the resolution of severe medical problems in an asthmatic patient.

J Dev Behav Pediatr 1984 Feb; 5(1): 21-5.  
The use of relaxation-mental imagery (self-hypnosis) in the management of 505 pediatric behavioral encounters.  
Kohen DP, Olness KN, Colwell SO, Heimel A. 
This report assessed outcomes of hypnotherapeutic interventions for 505 children and adolescents seen by four pediatricians over a period of one year and followed from four months to two years. Presenting problems included enuresis, acute pain, chronic pain, asthma, habit disorders, obesity, encopresis, and anxiety. Using strict criteria for determination of problem resolution (e.g., all beds dry) and recognizing that some conditions were intrinsically chronic, the authors found that 51% of these children and adolescents achieved complete resolution of the presenting problem; an additional 32% achieved significant improvement, 9% showed initial or some improvement; and 7% demonstrated no apparent change or improvement. Children as young as three years of age effectively applied self-hypnosis techniques. In general, facility in self-hypnosis increased with age. There was an inverse correlation (p less than 0.001) between clinical success and number of visits, suggesting that prediction of responsivity is possible after four visits or less.

1986

British Medical Journal (Clin Res Ed). 1986 Nov 1;293(6555):1129-32.  
Improvement in bronchial hyper-responsiveness in patients with moderate asthma after treatment with a hypnotic technique: a randomised controlled trial.
Ewer TC, Stewart DE. 
ABSTRACT:
A prospective, randomised, single blind, and controlled trial of a hypnotic technique was undertaken in 39 adults with mild to moderate asthma graded for low and high susceptibility to hypnosis. After a six week course of hypnotherapy 12 patients with a high susceptibility score showed a 74.9% improvement (p less than 0.01) in the degree of bronchial hyper-responsiveness to a standardised methacholine challenge test. Daily home recordings of symptoms improved by 41% (p less than 0.01), peak expiratory flow rates improved by 5.5% (p less than 0.01), and use of bronchodilators decreased by 26.2% (p less than 0.05). The improvement in bronchial hyper-reactivity occurred without a change in subjective appreciation of the degree of bronchoconstriction. A control group 17 patients and 10 patients undergoing treatment with low susceptibility to hypnosis had no change in either bronchial hyper-responsiveness or any of the symptoms recorded at home.
This study shows the efficacy of a hypnotic technique in adult asthmatics who are moderately to highly susceptible to hypnosis.

American Journal of Clinical Hypnosis Volume 29, Issue 1, 1986 pages 59-63
Hypnotherapy in the treatment of childhood psychogenic coughing: A case report
Gary R. Elkins Ph.D & Bryan D. Carter  
ABSTRACT 
A case study is presented of an 11-year-old child evidencing severe, intractable psychogenic coughing. The patient was treated with hypnotherapy consisting of mental imagery, direct suggestion, and self-hypnosis. In addition, the parents were instructed to avoid reinforcing the patient's symptoms through attention. A 7-month follow-up revealed a rapid and complete elimination of the psychogenic cough and good adjustment.


1988

Journal of the Royal Society of Medicine . 1988 Dec; 81(12) 701-4
Chronic asthma and improvement with relaxation induced by hypnotherapy
Morrison JB 
LINK:
Sixteen chronic asthmatic patients inadequately controlled by drugs had, after one year of hypnotherapy at Southport General Infirmary, Merseyside., a fall in admissions from 44 in the year before starting therapy to 13 in the year after. Duration of stay was reduced for 13 patients by 249 days; prednisolone was withdrawn in 6, reduced in 8 and increased in none. Side effects of drugs were reduced. Although 62% reported improvement on a visual analogue scale, observations of air flow gave variable results.


1989

Psychological Reports. 1989 Oct; 65(2): 691-8.
Hypnotic susceptibility and its relationship to outcome in the behavioral treatment  
Murphy AI, Lehrer PM, Karlin R, Swartzman L, Hochron S, McCann B.
ABSTRACT & LINK
Twelve subjects from an experiment on relaxation therapy for asthma were given the Harvard Group Scale of Hypnotic Susceptibility, Form A. Full scale hypnotic susceptibility scores were positively correlated, at a borderline significance, with improvement in the methacholine challenge test, a measure of asthma severity. Performance on the amnesia item of the Harvard Group Scale was correlated with improvement in self-reported symptoms of asthma.

Gastroenterology. 1989 Jun;96(6):1383-7.
Modulation of gastric acid secretion by hypnosis
Klein KB, Spiegel D
School of Medicine, University of North Carolina, Chapel Hill.
ABSTRICT AND LINK
The ability of hypnosis to both stimulate and inhibit gastric acid secretion in highly hypnotizable healthy volunteers was examined in two studies. In the first, after basal acid secretion was measured, subjects were hypnotized and instructed to imagine all aspects of eating a series of delicious meals. Acid output rose from a basal mean of 3.60 +/- 0.48 to a mean of 6.80 +/- 0.02 mmol H+/h with hypnosis, an increase of 89% (p = 0.0007). In a second study, subjects underwent two sessions of gastric analysis in random order, once with no hypnosis and once under a hypnotic instruction to experience deep relaxation and remove their thoughts from hunger. When compared to the no-hypnosis session, with hypnosis there was a 39% reduction in basal acid output (4.29 +/- 0.93 vs. 2.60 +/- 0.44 mmol H+/h, p less than 0.05) and an 11% reduction in pentagastrin-stimulated peak acid output (28.69 +/- 2.34 vs. 25.43 +/- 2.98 mmol H+/h, p less than 0.05).
We have shown that different cognitive states induced by hypnosis can promote or inhibit gastric acid production, processes clearly controlled by the central nervous system. Hypnosis offers promise as a safe and simple method for studying the mechanisms of such central control.


