Avoiding pain during propofol injection in pediatric anesthesia: Hypnoanalgesia of the hand versus intravenous lidocaine.

INTRODUCTION: Pain related to injection of propofol during induction of anesthesia decreases from 66.8% without prevention, to 22-31% of cases when lidocaine is associated. Hypnoanalgesia of the hand is currently used for painful procedures in children but has never been evaluated in this indication. The primary aim of this prospective randomized single-blind study was to evaluate the efficacy of hypnoanalgesia of the hand for the prevention of moderate to severe pain during intravenous injection of propofol alone in comparison to lidocaine admixture. The secondary aim was to compare the global satisfaction of children in both methods. PATIENTS AND METHODS: One hundred patients aged 7-14 years, ASA 1-2, admitted for scheduled surgery under general anesthesia were randomized into two groups. Group L received a mixture of 1% propofol (3 mg/kg) and 1% Lidocaine (0.3 mg/kg). Group H received 1% propofol (3 mg/kg) after hypnoanalgesia of the hand realized by a single experimented operator. A video was made in order to evaluate the pain related to propofol injection by a blinded observer using the 4-point score of Cameron (painful ≥ 2). The global satisfaction of children was evaluated in postanesthesia care unit and documented if visual analog score was <7/10. RESULTS: Ninety-six patients were analyzed. The rate of painful patients did not differ significantly between groups (8.5% in group H [n = 47] vs 6.1% in group L [n = 49], OR= 0.70; 95% CI [0.13-3.35], p = 0.65), nor did the rate of nonsatisfied patients (10.6 in group H vs. 12.2% in group L, OR = 0.85; 95% CI [0.19-3.65], p = 1). CONCLUSIONS: Our results suggest that hypnoanalgesia of the hand alone is effective to prevent the pain related to propofol injection in children. No significant difference was found in comparison with lidocaine admixture nor for pain or satisfaction.

The relevance of outcome expectations in group hypnosis for stress reduction: a secondary analysis of a multicenter randomized controlled trial.

Background: There is evidence that patients' positive outcome expectations prior to study interventions are associated with better treatment outcomes. Nevertheless, to date, only few studies have investigated whether individual outcome expectations affect treatment outcomes in hypnosis. Objective: To examine whether outcome expectations to hypnosis prior to starting treatment were able to predict perceived stress, as measured on a visual analog scale (VAS), after 5 weeks. Methods: We performed a secondary data analysis of a multicenter randomized controlled trial of intervention group participants only. Study participants with stress symptoms were randomized to 5 weekly sessions of a group hypnosis program for stress reduction and improved stress coping, plus 5 hypnosis audio recordings for further individual practice at home, as well as an educational booklet on coping with stress. Perceived stress for the following week was measured at baseline and after 5 weeks using a visual analog scale (0-100 mm; VAS). Hypnosis outcome expectations were assessed at baseline only with the Expectations for Treatment Scale (ETS). Unadjusted and adjusted linear regressions were performed to examine the association between baseline expectations and perceived stress at 5 weeks. Results: Data from 47 participants (M = 45.02, SD = 13.40 years; 85.1% female) were analyzed. Unadjusted (B = 0.326, t = 0.239, p = 0.812, R2 = 0.001) and adjusted (B = 0.639, t = 0.470, p = 0.641, R2 = 0.168) linear regressions found that outcome expectations to hypnosis were not associated with a change in perceived stress between baseline and after 5 weeks in the intervention group. Conclusion: Our findings suggest that the beneficial effect of group hypnosis in distressed participants were not associated with outcome expectations. Other mechanisms of action may be more important for the effect of hypnosis, which should be explored in future research.Clinical trial registration: ClinicalTrials.gov, identifier NCT03525093.

Mindful Self-Hypnosis Combined with Resistance Training to Reduce Perceived Stress and Improve Other Psychological Factors in Female College Students.

