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.

Traits linked to sensory processing sensitivity mediate the relationship between externally oriented thinking and fantasizing.

Introduction: Alexithymia is characterized by difficulties identifying and describing feelings but expression of externally oriented thinking (EOT) and difficulty fantasizing is more variable. In two studies, we investigated whether links between EOT and fantasizing are mediated by sensory processing sensitivity (SPS). Methods: University students completed measures of alexithymia, SPS, and fantasizing. Results: In Study 1 (N = 700) we identified two clusters of SPS traits: a positive facet (sensitivity to subtle stimuli) and a negative facet (sensitivity to uncomfortable stimuli). In the 499 participants who completed the fantasy measure, low EOT scores predicted stronger SPS positive and negative traits, which predicted a stronger tendency to mentally project oneself into the lives of characters in books, movies, and plays. In Study 2 (N = 600), the link between EOT and this same fantasizing tendency was again mediated by features of SPS-in this case fantasy proneness and emotional reactivity. Discussion: We suggest that, whereas individuals who score high on EOT have an impoverished fantasy life, those who score relatively low on EOT and turn their attention inward are able to maintain stronger representations of imagined events in working memory (enhancing the likelihood that they will be recalled) and react more strongly to these events (enhancing their salience). Stronger expression of these features of SPS, in turn, increases the likelihood that one will develop a cognitive style that involves the application of imagery-based strategies to support deep processing of the thoughts and feelings of characters depicted in narratives.

Zoofolkloristics: Imagination as a Critical Component.

Nonhuman animal protagonists of folklore texts in the European space have tended to be perceived primarily as performing a symbolic and metaphoric function. But behind the symbols and the metaphors hide real flesh-and-blood nonhuman animals, and flesh-and-blood humans interacting with them, mostly from a position of power. The emerging discipline of zoofolkloristics considers nonhuman animals in their own right. Through critical analysis of folklore material, zoofolkloristics examines the role of animals and power relations within the interspecies entanglement with the aim of deconstructing the oppressive system and establishing multispecies justice. We begin this paper with a brief reflection on the 'historical animal' as an embodied being and a human construct. We then perform a critical re-reading of three animal-related folklore texts from the Slovenian tradition and, applying Hubert Zapf's concept of imaginative counter-discourse, consider the potential of imagination as a methodological tool in the transformative program of zoofolkloristics. Implications for animal ethics, liberation, and conservation are also discussed.

Visions for planetary health: Results from open-ended questions of survey participants after a virtual planetary health lecture series.

INTRODUCTION: A profound transformation of all areas of human activities is urgently needed for planetary health. Developing a shared vision of the future that is grounded in values aligned with planetary health is indispensable in this regard. The Planetary Health Academy is the first open online lecture series in Germany aiming for transformative planetary health education. As part of a recent evaluation of the impact of the lecture series, participants' visions for planetary health were also examined. METHODS: As part of a retrospective, cross-sectional, self-administered online survey, participants were asked to respond to an open-ended question on their visions for planetary health. Results were analysed using summarising qualitative content analysis according to Mayring. Sociodemographic details of those participants who provided a valid answer (n = 197) were calculated. RESULTS: Eight main categories were developed to summarise participants' visions for planetary health. These were: Awareness for planetary health - Planetary health integrated in all types of education - Establishment and development of the concept - A different understanding of health (care) - A transformative movement and global community - Transforming human activities - Planetary health as a guiding principle - The future state of planetary health. DISCUSSION: Broadly, the participants' visions were about planetary health as a goal and the means necessary to achieve this goal. Our findings can only be seen as a first explorative step in eliciting aspects of a common vision for planetary health, as our study design did not include a mechanism of building consensus towards one common vision. Besides the field of planetary health, similar concepts and associated movements exist or are emerging. Facilitating dialogue and exchange across disciplines and narratives about the prevailing future visions will be key to achieving what we call planetary health and what others might call Ubuntu or buen vivir. CONCLUSION: The results of this study provide first insights into the planetary health visions of those whom we would consider members of a movement aligned behind the idea of planetary health. In future editions, the Planetary Health Academy could integrate more discursive elements with a particular focus on negotiating future visions to support the creation of a critical mass of change agents within the health community and beyond.

Causal role of the angular gyrus in insight-driven memory reconfiguration.