Journal of the Royal Society of Medicine. 1989 November; 82(11): 694–695..  
Chronic asthma and hypnotherapy.
J B Wilkinson 
Letter to Journal.  Link to text 

1990

Psychotherapy in Private Practice. Vol 8, Issue 3, 1990 - pages 41-48
Hypnosis with a Depressed, Suicidal, Asthmatic Girl 
Hava E. Mendelberg PhDa
ABSTRACT:
This study explores the relationship between asthmatic reactions and emotional stress in child development, through treatment intervention in a specific case: a 12 year old depressed, asthmatic preadolescent female, referred for treatment after a second suicidal attempt. Emotional stress has been widely reported, since ancient times, to be a precipitant of bronchospastic responses. More recently the identification of asthma attacks has questioned and overshadowed psychological involvement. This report focuses on the psychological determinant of asthma, the connection with depression, and the effects of hypnotherapy in treating both psychosomatic and neurotic symptoms. In the present case asthmatic reaction and episodes of suicidal depression both were triggered and precipitated by emotional factors with specific traumatic events.
Hypnotherapy was used in two treatment modalities: 1. Uncovering: used to identify causal factors. Helpless and sad moods were associated with family motifs. When the production of "family pictures" across time was suggested, the patient created painful family scenes, involving violent parental discord and separation from the mother during childhood. !he patient reacted to these images with asthmatic behaviors. Thus, spontaneous recreation of traumatic events induced respiratory changes. Further uncovering revealed the patient's wish to be close to her mother and her frustration and helplessness at the inability to retain the love object. 2. Corrective Imagery and Relaxation: used to induce rhythmic breathing and muscular tension and relaxation (including bronchial musculature). Symptoms then could be increased and decreased through imagery under hypnotic state. Asthmatic responses were experimentally induced and then overcome with an emphasis on self-efficacy and coping strategies. This intervention was used to change the patients reactions to emotional stress providing new experiences of mastery and relaxation. Inner images were used to facilitate ego strength and a sense of control. In summary, asthmatic responses and a lack of self love seem to have developed out of emotional conflicts over dependency needs and loss of love. Hypnotherapy was used in the uncovering and treatment of those conditions..

1991

Ir Med J. 1991 Oct;84(3):98-9.
Vocal cord dysfunction presenting as asthma
Caraon P, O'Toole C. 
ABSTRACT:
A 14 year old boy presented with deteriorating asthma and marked stridor. Neither asthma nor stridor responded to an increase in anti-asthma medication, including high dose oral steroids. Indirect laryngoscopy revealed adduction of the vocal cords throughout the respiratory cycle, a phenomenon previously identified as a psychosomatic conversion reaction. When gently confronted with these findings and offered psychological assistance the boy's symptoms abated totally. After two sessions of hypnotherapy he has had better control of both his physical (asthma) and psychological problems.

Am. J. Clin. Hypn. 1991 Oct; 34(2) 122-8 
A hypnotic protocol for eliciting physical changes through suggestions of biochemical responses  
Madrid AD, Barnes SH  
LINK
Brief hypnotherapy was used at the Erickson Institute, Santa Rosa, California to effect physical changes in patients suffering from medical disorders including allergies, rectal bleeding, systemic lupus, hyperemesis, headache, asthma, and chronic pain. In language appropriate to the individual patient, considerations and suggestions were presented to effect the release of healing biochemicals. Ideomotor signals indicated the patient's awareness of the healing. The authors hypothesise that the technique triggered novel state-dependent memory, learning and behavior.

1992

Thorax 1992;47:762; doi:10.1136/thx.47.9.762-b
Alternative and complementary medicine for asthma  
A F Kalyoncu, Z T Selçuk, A Iskendarani, L Cöplü, S Emri, A A Sahin, and Y I Baris   
Link to correspondence (Requires registration on-line).

1993

Handbook of clinical hypnosis., (pp. 357-381). American Psychological Association, xxv, 765 pp.
Hypnotherapy with children.
Kohen, Daniel P.; Olness, Karen
When used appropriately with children, hypnotherapy is a useful and efficient strategy. The skilled therapist not only helps the child to apply innate imagination in an enjoyable way but also instills or facilitates a sense of mastery in the child. Hypnotherapy is useful in addressing habit problems, acute and chronic anxiety, acute and chronic pain, biobehavioral disorders, and chronic diseases such as hemophilia or asthma. Techniques must be based on a child's developmental stage and interests. Unlike the side effects of many therapeutic interventions, the "side effect" or by-product of hypnotherapy is increased vs decreased competence.

1996

Applied Psychophysiology and Biofeedback.  
Relaxation/mental imagery (self-hypnosis) for childhood asthma: behavioural outcomes in a prospective, controlled study
Kohen, D. P. 
Findings included (a) fewer emergency room visits in the experimental group; (b) less school missed in the experimental group compared to the traditional control group and to the waking suggestion group; (c) no difference in psychological evaluations between groups; and (d) surprising findings regarding hypnotic and hypnotic-like experiences among subjects.