Perceived stress is a significant problem among female college students that can impact psychological distress, sleep, and overall well-being. Mindful self-hypnosis (MSH) and resistance training (RT) have both been shown to reduce perceived stress. The rationale for the present study was to investigate whether MSH combined with RT could be more effective at reducing perceived stress as measured by the Perceived Stress Scale than RT alone due to synergistic effects achieved by combining the interventions. Forty-four female college students were randomized to one of the three groups: MSH+RT, RT only, or a wait-list control (WLC). Results indicated that, compared to RT only, the addition of MSH led to pronounced improvements in perceived stress which was significantly greater than WLC. Also, MSH+RT resulted in significant increases in mindfulness, sleep, strength, and well-being in comparison to WLC. MSH+RT was shown to be feasible with highly satisfactory participant ratings. Future research should examine the MSH+RT intervention with a larger population and with older women who are more at risk for stress and declining strength.

Effect of Brain-gut Behavioral Treatments on Abdominal Pain in Irritable Bowel Syndrome: Systematic Review and Network Meta-analysis.

BACKGROUND AND AIMS: Some brain-gut behavioral treatments (BGBTs) are beneficial for global symptoms in irritable bowel syndrome (IBS). US management guidelines suggest their use in patients with persistent abdominal pain but their specific effect on this symptom has not been assessed systematically. METHODS: We searched the literature through 16th December 2023 for randomized controlled trials (RCTs) assessing efficacy of BGBTs for adults with IBS, compared with each other, or a control intervention. Trials provided an assessment of abdominal pain resolution or improvement at treatment completion. We extracted data as intention-to-treat analyses, assuming dropouts to be treatment failures and reporting pooled relative risks (RRs) of abdominal pain not improving with 95% confidence intervals (CIs), ranking therapies according to P-score. RESULTS: We identified 42 eligible RCTs, containing 5220 participants. After treatment completion, the BGBTs with the largest numbers of trials, and patients recruited, demonstrating efficacy for abdominal pain, specifically, included self-guided/minimal contact cognitive behavioral therapy (CBT) (RR = 0.71; 95% CI 0.54-0.95, P-score 0.58), face-to-face multicomponent behavioral therapy (RR = 0.72; 95% CI 0.54-0.97, P score 0.56), and face-to-face gut-directed hypnotherapy (RR = 0.77; 95% CI 0.61-0.96, P-score 0.49). Among trials recruiting only patients with refractory global IBS symptoms, group CBT was more efficacious than routine care for abdominal pain, but no other significant differences were detected. No trials were low risk of bias across all domains and there was evidence of funnel plot asymmetry. CONCLUSIONS: Several BGBTs, including self-guided/minimal contact CBT, face-to-face multicomponent behavioral therapy, and face-to-face gut-directed hypnotherapy may be efficacious for abdominal pain in IBS, although none were superior to another.

Revisiting Eye Movement Desensitization and Reprocessing Therapy for Post-traumatic Stress Disorder: A Systematic Review and Discussion of the American Psychological Association's 2017 Recommendations.

This literature review evaluates the efficacy and clinical applications of eye movement desensitization and reprocessing (EMDR) therapy for post-traumatic stress disorder (PTSD). The review highlights the effectiveness of EMDR in reducing PTSD symptoms and explores variations in treatment protocols, populations studied, and outcome measures. We conducted systematic searches of multiple databases, supplemented with manual searches and reference list exploration. The inclusion criteria focused on English-language studies published between January 2000 and June 2023, with a specific emphasis on adult psychiatric patients with PTSD receiving EMDR treatment. The review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for narrative literature reviews. Out of 867 identified studies, 16 met the eligibility criteria. Most studies found that EMDR was superior in relieving PTSD when compared to controls. Eleven of the 16 selected studies demonstrated improvement in PTSD symptoms. An additional three studies noted an improvement in PTSD symptoms when compared to their waitlist control counterparts. One study found EMDR superior in combating depressive symptoms when compared to rapid eye movement desensitization. EMDR therapy is an appropriate treatment for PTSD. Although some studies compared to waitlist controls, and others have a small number of participants, the data supports the use of EMDR for PTSD. Future studies are needed to continue to better understand the mechanism and application in different populations.

French Norms for a Shortened Online Adaptation of the Harvard Group Scale of Hypnotic Susceptibility, Form A.