Maintaining an accurate model of the world relies on our ability to update memory representations in light of new information. Previous research on the integration of new information into memory mainly focused on the hippocampus. Here, we hypothesized that the angular gyrus, known to be involved in episodic memory and imagination, plays a pivotal role in the insight-driven reconfiguration of memory representations. To test this hypothesis, participants received continuous theta burst stimulation (cTBS) over the left angular gyrus or sham stimulation before gaining insight into the relationship between previously separate life-like animated events in a narrative-insight task. During this task, participants also underwent EEG recording and their memory for linked and non-linked events was assessed shortly thereafter. Our results show that cTBS to the angular gyrus decreased memory for the linking events and reduced the memory advantage for linked relative to non-linked events. At the neural level, cTBS targeting the angular gyrus reduced centro-temporal coupling with frontal regions and abolished insight-induced neural representational changes for events linked via imagination, indicating impaired memory reconfiguration. Further, the cTBS group showed representational changes for non-linked events that resembled the patterns observed in the sham group for the linked events, suggesting failed pruning of the narrative in memory. Together, our findings demonstrate a causal role of the left angular gyrus in insight-related memory reconfigurations.

Self-guided imagery rescripting for worry images: A preliminary experimental investigation.

BACKGROUND: Mental images of feared events are overactive and intrusive in generalized anxiety disorder (GAD). Imagery rescripting involves integration of positive or neutral imagery and corrective information into images to facilitate emotional processing, reduce imagery intrusions, and re-structure underlying schema. Yet only one known study has applied the technique to treatment of worry. The present study aimed first to examine the relationship between trait worry and properties of future-oriented worry images, and second to examine the efficacy of a self-guided imagery rescripting intervention in improving individuals' response to their worries. METHODS: Participants recruited through Amazon Mechanical Turk (N = 365) identified their major worry and wrote the script of a worst-case scenario mental image. Participants were randomized to three conditions: re-writing the same worry image script (exposure), or writing scripts of either one or three positive alternative future-oriented images (rescripting conditions). RESULTS: In preliminary analyses, trait worry negatively predicted participants' ratings of worry images, including valence and ability to cope, and positively predicted distress, anticipated cost, and belief in their negative meaning. In experimental analyses, linear mixed-effects models revealed anxious response and cognitive appraisal of the threat were significantly lower among participants allocated to rescripting relative to exposure. There was no effect of rescripting type. CONCLUSIONS: This investigation demonstrated the impact of a future-oriented imagery rescripting task on anxiety and cognitive biases associated with real worries in an unselected sample. Results may contribute to the development of imagery rescripting interventions for GAD.

Counterfactual imagination impairs memory for true actions: EEG and behavioural evidence.

Imagined events can be misremembered as experienced, leading to memory distortions. However, less is known regarding how imagining counterfactual versions of past events can impair existing memories. We addressed this issue, and used EEG to investigate the neurocognitive processes involved when retrieving memories of true events that are associated with a competing imagined event. Participants first performed simple actions with everyday objects (e.g., rolling dice). A week later, they were shown pictures of some of the objects and either imagined the same action they had originally performed, or imagined a counterfactual action (e.g., stacking the dice). Subsequent tests showed that memory for performed actions was reduced after counterfactual imagination when compared to both veridical imagination and a baseline condition that had not been imagined at all, providing novel evidence that counterfactual imagination impairs true memories beyond simple forgetting over time. ERPs and EEG oscillations showed evidence of separate processes associated with memory retrieval versus post-retrieval processes that were recruited to support recall of memories that were challenging to access. The findings show that counterfactual imagination can cause impairments to sensorimotor-rich event memories, and provide new evidence regarding the neurocognitive mechanisms that are recruited when people need to distinguish memories of imagined versus true events.

Imagination and idealism after the COVID-19 pandemic: the science of healthy ageing.

On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a public health emergency of international concern. Medical science must now consider how it ought to recalibrate its imagination and idealism in a post-COVID-19 pandemic world. The fact that advanced age was the largest risk factor for COVID-19 mortality and serious illness, as well as for the most prevalent chronic diseases, reveals the urgency and significance of shifting the focus from mitigating each specific pathology risk, one at a time, to targeting biological ageing itself. In his 1910 JAMA Address entitled 'Imagination and Idealism in the Medical Sciences', Christian Herter made an important distinction between two ways imagination and idealism can be invoked in the medical sciences: (i) humanitarian medicine, which emphasizes the obvious and direct paths of ameliorating human suffering; and (ii) a curiosity-oriented approach which explores pure science and the experimental laboratory. The latter examines the indirect ways of winning, in Herter's words, 'the citadel' of health promotion. Herter's reflections on these two contrasting approaches to medicine have significance for both the COVID-19 pandemic and the aspiration to promote the ideal of healthy ageing in the post-COVID-19 pandemic era.