Aus. Journal of Clin. Exp. Hypn 1996 24(1) 12-28 
Relaxation/mental imagery (self-hypnosis) for childhood asthma: Behavioural outcomes in a prospective, controlled study  
Kohen DP 
ABSTRACT:
Twenty-eight 7-12-year-old children entered a controlled study of the effects of self-hypnosis on asthma. Asthma belief and behavioural inventories were collected before, and at one and two years after intervention. Asthma diaries were kept daily and mailed monthly. Subjects were randomly assigned to (a) experimental (self- hypnosis), (b) waking suggestion (no hypnosis), (c) attention placebo (no hypnosis or asthma discussion), or (d) traditional control groups. Twenty-four completed one-month follow-up, 16 completed six months, and 13 completed two years. Results included: (a) fewer emergency room visits in the experimental group (p<0.05); (b)less school missed in the experimental group compared to the traditional control group (p<0.001) and to the waking suggestion group (p<0.005); (c) no differences in psychological evaluations between groups; and (d) surprising findings regarding hypnotic and hypnotic-like experiences among subjects.

Allergy Vol 51, Issue 11, pages 761–769, November 1996 
Unconventional therapies in asthma:
an overview: behavioural outcomes in a prospective, controlled study
Lewith GT, Watkins AD.
ABSTRACT:
Acupuncture, homoeopathy, mind-body therapies, and nutritional, herbal, and environmental medicine have all been used in the management of patients with asthma. This paper reviews the evidence base for the use of these unconventional or complementary therapics. Although there is a paucity of large randomized, controlled trials in this area, there is sufficient evidence to suggest that many of these therapies can produce objective and subjective benefit in selected groups of patients. In view of the increasing popularity of complementary medicine among patients and general practitioners, there is now an urgent need for high-quality research to determine how, or whether, these therapies may be interwoven with the more orthodox treatments currently available.

1997

American Journal of Clinical Hypnosis. 1997 Jan;39(3):169-81.  
Applying hypnosis in a preschool family asthma education program: uses of storytelling, imagery, and relaxation
Kohen DP, Wynne E.
Dept of Pediatrics, University of Minnesota, Minneapolis, USA..
SUMMARY:
A Preschool Asthma Program was conducted 4 times for children 2 to 5 years of age and their parent(s). Twenty-five (25) child-parent(s) participated in the 7-session program. Data were collected prior to participation and again one year after completion of classes.
Following participation, physician visits for asthma were reduced (p = 0.0013) and parents reported increased confidence in self-management skills. Symptom severity scores improved significantly after participation (p < 0.001).
A possible association was noted between participation in the program and parental expectations or projections of future outcome (0.05 < p < 0.1). No changes were observed in the frequency of asthma episodes or in pulmonary function tests before and after the program. With the hypnotherapeutic approach of imagery, preschoolers developed new cooperation in asthma-care skills, including cooperative and consistent performance of peakflow measurements.

1998

Appl Psychophysiol Biofeedback 1998 Mar; 23(1): 13-41 
Emotionally triggered asthma: a review of research literature and some hypotheses for self-regulation therapies
Paul M. Lehrer
UMDNJ-Robert Wood Johnson Medical School, Piscataway, New Jersey 08854, USA.
Asthma is a common disease whose morbidity and mortality are rapidly increasing. Panic disorder is common in asthma. Panic, other negative emotions, and a passive coping orientation may affect asthma by producing hyperventilation, increased general autonomic lability, a specific pattern of autonomic arousal that may cause bronchoconstriction, and/or detrimental effects on health care behaviors. Generalized panic is a risk factor for increased asthma morbidity. A repressive coping style also appears to be a risk factor for asthma morbidity because it is accompanied by an impaired ability to perceive symptoms, a necessary prerequisite for taking appropriate remediation. Several self-regulation strategies are hypothesized to be useful adjuncts to asthma treatment. Preliminary research has been done on relaxation therapy, EMG biofeedback, biofeedback for improved sensitivity in perceiving respiratory sensations, and biofeedback training for increasing respiratory sinus arrhythmia. It is hypothesized that finger temperature biofeedback also may be a promising treatment method, and that relaxation-oriented methods will have their greatest effect among asthmatics who experience panic symptoms, while improved perceptual sensitivity will be helpful both for patients who panic and those with repressive coping styles

J Sch Nurs 1998, Oct 14(4) 44-8 
A holistic approach to meeting students' needs: using hypnotherapy techniques to assist students in managing their health
Watters KH  
Woodside High School, California, USA.
Nursing education has long been holistic in its approach to aiding the client or family. Further, most nurses, especially school nurses, are holistic by nature. That is, school nurses see a person as a whole being, physical, emotional, mental, and spiritual. The more conscious nurses become of their holistic nature and the more they expand their knowledge and skills in holistic methods, the more they can assist students and families in having greater control over their health. Examples of selected holistic techniques and their positive effects when used by students with diabetes and asthma are illustrated in case studies.

2000

J Asthma. 2000 Feb; 37(1): 1-15
Hypnosis and asthma: a critical review    
Hackman RM, Stern JS, Gershwin ME
University of California, Davis 95616, USA.
Asthma is among the most common chronic diseases of the western world and has significant effects on patients' health and quality of life. Asthma is typically treated with pharmaceutical products, but there is interest in finding nonpharmaceutical therapies for this condition.
Hypnosis has been used clinically to treat a variety of disorders that are refractive to pharmaceutical-based therapies, including asthma, but relatively little attention has been given recently to the use of clinical hypnosis as a standard treatment for asthma. Significant data suggest that hypnosis may be an effective treatment for asthma, but it is premature to conclude that hypnosis is unequivocally effective.
Studies conducted to date have consistently demonstrated an effect of hypnosis with asthma. More and larger randomized, controlled studies are needed. Existing data suggest that hypnosis efficacy is enhanced in subjects who are susceptible to the treatment modality, with experienced investigators, when administered over several sessions, and when reinforced by patient autohypnosis. Children in particular appear to respond well to hypnosis as a tool for improving asthma symptoms.