This study presents the norms and psychometric properties for a shortened online adaptation of a French version of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A). Assessment of involuntariness and subjective intensity was added to the traditional scoring. A total of 373 individuals completed an online hypnotizability screening test on their own computer. Participants received the HGSHS:A script through an audio recording lasting about 30 minutes. The results showed that the item difficulty and reliability of the short online HGSHS:A were consistent with the offline version of the scale and with the reference samples. Involuntariness and subjective intensity corrections improved significantly the accuracy in the measurement of the scale and helped to dissociate between different phenomenologies in hypnotic responding. These findings indicate that the short online HGSHS:A is a reliable tool for measuring hypnotizability. Moreover, we suggest that using complementary measures of involuntariness and subjective intensity helps to shed more light on hypnotizability as part of a multi-componential approach to hypnotic response.

A global neuronal workspace model of functional neurological disorders.

We introduce here a general model of Functional Neurological Disorders based on the following hypothesis: a Functional Neurological Disorder could correspond to a consciously initiated voluntary top-down process causing involuntary lasting consequences that are consciously experienced and subjectively interpreted by the patient as involuntary. We develop this central hypothesis according to Global Neuronal Workspace theory of consciousness, that is particularly suited to describe interactions between conscious and non-conscious cognitive processes. We then present a list of predictions defining a research program aimed at empirically testing their validity. Finally, this general model leads us to reinterpret the long-debated links between hypnotic suggestion and functional neurological disorders. Driven by both scientific and therapeutic goals, this theoretical paper aims at bringing closer the psychiatric and neurological worlds of functional neurological disorders with the latest developments of cognitive neuroscience of consciousness.

Hypnosis-Assisted Awake Craniotomy for Eloquent Brain Tumors: Advantages and Pitfalls.

BACKGROUND: Awake craniotomy (AC) is recommended for the resection of tumors in eloquent areas. It is traditionally performed under monitored anesthesia care (MAC), which relies on hypnotics and opioids. Hypnosis-assisted AC (HAAC) is an emerging technique that aims to provide psychological support while reducing the need for pharmacological sedation and analgesia. We aimed to compare the characteristics and outcomes of patients who underwent AC under HAAC or MAC. METHODS: We retrospectively analyzed the clinical, anesthetic, surgical, and neuropsychological data of patients who underwent awake surgical resection of eloquent brain tumors under HAAC or MAC. We used Mann-Whitney U tests, Wilcoxon signed-rank tests, and repeated-measures analyses of variance to identify statistically significant differences at the 0.05 level. RESULTS: A total of 22 patients were analyzed, 14 in the HAAC group and 8 in the MAC group. Demographic, radiological, and surgical characteristics as well as postoperative outcomes were similar. Patients in the HAAC group received less remifentanil (p = 0.047) and propofol (p = 0.002), but more dexmedetomidine (p = 0.025). None of them received ketamine as a rescue analgesic. Although patients in the HAAC group experienced higher levels of perioperative pain (p < 0.05), they reported decreasing stress levels (p = 0.04) and greater levels of satisfaction (p = 0.02). CONCLUSION: HAAC is a safe alternative to MAC as it reduces perioperative stress and increases overall satisfaction. Further research is necessary to assess whether hypnosis is clinically beneficial.

Beyond standard treatment: A qualitative descriptive study of cancer patients' perceptions of hypnotherapy in cancer care.