Can the prosocial benefits of episodic simulation transfer to different people and situational contexts?

Previous research has found that episodic simulation of events of helping others can effectively enhance intentions to help the same person involved and the identical situational context as the imagined scenarios. This 'prosocial simulation effect' is argued to reflect, at least in part, associative memory mechanisms whereby the simulation is reactivated when in the same situation as that imagined. However, to date, no study has examined systematically whether this 'prosocial simulation effect' can be transferred to response scenarios involving different people and/or situational contexts to the imagined scenarios, and if so, whether the degree of overlap with the imagined helping episode modulated the transfer effect. Across two experiments, we systematically varied the overlap of the simulated and response scenarios, both in terms of the persons in need and/or the situational contexts, and whether would influence the magnitude of prosocial simulation effect. Results from both experiments showed that the prosocial simulation effect can be transferred to response scenarios involving different people and situational contexts to the simulated scenarios. However, this finding was primarily driven by response scenarios that had a high degree of overlap to the simulated scenarios. The application of our findings to the practical implementation of simulation to promote prosociality in the real world is discussed.

Promoting moral imagination in nursing education: Imagining and performing.

Moral imagination is a central component of moral agency and person-centred care. Becoming moral agents who can sustain attention on patients and their families through their illness and suffering involves imagining the other, what moral possibilities are available, what choices to make, and how one wants to be. This relationship between moral agency, moral imagination, and personhood can be effaced by a focus on task-driven technical rationality within the multifaceted challenges of contemporary healthcare. Similarly, facilitating students' moral agency can also be obscured by the task-driven technical rationality of teaching. The development of moral agency requires deliberate attention across the trajectory of nursing education. To prepare nursing students for one practice challenge, workplace violence, we developed a multimodal education intervention which included a simulated learning experience (SLE). To enhance the realism and consistency of the educational experience, 11 nursing students were trained as simulated participants (SP). As part of a larger study to examine knowledge acquisition and practice confidence of learners who completed the SLE, we explored the experience of being the SP through interviews and a focus group with the SP students. The SP described how their multiple performances contributed to imagining the situation 'on both sides' prompting empathy, a reconsideration of their moral agency, and the potential to prevent violence in the workplace beyond technical rational techniques, such as verbal de-escalation scripts. The empirical findings from the SP prompted a philosophical exploration into moral imagination. We summarise the multimodal educational intervention and relevant findings, and then, using Johnson's conception of moral imagination and relevant nursing literature, we discuss the significance of the SP embodied experiences and their professional formation. We suggest that SLEs offer a unique avenue to create pedagogical spaces which promote moral imagination, thereby teaching for moral agency and person-centred care.

The Symbolism in a Case of Hysterical Psychosis

The authors take inspiration from a case of hysterical psychosis to illustrate a typical condition of this evocative disease: the symbolic language of hysteria, conjurer of archetypical images. The authors encourage the clinician not to decode such aspects in rational analytical terms, rather to have a more wide-open approach that promotes the emergence of the individual unconscious, reconnecting with the collective imagination. This approach could help psychiatrists better understand a subject's inner experiences and interpersonal behavior. (AU)

The effect of guided imagery applied on geriatric orthopaedic patients on preoperative anxiety and comfort.

BACKGROUND: This study was designed to examine the effect of guided imagery applied to geriatric orthopaedic patients on preoperative anxiety and comfort. METHODS: This study was conducted as a randomized controlled trial. The population of the study consisted of geriatric patients treated in the orthopaedics and traumatology clinic of a university hospital. The sample consisted of 80 patients, including the experimental group (n = 40) and the control group (n = 40). Personal Descriptive Form, The State-Trait Anxiety Inventory (STAI) and General Comfort Scale were used as data collection tools. RESULTS: After the guided imagery application, it was determined that the anxiety of the experimental group decreased statistically significantly, and their comfort improved (P < 0.05). CONCLUSION: After the imagery, it was determined that the patients in the experimental group had a decrease in their anxiety level and an improvement in their comfort. Since it is a low-cost and easily accessible method, applying imagery in the preoperative period is recommended.

Homemaking away from home: a semiotic cultural psychology perspective.