Journal of Prenatal & Perinatal Psychology & Health, October 2000
Does Maternal-Infant Bonding Therapy Improve Breathing in
Asthmatic Children
   
Antonio Madrid, Ralph Ames, Susan Skolek
|Full Text (click here)
ABSTRACT:
Six mothers of asthmatic children with histories of non-bonding were treated with a therapy aimed at repairing the bond between them and their children. Four of the children were then briefly treated to repair the bond and two infants were not treated. Eighteen variables were studied before treatment, after the mother’s treatment, and after the children’s treatment. There was improvement in all 18 variables. Five children experienced complete or nearly total improvement in their breathing. The two
infants had total remission of symptom. Hypnosis used o resolved the competing emotion and help mothers reconnect with their children.

2001

Pediatrics 2001 Feb; 107(2)  E21
Self-hypnosis for management of chronic dyspnea in pediatric patients
Ran D. Anbar, MD
Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, New York 13210, USA. anbarr@mail.upstate.edu
|Full Text (click here)   
INTRODUCTION:
Hypnotherapy can be useful in the management of anxiety, discomfort, and psychosomatic symptoms, all of which may contribute to a complaint of dyspnea. Therefore, instruction in self-hypnosis was offered to 17 children and adolescents with chronic dyspnea, which had not resolved despite medical therapy, and who were documented to have normal lung function at rest. The report documents the result of this intervention.

2002

BMC Pediatr. 2002 Dec 3; 2(1): 11
Hypnosis in pediatrics: applications at a pediatric pulmonary center
Ran D. Anbar, MD 
Department of Pediatrics, Upstate Medical University, 750 E, Adams Street, Syracuse, NY 13210, USA. Anbarr@mail.upstate.ed  
| Full Text (click here)
ABSTRACT:
Background:
This report describes the utility of hypnosis for patients who presented to a Pediatric Pulmonary Center over a 30 month period. METHODS: Hypnotherapy was offered to 303 patients from May 1, 1998 - October 31, 2000. Patients offered hypnotherapy included those thought to have pulmonary symptoms due to psychological issues, discomfort due to medications, or fear of procedures. Improvement in symptoms following hypnosis was observed by the pulmonologist for most patients with habit cough and conversion reaction. Improvement of other conditions for which hypnosis was used was gauged based on patients' subjective evaluations. RESULTS:
Hypnotherapy was associated with improvement in 80% of patients with persistent asthma, chest pain/pressure, habit cough, hyperventilation, shortness of breath, sighing, and vocal cord dysfunction. When improvement was reported, in some cases symptoms resolved immediately after hypnotherapy was first employed. For the others improvement was achieved after hypnosis was used for a few weeks. No patients' symptoms worsened and no new symptoms emerged following hypnotherapy.
CONCLUSIONS:
Patients described in this report were unlikely to have achieved rapid improvement in their symptoms without the use of hypnotherapy. Therefore, hypnotherapy can be an important complementary therapy for patients in a pediatric practice.

Journal of Paediatrics & Child Health. 38(3):252-257, June 2002
Survey of the use of complementary medicines and therapies in children with asthma
Shenfield, G 1; Lim, E 1; Allen, H2  
Full Text (click here)
ABSTRACT:
Objective:
To survey the frequency of use of complementary medicines (CM) and complementary therapies (CT) in asthmatic children.
Methodology:
A three-month survey of asthmatic inpatients and outpatients of a teaching hospital respiratory paediatrician was undertaken. Parents answered a structured questionnaire about their past and present usage and opinions of CM and CT. Parents and the physician independently assessed overall asthma control. 'Users' and 'non-users' of CM and CT were compared for characteristics of asthma, usage of conventional medications and parental demographics.
Results:
One hundred and seventy-four children with 331 parents were enrolled in the study. All of the children were on bronchodilators and 150 (86.2%) were on disodium cromoglycate or inhaled steroids. Control was assessed by a physician as good in 95 children (54.6%), fair in 65 (37.4%) and poor or very poor in 13 (7.5%). Ninety (51.7%) of the children had used at least one CM in their lifetime. Out of the 145 preparations used, 90 (62.1%) were in current use. Vitamins and minerals (53.2%) and herbal preparations (29%) were used most commonly. Only 47.8% of parents had told their doctors about the use of CM. Costs ranged from $A2-$A200 (median $A10) per month. Forty-three (24.7%) of the children had been taken to an alternative practitioner at a cost of $A25-$A400 (median $A40) per month. Users of CM and CT were significantly more likely than non-users to have persistent asthma (P < 0.02), be on high-dose inhaled or oral steroids (P < 0.05), to have poor or very poor control of symptoms (P < 0.04), and more frequent doctor visits (P < 0.05). They also had more adverse reactions to relieving bronchodilators(P < 0.02) and were significantly older than non-users (P < 0.02). The most common reasons for using CM and CT were dissatisfaction with conventional therapies and concerns about steroid side-effects.
Conclusions:
Health professionals should be aware of the high rates of usage of CM and CT in asthmatic children and of parental attitudes to conventional and alternative therapies.