BACKGROUND AND PURPOSE: Cancer remains a leading cause of death in Australia. The number of new cancer cases diagnosed each year is expected to surpass 200,000 by 2033. This marks a significant increase from about 88,000 cases in 2000 to an estimated 165,000 cases in 2023. Despite advancements in treatment, emotional and psychological challenges in cancer care are often overlooked. This study focuses on hypnotherapy, a complementary therapy recognized for its efficacy for physical and emotional symptoms, yet underutilized in Australian cancer care. The research aims to explore patients' perceptions of hypnotherapy and identify barriers to its integration, contributing to the development of holistic, patient-centered cancer care models. MATERIALS AND METHODS: A qualitative study employing semi-structured interviews was conducted with 14 adult cancer patients (breast, lung, and colorectal) undergoing active treatment, selected through convenience sampling. The interviews were carried out from May 2022 to August 2023, focusing on participants' experiences and attitudes toward hypnotherapy among other complementary and alternative medicine (CAM) therapies. Thematic analysis using Braun and Clarke's six-step framework was applied to the data. RESULTS: Five themes were developed following analysis: 1) emotional roller coaster of cancer diagnosis, 2) participants' perspectives on hypnotherapy among other CAM modalities, 3) hypnotherapy as a psychological vs physiological support, 4) fringe benefits of hypnosis, and 5) the main hurdles: cost and lack of information. Participants expressed a diverse range of experiences and attitudes towards hypnotherapy and CAM, with a strong emphasis on the need for emotional support in cancer care. Although hypnotherapy was recognized for its potential to address both emotional and physical symptoms, its predominant use was for emotional well-being. Participants also highlighted the importance of attitudes and endorsements from healthcare providers in their decision-making process about CAM therapies. CONCLUSION: The study findings emphasize the need for a more integrative and patient-centered approach in cancer care that includes hypnotherapy as a non-pharmacological intervention for physical and particularly emotional support. Healthcare providers should be aware of the potential value of hypnotherapy and consider patient preferences in their recommendations. In addition, addressing the identified barriers could improve the accessibility and integration of hypnotherapy into cancer care protocols in Australia.

Effects of hand catalepsy on subjective trance perception and relative parasympathetic tone in healthy volunteers during pleasant hypnotic session: a randomized controlled study.

This study was designed to evaluate the effects on hand catalepsy on parasympathetic tone assessed using Analgesia/Nociception Index (ANI) and on subjective rating of absorption, dissociation, and time perception among healthy volunteers. This was a randomized controlled trial including participants to a medical hypnosis congress in France. Ninety volunteers were randomized in two arms, all receiving a fifteen-minute positive hypnotic trance, with or without hand catalepsy. The relative parasympathetic tone assessed by ANI (Analgesia/Nociception Index), heart rate and respiratory rate were recorded at different times of the study protocol. The actual duration of the hypnotic session, calculated from eye closing to eye opening, was also recorded. At the end of the hypnotic trance, participants subjectively rated their level of absorption and dissociation on a 0-10 scale. They were also asked to estimate the duration of the hypnotic session from eye closing to eye opening. In total, ninety subjects were included in the study. One subject was excluded because of deviation in the protocol standard, leaving eighty-nine subjects for analysis. Subject characteristics were similar between groups. There was a statistically different increase in ANI and decrease in both heart rate and respiratory rate over time with no difference with or without hand catalepsy. There was no statistically significant difference in absorption and dissociation subjective scales between groups. The median [Q1-Q3] actual duration of hypnotic sessions was similar between the catalepsy and the control groups (9 [8-10] min vs. 8 [7-10] min, respectively). However, subjects in the catalepsy group estimated a longer duration of the hypnotic session (12 [10-15] min) than in the control group (10 [5-10] min) with a mean ± SD overestimation of 3 ± 4 min (p < 0.001). Parasympathetic comfort increased during the hypnotic trance with no difference between groups. However, adding hand catalepsy to a pleasant hypnotic trance did not appear to increase feelings of absorption or dissociation but created time distortion on the longer side that could be useful in some clinical settings. Nevertheless, further study is still needed to determine more precisely the physiological and psychological effects on hand catalepsy during the hypnotic trance.

Gut-Directed Hypnotherapy May Pose Specific Challenges in Gender-Diverse Patients: A Review of 3 Patients.

Disorders of gut-brain interaction are common and often characterized by chronic symptom courses. While gut-directed hypnotherapy is effective for refractory disorders of gut-brain interaction, the required internal awareness and vulnerability may be challenging. Driven by our own clinical experiences, we conducted qualitative interviews with patients who identified as transgender or gender diverse and who had discontinued gut-directed hypnotherapy. Four main themes were generated from these interviews related to distress resulting from body awareness, difficulty with vulnerability, the importance of gender-affirming supports, and external barriers. Providers are encouraged to consider gender diversity, and more broadly body image, in discussion of hypnosis treatment.

Sleep effects of psychological therapies for menopausal symptoms in women with hot flashes and night sweats: A systematic review.

