The numbers on smoking are pretty grim: Around 50 million Americans smoke. That habit claims more than 400,000 lives annually.

But one hopeful statistic stands out: Each year, about 1.3 million Americans successfully quit smoking.

Smokers often try many different methods to kick the habit: Nicotine patches, gum, antidepressants and even hypnosis.

However, until now, there hasn't been much evidence to suggest that hypnosis really works. In a new study, researchers from the University of California at San Francisco randomly assigned 125 smokers to receive hypnosis and a similar number of smokers to receive behavioral counseling.

After one year, 22 percent of those who had hypnosis had quit smoking compared to 15 percent of those who had traditional counseling.

Researchers say hypnosis appeared more effective in patients who had a history of depression.

Experts say it often takes several tries to stop smoking for good; so if one attempt fails, pick a new quit date and a new tactic and start again.

 Lose the Lamaze; ease the pain with hypnosis
    TRALEE PEARCE From Tuesday's Globe and Mail 
June 24, 2008 at 9:02 AM EDT

From the outside, it would appear the birth of Ashley Desson-Demetriadis's first child was a chaotic experience.

The Oakville, Ont., resident's plans for a home birth with a midwife were derailed when the baby's heart rate dropped and she was rushed to hospital.

But because Ms. Desson-Demetriadis, 25, was versed in a form of self-hypnosis geared to birthing moms, she says she was able to close her eyes and keep the complications at bay. A very healthy baby Noah arrived quickly, with the help of vacuum assistance.

"If you ask me, I say it was great. Fantastic," the interior designer says of the February birth. "As everything turned south, I don't feel like I experienced it. I feel like I witnessed it."

From left, Rachael Gukes, David Kennedy, Luke Woolford and Taryn McCormick participate in a Hypnosis for Childbirth workshop in Toronto. (Arantxa Cedillo for The Globe and Mail)

Forget Lamaze and its offspring. The latest in childbirth support is all about benign mind control. It's called hypnobirthing - and it has nothing to do with men in tuxedos waving pocket watches.

In the past 10 years, as hypnotherapy has grown in popularity for treatments such as smoking cessation, the practice has started inching into the mainstream. As Ms. Desson-Demetriadis's Hamilton-based instructor, Lara Stewart-Panko puts it, she's hearing a lot less "hypno what?"

Ms. Stewart-Panko teaches a trademarked technique called HypnoBirthing, created by a New Hampshire hypnotist, Marie Mongan, whose first client was her own pregnant daughter.

Others teach variations on the technique, such as Toronto hypnotist Shawn Gallagher, an associate with the Ontario Hypnosis Centre, who calls her course Hypnosis for Childbirth. The centre also trains hypnotherapists in the specialty - about 20 certified practitioners a year since 2002.

The underlying philosophy of hypnobirthing suggests that the more tense and afraid the mother is, the more pain she will feel; so controlling stress and fear are the starting

point to a more comfortable experience.

Practitioners teach moms-to-be how to close their eyes, breathe deeply and sink into a deep meditative state, often with the help of their partners, who can offer a physical cue such as a hand on the shoulder to initiate the hypnosis. Visualization methods are also used, as are tips on how to manage pain, especially during contractions, which the hypnobirthing community calls "waves" or "surges."

Last weekend, Ms. Gallagher had students hold their hands in buckets of ice water to learn how to numb pain using positive affirmations. Another goal is to shorten the time spent in active labour. Many of the mothers she has trained in the past 10 years happily report short labours - about 4 1/2 hours seems to be the norm, Ms. Gallagher says.

Still, while Ms. Gallagher is encouraged by the interest in her practice and in hypnosis in general, she is careful to explain that self-hypnosis may not be for everyone.

"Some people are naturally talented at it, but there are a range of responses," she says, adding that couples looking for courses should be wary of anyone who promises a completely pain-free experience.

Ms. Desson-Demetriadis was intrigued when a friend told her about using the technique. She was looking for an alternative to the gruesome, painful birth stories she was hearing from friends and family.

While the practice is a form of natural childbirth aimed at steering expectant moms away from rising numbers of induced births, epidurals and cesarean sections, hypnotherapists are not all vehemently opposed to these practices.

It's not an either-or choice, says Janice Daigle, a doula and hypnobirthing practitioner in Richibucto, N.B.Ms. Daigle uses the analogy of a baseball team: A woman about to give birth needs everyone on her bench, she says. Her starting player may be hypnobirthing, but she's also got to have doctors, nurses, the epidural and the cesarean section on her team. Hypnobirthing can help her deal with the worst of it.

Practitioners say they are starting to receive referrals from obstetricians and nurses. And some doctors and nurses are enrolling themselves.

Ms. Daigle currently has five doctors enrolled in her course. One Montreal medical resident, Marie (who asked that her name not be used because she wasn't offering her professional opinion), says she's taking a hypnobirthing class to balance her medical knowledge.