Thorax 2002;57:127-131 doi:10.1136/thorax.57.2.127
Relaxation therapies for asthma: a systematic review
A Huntley, A R White, E Ernst  
ABSTRACT:
Background:
Emotional stress can either precipitate or exacerbate both acute and chronic asthma. There is a large body of literature available on the use of relaxation techniques for the treatment of asthma symptoms. The aim of this systematic review was to determine if there is any evidence for or against the clinical efficacy of such interventions.
Methods:
Four independent literature searches were performed on Medline, Cochrane Library, CISCOM, and Embase. Only randomised clinical trials (RCTs) were included. There were no restrictions on the language of publication. The data from trials that statistically compared the treatment group with that of the control were extracted in a standardised predefined manner and assessed critically by two independent reviewers.
Results:
Fifteen trials were identified, of which nine compared the treatment group with the control group appropriately. Five RCTs tested progressive muscle relaxation or mental and muscular relaxation, two of which showed significant effects of therapy. One RCT investigating hypnotherapy, one of autogenic training, and two of biofeedback techniques revealed no therapeutic effects. Overall, the methodological quality of the studies was poor.
Conclusions:
There is a lack of evidence for the efficacy of relaxation therapies in the management of asthma. This deficiency is due to the poor methodology of the studies as well as the inherent problems of conducting such trials. There is some evidence that muscular relaxation improves lung function of patients with asthma but no evidence for any other relaxation technique.


2003

BMC Pediatrics 2003, 3:7doi:10.1186/1471-2431-3-7
Self-hypnosis for anxiety associated with severe asthma: a case report
Ran D. Anbar, MD   
Full Text (click here)
ABSTRACT:
Background: Management of asthma can be complicated by both medical and psychiatric conditions, such as gastroesophageal reflux, chronic sinusitis, and anxiety. When symptoms of asthma are interpreted without regard to such conditions treatment may yield a suboptimal outcome. For example, anxiety-associated dyspnea, tachypnea, and chest tightness can be mistakenly interpreted as resulting from an exacerbation of asthma. Medical treatment directed only for asthma may thus lead to overuse of asthma medications and increased hospitalizations.
Case Presentation: The described case illustrates how a systemic steroid-dependent patient with asthma benefited from receiving care from a pediatric pulmonologist who also was well versed in the diagnosis and treatment of anxiety. By using self-hypnosis, the patient was able to reduce her dependence on bronchodilators. Following modification of her medical therapy under supervision of the pulmonologist, and regular use of hypnosis, the patient ultimately was weaned off her systemic steroid therapy.
Conclusions: This report emphasizes that anxiety must be considered as a comorbid condition in the treatment of asthma. Self-hypnosis can be a useful skill in the treatment of a patient with anxiety and asthma.ice.

2005

BMC Pediatr. 2005 Apr 25; 5(1): 6
Identification of children who may benefit from self-hypnosis at a pediatric pulmonary center

Anbar RD, Geisler SC.    
Full Text (click here)
Department of Pediatrics, University Hospital, State University of New York Upstate Medical University, Syracuse, NY, USA. anbarr@upstate.edu BACKGROUND: Emotional difficulties can trigger respiratory symptoms. Thus, children presenting with respiratory complaints may benefit from a psychological intervention. The purpose of this study was to define the proportion of patients referred to a Pediatric Pulmonary Center who may benefit from instruction in self-hypnosis, as a psychological intervention. METHODS: A retrospective chart review was conducted for all newly referred patients to the SUNY Upstate Medical University Pediatric Pulmonary Center during an 18 month period beginning January 1, 2000. Patients were offered hypnosis if they presented with symptoms or signs suggestive of psychological difficulties. Hypnosis was taught in one or two 15-45 minute sessions by a pediatric pulmonologist. RESULTS: Of 725 new referrals, 424 were 0-5 years old, 193 were 6-11 years old, and 108 were 12-18 years old. Diagnoses of anxiety, habit cough, or vocal cord dysfunction accounted for 1% of the 0-5 year olds, 20% of the 6-11 year olds, and 31% of the 12-18 year olds. Hypnotherapy was offered to 1% of 0-5 year olds, 36% of 6-11 year olds, and 55% of 12-18 year olds. Of 81 patients who received instruction in self-hypnosis for anxiety, cough, chest pain, dyspnea, or inspiratory difficulties, 75% returned for follow-up, and among the returning patients 95% reported improvement or resolution of their symptoms. CONCLUSION: A large number of patients referred to a Pediatric Pulmonary Center appeared to benefit from instruction in self-hypnosis, which can be taught easily as a psychological intervention.

Am J Clin Hypn. 2005 Jul; 48(1): 45-9.
Teamwork approach to clinical hypnosis at a pediatric pulmonary center
Anbar RD, Hummell KE.  
Department of Pediatrics, SUNY Upstate Medical University, 750 E Adams St., Syracuse, NY 13210, USA. anbarr@upstate.edu The aim of this report is to demonstrate the success of a teamwork approach for providing instruction in self-hypnosis at a Pediatric Pulmonary Center. In order to add to the hypnosis service provided by a pulmonologist at the Center, the Center social worker learned how to use clinical hypnosis. During a 3-year period, she instructed 72 patients (average age 11.6 years) in self-hypnosis. Eighty-two percent of the patients reported improvement or resolution of the primary symptoms, which included anxiety, asthma, chest pain, dyspnea, habit cough, hyperventilation, sighing, and vocal cord dysfunction. The social worker and pulmonologist consulted with each other on a regular basis regarding their hypnosis work, and achieved similar successful results following their hypnosis interventions. Thus, clinical hypnosis at a Pediatric Pulmonary Center can be provided by a team of varied professionals. As a team, these professionals can support each other in their on-going development of hypnosis skills