Sleep disturbance is frequently reported by women during the menopausal transition due to various physiological changes and environmental factors. Insomnia is a critical treatment target for its deleterious effects on daytime functioning and quality of life and increased risk of developing a depressive disorder. Due to medication side effects and patient preferences, there is increased interest in the use of psychological treatments that address the myriad of menopausal symptoms, including cognitive-behavioural therapy, clinical hypnosis and mindfulness-based therapies. The objective of this article is to review the effects of psychological treatments for menopausal symptoms on sleep disturbance in peri-/postmenopausal women. We conducted a systematic review of the literature using PubMed and reference lists from inception until May 2023, including 12 studies that evaluated sleep as a secondary outcome. Most studies found that group and self-help (guided and unguided) cognitive-behavioural therapies and clinical hypnosis for menopausal symptoms have positive effects on sleep among women with significant vasomotor symptoms. There was preliminary support for mindfulness-based stress reduction. Future research including more diverse samples and women with sleep disorders is needed. Evaluating the implementation of psychological therapies in clinics where menopausal women seek care is an important next step.

The Effectiveness of Hypnoanalgesia Using Conventional and Placebo Hypnosis Induction.

The effectiveness of hypnosis-based pain management is well-established. However, mechanisms of action and specific effective components are not well understood. The sociocognitive theory of hypnosis proposes that the effectiveness of hypnosis for pain management is determined by the nonspecific features of response expectancy and context. We tested this claim by contrasting the effectiveness of 2 hypnoanalgesia procedures in a within subjects design using the cold pressor task. The 2 procedures were identical, including analgesic suggestions, except for the hypnosis induction used. One condition involved a well-established hypnosis induction, including suggestions for focused attention, relaxation, and deepening. The other condition included a sham induction procedure using only white noise. In our confirmatory analysis (N = 46), we found that pain tolerance increased compared to baseline equivalently in the conventional and sham induction conditions (mean increase 13.7 and 12.4 seconds respectively, average within subject difference -1.27 seconds, 90% confidence interval [CI] = -8.46, 5.90). This finding supports the claim of the sociocognitive theory considering that response expectancy for pain reduction was also equivalent between the conditions (average difference 2.30, 90% CI = -2.23, 6.84). However, self-reported hypnosis depth was greater in the conventional induction condition (average difference -.78, 90% CI: -1.36, -.07), which contradicts sociocognitive predictions. Our findings indicate that conventional procedural elements of hypnosis inductions, such as suggestions for focused attention, relaxation, and deepening, may not be necessary to achieve acute pain reduction in an experimental setting when the hypnosis intervention includes analgesic suggestions. PERSPECTIVE: This study assessed the necessary effective components of hypnosis-based analgesia interventions. Our findings suggest that procedural features such as suggestions for focused attention, relaxation, and deepening may not be necessary for hypnoanalgesia as long as pain relief suggestions are present, and the hypnosis context and response expectancy are established. TRIAL REGISTRATION: This trial was registered on Open Science Framework with the registry number e96xk, available at https://osf.io/e96xk.

Neuroscientific results of experimental studies on the control of acute pain with hypnosis and suggested analgesia.

This narrative review summarizes a representative collection of electrophysiological and imaging studies on the neural processes and brain sources underlying hypnotic trance and the effects of hypnotic suggestions on the processing of experimentally induced painful events. It complements several reviews on the effect of hypnosis on brain processes and structures of chronic pain processing. Based on a summary of previous findings on the neuronal processing of experimentally applied pain stimuli and their effects on neuronal brain structures in healthy subjects, three neurophysiological methods are then presented that examine which of these neuronal processes and structures get demonstrably altered by hypnosis and can thus be interpreted as neuronal signatures of the effect of analgesic suggestions: (A) On a more global neuronal level, these are electrical processes of the brain that can be recorded from the cranial surface of the brain with magnetoencephalography (MEG) and electroencephalography (EEG). (B) On a second level, so-called evoked (EPs) or event-related potentials (ERPs) are discussed, which represent a subset of the brain electrical parameters of the EEG. (C) Thirdly, imaging procedures are summarized that focus on brain structures involved in the processing of pain states and belong to the main imaging procedures of magnetic resonance imaging (MRI/fMRI) and positron emission tomography (PET). Finally, these different approaches are summarized in a discussion, and some research and methodological suggestions are made as to how this research could be improved in the future.

