Hypnosis And Psychoneuroimmunology

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In light of current interest in psychoneuroimmunology and mind-body connections, a somewhat neglected area of hypnotherapy research of major theoretical and practical interest is the underlying neurophysiological processes that might mediate hypnosis in its contribution to immunomodulation. Interpretation of earlier research is hindered by methodological shortcomings; these shortcomings are now being addressed and overcome with the most recent wave of research. It is suggested that the reduction of stress, enhancement of positive emotional states and enhanced imaginal processing that often occur during clinical applications of hypnosis may be contributing factors. Spiegel (1993) suggests that self-hypnosis may enhance feelings of control which, in turn, produce reduced pain and increased immune functioning for highly hypnotizable individuals and, perhaps, lows as well. Whether physiological reactivity, hypnotic responsiveness, mood state, or some other factor mediates these hypothesized connections between hypnosis and immunomodulation needs further investigation.

A review of the literature (Laidlaw, Richardson, Booth & Large, 1994) points out that the combination of hypnosis and skin reactivity has been investigated for over 50 years, first beginning with work by Clarkson (1937), Zeller (1944) and the early studies by Black and Mason in England (e.g., Black, 1963a,b, 1969; Black, Humphrey & Niven, 1963; Mason & Black, 1958) and continuing to a resurgence of interest in the past 10 years (e.g., Laidlaw, Booth & Large, 1994, 1996; Laidlaw, Large & Booth, 1997; Laidlaw, Richardson, Booth & Large, 1994; Zacharie & Bjerring, 1993; Zachariae, Bjerring & Arendt-Nielsen, 1989). The Mantoux reaction to tuberculin was inhibited by highly hypnotizable subjects who were Man-toux-positive (Black, Humphrey & Niven, 1963; Zachariae, Bjerring & ArendtNielsen, 1989), yet two other studies (Beahrs, Harris & Hilgard, 1970; Locke, Ransil, Covino et al., 1987) were unable to replicate. Asthmatic patients reduced reactions to histamine more so in hypnosis than nonhypnosis conditions (Laidlaw et al., 1994). Further work from New Zealand found that subjects given hypnotic suggestions were able to decrease their reactivity to histamine reactions (Laidlaw, Booth & Large, 1996) and allergen reactions (Laidlaw, Large & Booth, 1997). Those who produced the largest effects tended to be more hypnotizable (Laidlaw, Large & Booth, 1997). Of great interest is that mood was an important correlate: low irritability rating was associated with smaller wheals (Laidlaw, Booth & Large, 1994, 1996). Hypnotic treatment of warts was found to be more successful than topical medication or placebo medication (e.g., Spanos, Williams & Gwynn, 1990).

Beyond the space of this chapter are other important physiological changes accompanying waking and hypnotic suggestions that are worthy of further investigation. Suggestions of cooling and imagery have assisted burn patients, particularly those who were noted to image well, within hours of the burn incident (Margolis, Domangue, Ehleben & Shrier, 1983; for a review, see Patterson, Adcock & Bombardier, 1997). Suggestions have led to reduced blood loss in spinal (Bennett, Benson & Kuiken, 1986) and maxillofacial (Enqvist, von Konow & Bystedt, 1995) surgery patients, possibly because of the reduced anxiety and lowered blood pressure accompanying the suggestions. Suggestions have enhanced blood clotting in severe hemophilia (Swirsky-Sacchetti & Margolis, 1986). Increased blood volume was increased in Raynaud's disease (Conn & Mott, 1984). Hypnosis in the successful treatment of asthma has been demonstrated (e.g., Collison, 1975; Ewer & Stewart, 1986). The possible effect of hypnosis on T and B cell functioning, neutrophil adhesiveness and other immunological factors may have important implications for cancer and the psychology of healing (e.g., Hall, 1982-83, Hall, Minnes, Tosi & Olness, 1992; Hall, Mumma, Longo & Dixon, 1992; Ruzyla-Smith, Barabasz, Barabasz & Warner, 1995).

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