.Am J Clin Hypn. 2005 Oct-2006 Jan; 48(2-3): 199-211. 
HeBMC Pediatr. 2005 Apr 25; 5(1): 6
Identification of children who may benefit from self-hypnosis at a pediatric pulmonary center

Anbar RD, Geisler SC.    
Full Text (click here)
Department of Pediatrics, University Hospital, State University of New York Upstate Medical University, Syracuse, NY, USA. anbarr@upstate.edu BACKGROUND: Emotional difficulties can trigger respiratory symptoms. Thus, children presenting with respiratory complaints may benefit from a psychological intervention. The purpose of this study was to define the proportion of patients referred to a Pediatric Pulmonary Center who may benefit from instruction in self-hypnosis, as a psychological intervention. METHODS: A retrospective chart review was conducted for all newly referred patients to the SUNY Upstate Medical University Pediatric Pulmonary Center during an 18 month period beginning January 1, 2000. Patients were offered hypnosis if they presented with symptoms or signs suggestive of psychological difficulties. Hypnosis was taught in one or two 15-45 minute sessions by a pediatric pulmonologist. RESULTS: Of 725 new referrals, 424 were 0-5 years old, 193 were 6-11 years old, and 108 were 12-18 years old. Diagnoses of anxiety, habit cough, or vocal cord dysfunction accounted for 1% of the 0-5 year olds, 20% of the 6-11 year olds, and 31% of the 12-18 year olds. Hypnotherapy was offered to 1% of 0-5 year olds, 36% of 6-11 year olds, and 55% of 12-18 year olds. Of 81 patients who received instruction in self-hypnosis for anxiety, cough, chest pain, dyspnea, or inspiratory difficulties, 75% returned for follow-up, and among the returning patients 95% reported improvement or resolution of their symptoms. CONCLUSION: A large number of patients referred to a Pediatric Pulmonary Center appeared to benefit from instruction in self-hypnosis, which can be taught easily as a psychological intervention.drid, Antonio.  

Full Text (click here) 
Studies about the psychology of childhood asthma have revealed that parenting difficulties are related to the development of asthma in some children. Disruptions in maternal-infant bonding are highly correlated with pediatric asthma and are presented as a cause for these parenting problems. Bonding problems are known to be caused most often by physical separation at birth or by some recent trauma in the mother's life. By using hypnosis to remove the pain of the separation or trauma in the mother, and by creating a new birth history in her imagination, some children's asthmatic symptoms have been shown to remit or greatly improve. The hypnotic method for this treatment is described

2007

International Journal of Clinical & Experimental Hypnosis. 2007 Apr;55(2):220-49. 
Evidence-based hypnotherapy for asthma: a critical review

Brown D. Harvard Medical School, Cambridge, Massachusetts, USA..    
ABSTRACT:
Asthma is a chronic disease with intermittent acute exacerbations, characterized by obstructed airways, hyper-responsiveness, and sometimes by chronic airway inflammation. Critically reviewing evidence primarily from controlled outcome studies on hypnosis for asthma shows that hypnosis is possibly efficacious for treatment of symptom severity and illness-related behaviors and is efficacious for managing emotional states that exacerbate airway obstruction. Hypnosis is also possibly efficacious for decreasing airway obstruction and stabilizing airway hyper-responsiveness in some individuals, but there is insufficient evidence that hypnosis affects asthma's inflammatory process. Promising research needs to be replicated with larger samples and better designs with careful attention paid to the types of hypnotic suggestions given. The critical issue is not so much whether it is used but how it is used. Future outcome research must address the relative contribution of expectancies, hypnotizability, hypnotic induction, and specific suggestions..

American Journal of Clinical Hypnosis Volume 50, Issue 2, 2007 pages 171-175 
User Friendly Hypnosis as an adjunct for treatment of habit cough: A case report

Ran D. Anbar MD   
ABSTRACT
The more user friendly medical hypnosis can be, the more readily it will be accepted by patients and the medical community. Hypnosis is user friendly when it is simple to employ, and yields rapid, effective, and clinically significant results. Thus, we should define reasons for the effectiveness of such successful hypnosis methods, and provide this information to students of hypnosis. Some of the elements that may permit hypnosis to be user friendly are establishment of rapport, a belief that a symptom often has a functional role, and a flexible approach to the hypnosis encounter. This case report of a child with habit cough, illustrates the importance of these elements.

Pediatric Pulmonology Volume 42, Issue 2, pages 114–124, February 2007
A systematic review of psychological interventions for children with asthma

Yorke J, Fleming SL, Shuldham C.
Royal Brompton & Harefield NHS Trust, Sydney Street, London, United Kingdom.
ABSTRACT:
Aim:
Psychological factors may influence the symptoms and management of asthma in children in many ways. It is, therefore, suggested that psychological interventions may be appropriate for this population. This paper reports a systematic review assessing the efficacy of psychological interventions in improving health outcomes for children with asthma.
Methodology:
A review of Randomized Controlled Trials (RCT) was designed. RCTs assessing the effects of a psychological intervention in child participants were included in the review. Outcome measures included healthcare utilization, lung function, asthma symptoms, and psychological health status. The search was conducted until April 2005.
Results:
Twelve studies, involving 588 children, were included in the review; however, study quality was poor and sample sizes were frequently small. A meta-analysis was performed on two studies, examining the effects of relaxation therapy on PEFR which favored the treatment group (SD 0.82, CI 0.41–1.24). No other meta-analysis could be performed due to the diversity of interventions and the outcomes assessed. In addition, many studies reported insufficient data.
Conclusions:
This review was unable to draw firm conclusions for the role of psychological interventions for children with asthma. We recommend that valid outcome measures for evaluating the effectiveness of psychological interventions for children with asthma need to address adjustment to and coping with asthma, as well as other psychological indicators. The absence of an adequate evidence base is demonstrated, highlighting the need for well-conducted RCTs in this area. Pediatr Pulmonol. 2007; 42:114–124. © 2006 Wiley-Liss, Inc.