How do migrants create a sense of home in the context of migration? What does it mean for a person to physically move away from one home and psychologically move toward another one somewhere else? How do migrants create a sense of continuity between the home that is no longer there and the home that is not yet here? This theoretical article is an invitation to address these questions from a semiotic cultural psychology perspective. The article emphasizes the importance of both geographical and semiotic movements in understanding the migration process. It shifts the focus away from tangible aspects of migration and toward the imagined and desired aspects of the process of homemaking. The concept of home is explored as a semiotic construction that guides human meaning-making processes, emphasizing its affective value and highlighting the dynamic dialectics of home and non-home. This alternative conceptualization offers new ways of understanding homemaking and being at home, beyond the commonly celebrated ideals of being settled or always being on the move. Finally, the article discusses the dynamic and developmental nature of migration, which can both threaten and open up opportunities for transformation and development, and suggests some general methodological principles that could guide research concerning the interplay between homemaking, migration, and culture.

Effect of Graded Motor Imagery Combined With Repetitive Transcranial Magnetic Stimulation on Upper Extremity Motor Function in Stroke Patients: A Randomized Controlled Trial.

OBJECTIVE: To investigate the efficacy of graded motor imagery therapy (GMI) and repetitive transcranial magnetic stimulation (rTMS) on upper extremity function alone and in combination in patients with stroke. DESIGN: This was a prospective randomized controlled trial. SETTING: A rehabilitation hospital. PARTICIPANTS: Participants (N=56) were randomized into GMI (n=19), rTMS (n=18), or combined groups (n=19). INTERVENTIONS: There were 2 interventions: (1) 20 minutes of 1 Hz rTMS. (2) 30 minutes of GMI. In addition to this, all participants receive conventional rehabilitation including 120 minutes of physical therapy and occupational therapy daily. All treatments were administered once a day, 5 days a week, for 4 weeks. The Fugl-Meyer assessment of upper extremity (FMA-UE), Action Research Arm Test (ARAT), modified Barthel Index (MBI), motor activity log (MAL), and motor evoked potential (MEP) were assessed in a blinded manner at baseline and 4 weeks after treatment, respectively. MAIN OUTCOME MEASURES: The primary endpoint was the improvement from baseline in FMA-UE for stroke patients at 4 weeks. RESULTS: After 4 weeks of treatment, the FMA-UE scores in the GMI, rTMS, and combined groups were higher than those at baseline assessment, with statistically significant differences among the 3 groups (P=.009). The efficacy of the combined group was significantly better than that of the GMI and rTMS groups (P=.015, P=.043, respectively). In the motor activity log-amount of use (MAL-AOU) score, the efficacy of the combined group was better than that of the rTMS group (P=.035). CONCLUSIONS: Both GMI and rTMS were effective in improving upper extremity function in patients with stroke, but the combination of the 2 techniques was more effective. However, GMI was better than rTMS in improving the interest of stroke patients in active training.

Thematic Contents of Mental Imagery are Shaped by Concurrent Task-Irrelevant Music.

Imagination plays a key role in evidence-based, cognitive therapies, and recent research highlights that music - a perceptual stimulus imbued with affective and social meaning - can influence some aspects of imagination, such as vividness and emotional tone. However, little is known about music's capability to facilitate specific imagery themes that may be relevant for therapy. Here, we examine whether the quantity and quality (related to themes of affect, social dynamics, and confidence) of people's imagery is affected by the presence of task-irrelevant background music. One hundred participants imagined the continuation of a figure's journey while listening to different musical excerpts or silence. Written reports of imagined journeys underwent linguistic analysis to reveal the number of words belonging to the themes of interest. Bayesian Mixed Effects models revealed that music (vs. silence) led to longer reports and predicted imagery characterised by affect, social dynamics, and confidence. Implications for therapy are discussed.

[The body in motion to cope with the disabled body]. / Le corps en mouvement pour faire face au corps en situation de handicap.

An experimental art-mediated psychotherapy workshop is offered to patients who, after a stroke, find their physical and mental capacities diminished. The traumatic experience of this brutal event and the resulting handicaps are a source of psycho-affective disorders that can hinder favorable motor recovery. The workshop's ethnoscenological approach provides an integrative reading of the psychological mechanisms at play, enabling us to work psychologically with the modified body through experiential performative practice and stage exercises that encourage the embodiment of the imaginary.

What networks in the brain system sustain imagination?