Ciprofol as compared to propofol for sedation and general anesthesia: a systematic review of randomized controlled trials.

BACKGROUND: Propofol is the most commonly used hypnotic agent used during sedation and general anesthesia (GA) practice, offering faster recovery compared to benzodiazepines. However, cardiovascular impact of propofol and pain at injection are commonly encountered side effects. Ciprofol is a novel disubstituted phenol derivative, and there is growing evidence regarding its clinical use. METHODS: We conducted a systematic literature search (updated on 23 July 2023) to evaluate safety and efficacy of ciprofol in comparison to propofol in patients undergoing procedures under sedation or GA. We focused on randomized controlled trials (RCTs) only, extrapolating data on onset and offset, and on the side effects and the pain at injection. RESULTS: The search revealed 14 RCTs, all conducted in China. Eight RCTs studied patients undergoing sedation, and six focused on GA. Bolus of ciprofol for sedation or induction of GA varied from 0.2 to 0.5 mg/kg. In four studies using ciprofol for maintenance of GA, it was 0.8-2.4 mg/kg/h. Ciprofol pharmacokinetics seemed characterized by slower onset and offset as compared to propofol. Pain during injection was less frequent in the ciprofol group in all the 13 studies reporting it. Eight studies reported "adverse events" as a pooled outcome, and in five cases, the incidence was higher in the propofol group, not different in the remaining ones. Occurrence of hypotension was the most commonly investigated side effects, and it seemed less frequent with ciprofol. CONCLUSION: Ciprofol for sedation or GA may be safer than propofol, though its pharmacokinetics may be less advantageous.

Post-hypnotic suggestion improves confidence and speed of memory access with long-lasting effects.

In our study, we use the post-hypnotic suggestion of easy remembering to improve memory with long-lasting effects. We tested 24 highly suggestible participants in an online study. Participants learned word lists and recalled them later in a recognition memory task. At the beginning of the study, participants were hypnotized and the post-hypnotic suggestion to remember easily was associated with a cue that participants used during the recognition memory task. In a control condition, the same participants used a neutral cue. One week later, participants repeated both conditions with new word lists. Participants were significantly faster and more confident in their recognition ratings in the easy-remembering condition compared to the control condition, and this effect persisted over one week. Crucially, the increased speed and confidence in the easy-remembering condition did not affect memory accuracy. That makes our hypnosis intervention promising for patients experiencing subjective memory impairments. APA PSYCINFO CODES: 2343 (Learning and Memory), 2380 (Consciousness States), 3351 (Clinical Hypnosis).

Exploring the Role of Conscious and Unconscious Processes in Hypnosis: A Theoretical Review.

This review provided a comprehensive examination of various theories that attempt to explain hypnosis, focusing on the interplay between conscious and unconscious processes. We conducted a thorough analysis of key theories, from historical origins to recent models centered on cognition, social factors, and attributions. A central theme emerged: the critical role of the unconscious as a "gatekeeper" that modulates and guides the hypnotic experience. This notion appears in various forms across many theories, with the unconscious actively shaping and regulating the flow of information between conscious and unconscious realms during hypnosis. Understanding this dynamic interplay is crucial for comprehending the complex nature of hypnosis. The synthesized view of the unconscious as a "gatekeeper" offers a framework for integrating insights from diverse perspectives and highlights the centrality of unconscious processes in shaping hypnotic phenomena. Future research should further investigate the mechanisms of this unconscious "gatekeeper" role and its impact on hypnosis.

Changes in high-order interaction measures of synergy and redundancy during non-ordinary states of consciousness induced by meditation, hypnosis, and auto-induced cognitive trance.