2009

Psychotherapy and Psychosomatics. Vol. 78, No. 4, 2009
Functional Relaxation and Guided Imagery as Complementary Therapy in Asthma: A Randomized Controlled Clinical Trial

C. Lahmann, M. Nickel, T. Schuster, N. Sauer, J. Ronel, M. Noll-Hussong, K. Tritt, D. Nowak, F. Röhricht, T. Loew
ABSTRACT:
Asthma is a frequently disabling and almost invariably distressing disease that has a high overall prevalence. Although relaxation techniques and hypnotherapeutic interventions have proven their effectiveness in numerous trials, relaxation therapies are still not recommended in treatment guidelines due to a lack of methodological quality in many of the trials. Therefore, this study aims to investigate the efficacy of the brief relaxation technique of functional relaxation (FR) and guided imagery (GI) in adult asthmatics in a randomized controlled trial. Methods: 64 patients with extrinsic bronchial asthma were treated over a 4-week period and assessed at baseline, after treatment and after 4 months, for follow-up. 16 patients completed FR, 14 GI, 15 both FR and GI (FR/GI) and 13 received a placebo relaxation technique as the control intervention (CI). The forced expiratory volume in the first second (FEV1) as well as the specific airway resistance (sRaw) were employed as primary outcome measures. Results: Participation in FR, GI and FR/GI led to increases in FEV1 (% predicted) of 7.6 ± 13.2, 3.3 ± 9.8, and 8.3 ± 21.0, respectively, as compared to –1.8 ± 11.1 in the CI group at the end of the therapy. After follow-up, the increases in FEV1 were 6.9 ± 10.3 in the FR group, 4.4 ± 7.3 in the GI and 4.5 ± 8.1 in the FR/GI, compared to –2.8 ± 9.2 in the CI. Improvements in sRaw (% predicted) were in keeping with the changes in FEV1 in all groups. Conclusions: Our study confirms a positive effect of FR on respiratory parameters and suggests a clinically relevant long-term benefit from FR as a nonpharmacological and complementary therapy treatment option

Journal of Applied Sciences Year: 2009 Vol: 9 Issue: 1 (188-192 )
Self-Hypnosis in Attenuation of Asthma Symptoms Severity

M. Zobeiri,A. Moghimi,D. Attaran,M. Fathi,A. A. Ashari
 Abstract
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According to probable effects of psychological stress on exacerbation of asthma symptoms, utilizing complementary therapies such as hypnosis may be an effective treatment for reduction of asthma symptoms severity. Forty asthmatic patients were randomly allocated to self-hypnosis and control groups. Person`s subjective perception of dyspnoea in both groups was assessed in 4 different stages via modified MRC scale (Modified Medical Research Council Dyspnoea Scale; range 0-4). Also, the Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1) were measured through spirometry twice a time, once prior to and again at the end of this one month study period. Only 72.5% of the patients completed the trial. The median change in dyspnoea symptom scores was greater in self-hypnosis group than control group (p = 0.004). There was no significant difference in FVC, FEV1 and FEV1% within each group and between them. According to the results, self-hypnosis can improve symptoms but does not seem to change lung function in asthmatic patients, at least in short periods of time.

2010

Pediamatric Asthma, Allery & Immunology Vol XX, Number XX, 2010
Why Should Hypnosis Be Used for Pediatric Patients With Respiratory Problems?

Anbar RD.
SUMMARY: Utilisation of hypnosis as part of the care of children with respiratory disorders helps them achieve symptomatic relief, improves the clinician’s ability to diagnose and treat patients with complicated clinical presentations, and saves some patients from undergoing costly investigations or receiving nonessential treatments. Hypnosis can be defi ned as a state of inward attention during which the mind is focused on ideas of therapeutic value that can potentiate physiologic change. There are few published randomized trials demonstrating the effectiveness of hypnosis in the management of asthma. Published case series suggest that hypnosis is of benefi t for children with cystic fi brosis, dyspnea, habit cough, insomnia, or vocal cord dysfunction. Hypnosis helps patients control their response to discomfort, which may allow reduction in the amount of pharmacologic analgesia during medical procedures such as phlebotomy or bronchoscopy. Once children decide to learn hypnosis, initial instruction time can require 5–30 min with older children and even less time with younger children. This training can be incorporated within regular medical offi ce appointments. Clinical hypnosis for use by various staff members at a respiratory specialty center is learned best through active participation in 20-h experiential hypnosis workshops endorsed by medical hypnosis organizations. While acquiring the skills required for incorporating hypnosis into clinical practice may take relatively few hours, it is the clinician’s years of professional training that permits its appropriate use.
CONCLUSION: Clinical hypnosis is an efficient and effective tool for addressing the mind/body connection for children with respiratory disorders.
© Mary Ann Liebert, Inc. DOI: 10.1089/pai.2009.0025. 
Link to full text