The brain cannot stop elaborating information. While the circuitries implied in processing sensory information, and those involved in programming and producing movements, have been extensively studied and characterized, what circuits elicit and sustain the endogenous activity (which might be referred to as imaginative activity) has not been clarified to a similar extent. The two areas which have been investigated most intensely are visual and motor imagery. Visual imagery mostly involves the same areas as visual processing and has been studied by having the subject face specific visual imagery tasks that are related to the use of the visual sketchpad as a component of the working memory system. Much less is known about spontaneous, free visual imagination, what circuits drive it, how and why. Motor imagery has been studied with several approaches: the neural circuits activated in the brain during performance of a movement have been compared with those involved in visually or kinaesthetically imagining performing the same movement, or in observing another person performing it. Some networks are similarly activated in these situations, although primary motor neurons are only activated during motor execution. Imagining the execution of an action seems unable to activate circuits involved in eliciting accompanying motor adjustments (such as postural adaptations) that are unconsciously (implicitly) associated to the execution of the movement. A more faithful neuronal activation is obtained through kinaesthetic motor imagination-imagining how it feels to perform the movement. Activation of sensory-motor and mirror systems, elicited by observing another person performing a transitive action, can also recruit circuits that sustain implicit motor responses that normally accompany the overt movement. This last aspect has originated the expanding and promising field of action observation therapy (AOT). The fact that the various kinds of motor imagery differentially involve the various brain networks may offer some hints on what neural networks sustain imagery in general, another activity that has an attentive component-recalling a memory, covertly rehearsing a speech, internally replaying a behaviour-and a vague, implicit component that arises from the freely flowing surfacing of internal images, not driven by intentional, conscious control.

Applied imagination.

Imagination is a fundamental human capacity, and to navigate our current global challenges, we need to define and encourage the practice of imagination, or what we term "applied imagination." In this study, we convened a series of focus groups or "virtual salons" to address three guiding questions: (1) How might we define imagination? (2) How might we (or should we) measure imagination? And (3) How might we foster imagination? Our efforts to define applied imagination highlight the crucial role imagination plays in human survival and thriving, the role of social forces in fostering or discouraging imagination, the connection between imagination and faith, and the "dark side" or maladaptive aspects of imagination. The discussions on measuring imagination were quite divided, with some salon participants arguing for the potential of indirect modes for measuring imaginative capacity while others argued that measuring imagination was functionally impossible and morally suspect. Finally, our results around fostering imagination suggest the importance of using play and humor, separating imaginative activities from the everyday, and employing constraints to prompt imaginative responses. We end with a discussion of possible directions for future research and a call to create a transdisciplinary field of imagination studies.

Hypnagogic states are quite common: Self-reported prevalence, modalities, and gender differences.

The hypnagogic state refers to the transitional phase between wakefulness and sleep during which vivid experiences occur. In this questionnaire study, we assessed the self-reported prevalence of hypnagogic states considering the frequency of experiences in different modalities. We also assessed the emotional quality and the vividness of the experiences. Moreover, we compared hypnagogic states to other phenomena, such as dreams, sleep paralysis, imagination, and extra-sensory perception in these measures. Hypnagogic states were reported by 80.2 % of 4456 participants and were more prevalent in women than men. Experiences were most often kinaesthetic and visual, and less often auditory, tactile, and olfactory or gustatory. Hypnagogic states were less prevalent than dreams and characterized by different modality profiles. However, they were similar to dreams in their emotional quality, the irritation they caused, and in their vividness. In conclusion, hypnagogic states are quite common.

The Black radical imagination: a space of hope and possible futures.

The radical imagination entails stepping outside the confines of the now and into the expansiveness of what could be. It has been described as the ability to dream of possible futures and bring these possibilities back to the present to drive social transformation. This perspective paper seeks to provide an overview of the radical imagination and its intersections with Afrofuturism, a framework and artistic epistemology that expresses the Black cultural experience through a space of hope where Blackness is integral. In this paper, I propose three processes that comprise the radical imagination: (1) imagining alternative Black futures, (2) radical hope, and (3) collective courage. I consider the neural networks that underlie each process and consider how the Black radical imagination is a portal through which aging Black adults experience hope and envision futures that drive social change. I conclude with considerations of what brain health and healing justice looks like for aging Black Americans- specifically, how invocation of the Black radical imagination may have positive brain health effects for a demographic group at increased risk for Alzheimer's disease and related dementias.