High-order interactions are required across brain regions to accomplish specific cognitive functions. These functional interdependencies are reflected by synergistic information that can be obtained by combining the information from all the sources considered and redundant information (i.e., common information provided by all the sources). However, electroencephalogram (EEG) functional connectivity is limited to pairwise interactions thereby precluding the estimation of high-order interactions. In this multicentric study, we used measures of synergistic and redundant information to study in parallel the high-order interactions between five EEG electrodes during three non-ordinary states of consciousness (NSCs): Rajyoga meditation (RM), hypnosis, and auto-induced cognitive trance (AICT). We analyzed EEG data from 22 long-term Rajyoga meditators, nine volunteers undergoing hypnosis, and 21 practitioners of AICT. We here report the within-group changes in synergy and redundancy for each NSC in comparison with their respective baseline. During RM, synergy increased at the whole brain level in the delta and theta bands. Redundancy decreased in frontal, right central, and posterior electrodes in delta, and frontal, central, and posterior electrodes in beta1 and beta2 bands. During hypnosis, synergy decreased in mid-frontal, temporal, and mid-centro-parietal electrodes in the delta band. The decrease was also observed in the beta2 band in the left frontal and right parietal electrodes. During AICT, synergy decreased in delta and theta bands in left-frontal, right-frontocentral, and posterior electrodes. The decrease was also observed at the whole brain level in the alpha band. However, redundancy changes during hypnosis and AICT were not significant. The subjective reports of absorption and dissociation during hypnosis and AICT, as well as the mystical experience questionnaires during AICT, showed no correlation with the high-order measures. The proposed study is the first exploratory attempt to utilize the concepts of synergy and redundancy in NSCs. The differences in synergy and redundancy during different NSCs warrant further studies to relate the extracted measures with the phenomenology of the NSCs.

Hypnosis in psychotherapy, psychosomatics and medicine. A brief overview.

Aspects of hypnosis and its application in psychotherapy, psychosomatics and medicine are examined and contextualized in the 250-year history of hypnosis. Imagination as an essential element of hypnotic treatments appeared as early as 1784 as an argument rejecting the theory of animal magnetism of Franz Anton Mesmer. In somnambulism of German romanticism, another proto-form of hypnosis after 1800, concepts of the mind-body problem were dealt with, which still characterize the understanding of unconscious mental processes today. Hypnosis was at the beginning of psychoanalysis, but was not pursued further by Sigmund Freud from 1900 onwards. Nevertheless, there were some hypnoanalytical approaches in the 20th century, as well as attempts to integrate hypnosis into behavior therapy. Techniques of imagination and relaxation combine both; in particular findings from cognitive psychology explain processes of both hypnosis and cognitive behavioral therapy. The influence of social psychology brought a new perspective to the debate about the nature of hypnosis, which continues to this day: is hypnosis to be understood as a special state of consciousness or is it a completely normal, mundane interaction? The experiments that were carried out to support one side or the other were also dependent on the hypnotizability of the subjects involved, as the more difficult hypnotic phenomena such as paralysis, hallucinations or identity delusions can only be demonstrated by highly hypnotizable subjects. The fact that these are not mere compliance reactions has now been proven by many studies using imaging techniques. But even those who are moderately hypnotizable benefit from hypnosis rituals. Variables postulated by socio-cognitive hypnosis researchers, such as motivation and expectation, are relevant, as is a good "hypnotic rapport." Practical application of hypnotherapy today is characterized by the innovative techniques and strategies developed by Milton H. Erickson. Research into the effectiveness of hypnosis in the field of psychotherapy and psychosomatics still leaves much to be done. The situation is different in the field of medical hypnosis, where there are considerably more studies with a satisfactory design and verifiable effects. However, the impact in practical application in everyday medical practice is still low. Newer developments such as virtual reality and artificial intelligence are being looked at with critical interest.

Applying hypnotic associative - dissociative techniques in psychotherapy for psychosomatic symptoms.

Patients experiencing psychosomatic symptoms frequently have difficulty obtaining correct treatment. They are often reluctant to partially attribute their symptoms to psychological factors and, as a result, delay referrals to mental health professionals. Furthermore, the dropout rate from therapy is high and relapses are common. Hypnosis is a complex psycho-physiological phenomenon. Hence, hypnotic psychotherapy may play an important role in managing and treating psychosomatic symptoms and disorders that involve both the mind and body. In the current study, we propose a clinically oriented, four-phase, hypnotic approach, the hypnotic associative-dissociative approach (HADA), which may be useful in encouraging more patients with psychosomatic problems to engage in psychotherapy, thereby achieving effective long-term effects.