"I'm a rational person. It's really simple," says Marie, 27. " It gives me more tools. I don't want to be passive."

Even women who know their pregnancies are high-risk are turning to the practice.

Oakville mother Nancy Ortenburg, 38, choose hypnobirthing for her second birth after her first baby was stillborn in a very difficult labour.

"I was hysterical with pain," she says. "I thought, 'There has to be a better way.' "

When her second daughter started to arrive prematurely in January, Ms. Ortenburg and her husband rushed to hospital in Oakville, but there was no neonatal intensive care unit there. If Ms. Ortenburg could hold on until the next morning, there would be room for her baby at the Hospital for Sick Children in Toronto.

She credits hypnobirthing with slowing her contractions. "It got me through 28 hours," she says. When mom and baby were ready, it took only five pushes for baby Charlotte to appear. While she did need a pain reliever near the end, Ms. Ortenburg feels that hypnobirthing helped her and her husband "make the best we could have out of the situation at hand."

Hypnosis Works. The power of trance can no longer be disputed, a psychiatrist at Stanford University says.
Now we just haveto use it. 
                           Discover Magazine.com  By Michael Abrams, Photography by Dan Winters 11.25.2004 
                                
On one, I want you to do
one thing: Look up. 

On two, do two things:

Slowly close your eyes and take

a deep breath. 

On three, do three things:

Breathe out, relax your eyes, and

let your body float. 

Imagine you are floating in

a bath, a lake, a hot tub,

or just floating in space. 

Each breath is getting

deeper and easier . . .

The patient is 80 years old. She is lying under the bright lights of an operating room at Harvard’s Beth Israel Deaconess Medical Center, where radiologist Elvira Lang is about to thread a catheter through her arteries. The tiny tube will work its way to one of the woman’s kidneys, where it will block the organ’s blood supply. A surgeon is scheduled to remove the kidney the next day. Embolizing the kidney will help keep the operation simple, safe, and tidy. But the woman is running a fever, and her kidney may be infected. Because she ate earlier in the day, she can’t be given a sedative. What should have been a routine procedure has become an ordeal.

“This is your safe and pleasant place to be,” one of Lang’s associates reads from a laminated card. “You can use it in a sense to play a trick on the doctors. Your body has to be here, but you don’t.”

Lang is one of a growing number of hospital physicians who use hypnosis in addition to anesthesia. Together with David Spiegel, a professor of psychiatry at Stanford University School of Medicine, she has conducted extensive studies of hypnosis in the operating room, often with dramatic results. Hypnosis and interventional radiology interest Lang for the same reason: Both are ways of making a visit to the hospital less horrific. A tiny incision is all that’s required. By threading a stent into an artery, for example, Lang can help her patients avoid far more invasive surgery. “I’m your medical plumber,” she says. By adding hypnosis, she can make an operation shorter, less painful, and less dependent on drugs. The hardest part of the procedure is getting other doctors to accept it.

Over the years, a number of rigorously controlled studies have proved that hypnosis reduces pain, controls blood pressure, and can even make warts go away. But because very few studies have attempted to find out how it works, most scientists are skeptical of its power. Critics suggest hypnosis is no different from the placebo effect. They both use the power of suggestion to get the mind to heal the body; both are no substitute for medicine.

That skepticism has driven Spiegel and other researchers to take a hard look at what happens in the brain during hypnosis. Trance, they’ve found, opens a window onto the nature of the imagination. Through it, we are beginning to glimpse how the mind distinguishes daydreams from reality.

Spiegel is a second-generation hypnotist. His father, Herbert Spiegel, is a psychiatrist who first used hypnosis as a battlefield surgeon in World War II. In 1943 he even used the technique on himself when he was struck by a mortar from a German tank in Mateur, Tunisia. A steel shell fragment protruded from his ankle, but he managed to tune out the pain.

Soon after returning home, Spiegel was hired as a professor of combat psychiatry at the School of Military Psychiatry at Mason General Hospital in Brentwood, New York. There, he treated hundreds of returning veterans with hypnosis, becoming ever more convinced of its effectiveness. At the same time, the first clinical studies of hypnosis began to appear. In 1961 psychiatrist Ralph August published a study of 850 women who gave birth under hypnosis. Only 4 percent—34 women—required painkillers. Other studies found that hypnotized subjects could resist intense pain for a full minute longer than those who weren’t hypnotized, and for 30 seconds longer than those who had been given a placebo painkiller.

By the 1960s, Spiegel was teaching clinical hypnosis at Columbia University, and his son was among his students. David Spiegel went on to attend medical school at Harvard and to specialize in psychiatry and clinical hypnosis as his father had. In 1978 the two Spiegels coauthored the standard textbook in the field: Trance and Treatment: Clinical Uses of Hypnosis.