2011

American Journal of Clinical Hypnosis Vol 54, Issue 1, 2011
Treatment of Psychological Factors in a Child With Difficult Asthma: A Case Report

Ran D. Anbara, Shagun Sachdevaa
ABSTRACT:
Difficult asthma is defined as the persistence of asthma symptoms, abnormal pulmonary function showing airway obstruction, and continued requirement for short-acting bronchodilator therapy, despite adequate treatment with inhaled corticosteroids. It calls for a thorough evaluation of the patient to look into alternate and complicating diagnoses. The authors report a case of a 9-year-old patient with difficult asthma who failed to respond to conventional therapy. Although it was recognized that he had a number of potential medical complicating factors including allergies, chronic sinusitis, and gastroesophageal reflux, a psychological intervention using hypnosis ultimately appeared to help alleviate his symptoms completely. Thus, psychological evaluation and intervention should be considered early in the course of management of a patient with difficult asthma, because it may help avoid time-consuming and expensive investigations of potential complicating factors, and it may yield rapid improvement in the patient's clinical condition

2012

Procedia - Social and Behavioral Sciences  Vol 33, 2012, Pages 75–79
The use of Ericksonian hypnosis in somatic disorders

Irina Holdevicia, Barbara Cr?ciunb
ABSTRACT:
Hypnotic techniques play an important role in treating psychosomatic disorders. The connection between psyche and soma represents the basis on which hypnosis works, stimulating the subject to find in his own subconscious the healing resources. The present study has as main objective to evaluate the efficiency of a psychotherapy program based on Ericksonian hypnosis techniques of reducing pain and symptoms in psychosomatic disorders. The main disorders that have been treated by hypnotic techniques are migraines, asthma and gastrointestinal disorders. The results have shown a significant decrease of pain level and symptom relief for these patients.

Respiratory Medicine 2012, pp 227-249
Hypnosis for the Treatment of Functional Respiratory Disorders

Ran D. Anbar
LINK TO GOOGLE BOOK VERSION
ABSTRACT:
Clinical hypnosis is an efficient and effective tool for addressing the mind/body connection for many patients with functional respiratory disorders. Such patients can benefit from learning self-hypnosis techniques in as little as 10 min, which can help them rapidly improve or resolve their symptoms altogether, as ­demonstrated in several published case series.
Asthma sometimes has been shown to improve with the use of hypnosis perhaps because of the large number of patients who have a functional component as part of their presentation. Keys to successful hypnosis include establishment of rapport with patients and their families, facilitating patients’ self-mastery, and following patients’ expectations, motivation, lead, and interests.
Clinicians who have completed 3- to 4-day hypnosis training workshops learn to appreciate better the power of communication and usually find that their language and nonverbal interactions with patients improve, even when they are not employing formal hypnosis. Practical considerations regarding provision of clinical hypnosis in a primary care setting are discussed in this chapter; a sample text of an hypnotic encounter intended to achieve relaxation is provided; and case studies are presented that include links to videos demonstrating instruction in ­hypnosis to children and adults, with accompanying quiz questions and explanatory material regarding patients with chest pain, dyspnea, habit cough, vocal cord ­dysfunction, and insomnia.


Procedia - Social and Behavioral Sciences Volume 33, 2012, Pages 75–79
The use of Ericksonian hypnosis in somatic disorders

Irina Holdevicia, , , Barbara Cr?ciunb
a Faculty of Psychology, Titu Maiorescu University, Calea V?c?re?ti nr.187, sector 4, Bucharest, 040051, Romania
b Faculty of Psychology and Educational Sciences, Bucharest University, ?os. Panduri nr. 90, sector 5, Bucharest,050656, Romania
ABSTRACT:
Hypnotic techniques play an important role in treating psychosomatic disorders. The connection between psyche and soma represents the basis on which hypnosis works, stimulating the subject to find in his own subconscious the healing resources. The present study has as main objective to evaluate the efficiency of a psychotherapy program based on Ericksonian hypnosis techniques of reducing pain and symptoms in psychosomatic disorders. The main disorders that have been treated by hypnotic techniques are migraines, asthma and gastrointestinal disorders. The results have shown a significant decrease of pain level and symptom relief for these patients.

Chem Immunol Allergy. 2012;98:1-13. doi: 10.1159/000336493. Epub 2012 Jun 26.
Relations between asthma and psychological distress: an old idea revisited

Van Lieshout RJ, Macqueen GM.
Source
Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ont., Canada.
ABSTRACT:
Asthma has long been considered a condition in which psychological distress exerts a negative impact. Epidemiological studies confirm that depression and anxiety disorders, amongst the most common psychiatric disorders, occur in higher rates in people with asthma than in the general population. Alterations in the stress axis, immune and autonomic nervous systems appear to be involved in the pathogenesis of each disorder and may contribute to the observed associations between these conditions. Although there is increasing recognition of the importance of treating psychological distress to optimize symptom control in people with asthma, there are few studies examining whether specific treatments for depression or anxiety can improve symptom control in asthma and result in better overall function and outcome.

2013

Acta Bio Medica - Journal of the Society of Medicine and Natural Sciences of Parma – Vol 84 No 2 (2013)
Controlled outcome studies of child clinical hypnosis

Barbara Adinolfi, Nicoletta Gava
ABSTRACT:
Background
Hypnosis is defined as “as an interaction in which the hypnotist uses suggested scenarios (“suggestions”) to encourage a person’s focus of attention to shift towards inner experiences”.
Aim of the work
The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues.
Results
Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children.
Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress.
Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children.
Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema
Conclusions
Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations.
Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem.
   
 



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