Now 58, David Spiegel is tall and a bit disheveled, with his father’s oval face and serene features. He speaks in complex but reasoned sentences and listens with the stoic patience of a man who has faced many disbelievers. “Hypnosis has been controversial since the beginning,” he says. “The thing is, it just won’t go away. There’s so much about the phenomenon that’s interesting.” Among researchers in the field, Spiegel says, there are two schools of thought and a growing chasm between them. One school claims that hypnosis fundamentally alters a subject’s state of mind; the other believes that hypnosis is simply a matter of suggestibility and relaxation. Spiegel belongs to the first school, and over the years he has had a running debate with two scientists on the other side: Irving Kirsch, a psychologist at the University of Connecticut at Storrs, and Stephen Kosslyn, a professor of psychology at Harvard.

Hypnosis Works pg2

Kirsch often uses hypnosis in his practice, and he doesn’t deny that it can be effective. “With hypnosis you do put people in altered states,” he says. “But you don’t need a trance to do it.” He likes to illustrate the point with an ancient talisman of the hypnotic trade: the pocket watch hanging on a chain. Put your elbow on a table, he says, holding the chain between your thumb and forefinger, and let the weight swing freely. Now, keeping your hand as steady as possible, imagine that the pendulum is moving back and forth parallel to your chest. “Just focus on it moving in that direction. Side to side,” he says. “Ignore everything else and imagine it going side to side at its own rhythm.” Once it’s swaying that way, and it inevitably will, imagine it swinging another way—clockwise, say, or toward you—just to prove to yourself that it’s not a coincidence. Once again, the weight will obey your mind. This little trick works on even the most skeptical and unhypnotizable of people. You don’t have to enter a trance for your subconscious and your body—in this case, the tiny muscles in your fingers—to respond to a suggestion. “I could have hypnotized you and done the same thing, but it wouldn’t have been a result of the hypnosis,” Kirsch says. “It would have been a result of your focusing on moving it in a particular direction.”

Spiegel disagrees. One of his best-known studies found that when subjects were hypnotized and given suggestions, their brain-wave patterns changed. He admits that suggestion alone is a powerful tool but believes that hypnosis magnifies its effects. In another of Spiegel’s studies, people under hypnosis were told their forearms were numb, then given light electrical shocks to the wrists. They didn’t flinch or respond in any way, and their brain waves resembled those of people who experienced a much weaker shock.

To Kirsch, this still wasn’t enough to prove the power of trance, but Stephen Kosslyn  was willing to be convinced. Kosslyn is an exceedingly polite man, with a gray, philosophical beard and perpetually raised eyebrows. The hypnosis literature is rife with examples of subjects aping what they believe is hypnotic behavior, he says. Such “demand effects” are exactly what make placebos so effective. As for the brain-wave study, other events in the lab—such as interaction with the investigators—could have caused the shift in the subjects’ state of mind. “Is it just playacting?” Kosslyn wondered, when he first saw Spiegel’s data. “Or is there something really going on in the brain?”

To find out, Spiegel and Kosslyn decided to collaborate on a study, focusing on a part of the brain that is well understood: the fusiform circuit. Located on the occipital lobe, the circuit has been found to process the perception of color. Neuroscientists zeroed in on it by placing subjects in a positron-emission tomography (PET) scanner to measure blood flow in the brain, then having them look at cards with color rectangles. Spiegel and Kosslyn wanted to see if subjects could set off the same circuit by visualizing color while under hypnosis.

The first step was to find the right study subjects. Only a small fraction of the population—known as highs in hypnotic circles—can enter a deep trance, just as only a few people cannot be hypnotized at all. The rest of us fall on a spectrum in between. (See “Can You Be Hypnotized?” page 60.) Spiegel and Kosslyn selected eight people from a pool of around 120 subjects, then Kosslyn’s team ran the experiment at Massachusetts General Hospital in Boston. As in the previous studies, subjects were put inside a PET scanner, shown a slide with color rectangles, and their brain activity was mapped. Then they were shown a black-and-white slide and told to imagine its having a color. Both tasks were repeated while under hypnosis.

The results, published in the American Journal of Psychiatry in 2000, were striking. When the subjects truly saw the color rectangles, the fusiform circuit lit up on both sides of their brain; when they had to imagine the color, the circuit only lit up in the right hemisphere. Under hypnosis, though, both sides of the brain became active—just as in regular sight. Under hypnosis, imagination seemed to take on the quality of a hallucination.

After the experiment, Kosslyn’s raised eyebrows, for once, came down. “I’m absolutely convinced now that hypnosis can boost what mental imagery does,” he says. “It sort of gives it a shot of vitamin A or something.” But Kirsch remains skeptical. The color experiments demonstrate that people “are really experiencing the effects of hypnotic suggestion,” Kirsch says, but not necessarily that they enter a trance. The subjects were told to see the card in color when they were hypnotized but only to imagine it in color when they weren’t, Kirsch points out. “Being told to pretend that you’re having the experience is a very different thing than the suggestion to have the experience.”

“Technically, he’s right,” Kosslyn says. Because the eight subjects were all highly hypnotizable—or at least highly suggestible—Kosslyn and Spiegel were afraid that if the subjects were told to see the color, just as they had been when hypnotized, they would slip into a trance. Kosslyn doubts that changing the wording would have made a difference. “The hypnotized people would tell you that they could literally see. ‘Lows’ couldn’t even do the task. They simply couldn’t do it.”

Hypnosis Works pg3

To Kosslyn, the hypnosis study shows how the brain distinguishes between imagination and perception. The right side of the brain processes specific examples of things, while the left side processes more general concepts and categories. The left side knows that Spot is a dog, for instance, while the right side knows that the dog is Spot. That’s why the right side of the brain lights up when we imagine a particular color, but the left side is left cold: The details of the daydream may seem real, but they don’t apply to a larger reality.

“The realms of imagination and perception are not entirely distinct,” Spiegel says. “This goes back to philosophers as far as Kant. What we take as reality is our processing of perceptual input.” We make assumptions about what’s real from small cues that are far from the complete picture. If you are expecting to meet a friend at a restaurant and a stranger comes in with the same jacket and hair, you might call out your friend’s name, but as soon as you see his face your mistake will be obvious. “Rather than passively accepting perception, we set up a competition between imagination and perception,” Spiegel says. “Imagination can alter perception—in a sense it always does. But we’re not aware of it.” Under hypnosis, that distinction breaks down.

Kosslyn believes that hypnosis allows the body to tap into hidden reserves. He compares its effect to that of breaking a world record in sports: It changes our sense of the possible. “For years and years and years, no one could run a mile under four minutes,” he says. “It was like the sound barrier—people thought that limbs would start falling off.” Yet only six weeks after the record was finally broken, by British runner Roger Bannister in 1954, it was broken again by another runner. “Nowadays 40-year-olds can do it.” Hypnosis may have the same effect, Kosslyn says. “It shifts what I call the assumed norm. It can play the part that Roger Bannister did in the four-minute mile.”

Spiegel is a clinician first and a scientist second. The whys of hypnosis aren’t as important, he believes, as that doctors recognize its power and start to use it. To that end, he and Lang have put the technique to the test in the operating room, just as he and Kosslyn did in the PET scanner. Seven years ago, Spiegel and Lang took 241 patients slated for vascular or kidney surgery and divided them into three groups. One group received standard care; another received standard care with an “empathic care provider”; and the third received standard care, an empathic care provider, and hypnosis. During the operation, the patients lay with their heads behind an opaque, soundproof barrier, so surgeons couldn’t tell what care they were receiving. Every 15 minutes, the patients were asked to rate their level of anxiety and pain. They were also hooked up to an IV and given as much painkilling medication as they wanted.

The results of the study were published in The Lancet. On average, Spiegel and Lang found, the hypnotized subjects used less medication, experienced less pain, and felt far less anxiety than the other two groups. Patients who weren’t hypnotized felt more pain over time regardless of how much medication they received; those who were hypnotized stayed equally comfortable throughout the surgery. Operations on hypnotized patients averaged 17 minutes shorter than those of other patients, and the cost of a standard radiological procedure fell from $638 to $300.

Lang has since bolstered those findings with two other ongoing studies, involving more than 330 patients. Once again, the hypnotized patients used less medication, recovered faster, and spent less time in the hospital than those with standard care.

Lang doesn’t test her patients to see if they are highly hypnotizable. The more anxious they are about a procedure, she says, the more likely they are to benefit from hypnosis. “A person with a worst-case scenario about what’s going to happen is somebody that has good imagery potential. It takes a very vivid mind to do that.” Studies have shown that phobic people tend to be highly hypnotizable. Lang believes that people slip in and out of trances daily—that everyone has such moments of utter absorption when they can’t hear what others are saying to them. “The ability to tune out is practiced throughout the world. Particularly in married couples,” she says. Learning to control that absorption offers a way to learn to control pain.

The kidney operation Lang performed that day at Harvard was a good example. The 80-year-old patient came out of her trance at one point—“What is this rubbish about the beach?” she said—but the doctors soon put her under again with a simple hypnotic suggestion: “Your eyes won’t close until your inner mind gives you permission.” If hypnosis is ever to work its way into the mainstream, physicians will need to overcome their reluctance to say such things, knowing there is solid science behind what sounds like mysticism. “I think it should be based on data, not on belief,” Spiegel says. “But in the end it doesn’t matter why it works.”