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Hypnosis and diabetes: Applications for children, adolescents, and adults
Abstract
This article describes applications of hypnosis in the treatment of diabetes for children, adolescents, and adults. Research is increasingly showing a connection between hypnosis and the brain. For children, adolescents, and adults with diabetes, hypnosis can be used to reduce stress which affects glucose levels. Moreover, adolescents tend to have many cognitive distortions about themselves and diabetes, and hypnosis can help these youths to normalise feelings, remove negative foci, and to form healthy relationships. Because hypnosis can be viewed as a cognitive-behavioural strategy, it has applications for managing the cognitive aspects of a diabetic treatment plan. In conjunction with medical treatments, hypnosis can influence health-related behaviours. In terms of future research, studies are needed that explore the implications of cognitive distortions on glucose levels and the effects of hypnosis in capitalising on this mind-body interaction.
Objective:
To explore the impact of an integrated method of coaching and self-hypnosis on the maintenance of blood glucose levels among older adults in Indonesia.
Method:
The study's design was quasi-experimental with two sample groups: an intervention group and a controlled group. For the sampling method, 76 people were chosen using the multistage sampling method, then the member of the intervention group was chosen based on the study's purpose. This study used a paired t-test and an independent t-test. Non-fasting blood sugar tests (random blood sample) were taken twice, before and after the intervention for 4 weeks.
Results:
There was a significant difference between blood glucose levels before and after intervention in the intervention group (p=0.000). Coaching and self-hypnosis method was decreasing blood glucose levels significantly in the intervention group better than in the controlled group.
Conclusions:
Coaching and self-hypnosis, when sustained for 4 weeks, can decrease blood glucose levels. This intervention can be part of lifestyle modification to decrease the blood glucose levels of older adults with diabetes mellitus. Furthermore, coaching and self-hypnosis intervention can also be integrated as part of the promotion and preventive acts in the prevention and management of non-communicable disease programs in communities.
I. Kirsch, G. Montgomery, and G. Sapirstein (1995) meta-analyzed 6 weight-loss studies comparing the efficacy of cognitive-behavior therapy (CBT) alone to CBT plus hypnotherapy and concluded that "the addition of hypnosis substantially enhanced treatment outcome" (p.214). Kirsch reported a mean effect size (expressed as d) of 1.96. After correcting several transcription and computational inaccuracies in the original meta-analysis, these 6 studies yield a smaller mean effect size (.26). Moreover, if 1 questionable study is removed from the analysis, the effect sizes become more homogeneous and the mean (.21) is no longer statistically significant. It is concluded that the addition of hypnosis to CBT for weight loss results in, at most, a small enhancement of treatment outcome.
Recent neuroimaging studies have used hypnotic suggestion to distinguish the brain structures most associated with the sensory and affective dimensions of pain. This paper reviews studies that delineate the overlapping brain circuits involved in the processing of pain and emotions, and their relationship to autonomic arousal. Also examined are the replicated findings of reliable changes in the activation of specific brain structures and the deactivation of others associated with the induction of hypnosis. These differ from those parts of the brain involved in response to hypnotic suggestions. It is proposed that the activation of a portion of the prefrontal cortex in response to both hypnotic suggestions for decreased pain and to positive emotional experience might indicate a more general underlying mechanism. Great potential exists for further research to clarify the relationships among individual differences in reactivity to pain, emotion, and stress, and the possible role of such differences in the development of chronic pain.
Recently, Barber has presented a three dimensional paradigm of hypnosis. He proposed that there are three hypnotic types of clients- the fantasy-prone, amnesic-prone, and positively-set. This paper discusses the major theoretical implications of this new paradigm, and, if Barber is correct, his new theory should bridge a gap between the special process (state) and nonstate theorists. Finally, only research will determine if Barber's new theory will actually unify the previous disagreements between the state and nonstate theorists.
This study focuses on peer group interactions of five latency-aged diabetic girls who participated in 34 weekly sessions of group psychotherapy The group format enabled the girls to share readily their feelings of differentness and vulnerability and their anxiety about future disasters The inability of these girls to work together as a unit and to establish a sense of group cohesiveness was striking and confirmed prior research studies on difficulties in the establishment of peer group relationships among diabetic children.
Rapid advances in medical technology have resulted in increased survival of children with chronic illness. As a result, growing numbers of adolescents and their families need psychosocial services. This article calls for further efforts by social workers to address the needs of chronically ill adolescents. Psychosocial interventions to aid adolescents are described, and the potential application of communication technologies such as computers and videos to traditional therapeutic and educational services is discussed.
Three papers of special interest to researchers and clinicians alike have recently appeared in the general scientific and medical literatures. Two of these papers are original research studies that employ brain-imaging technologies, one using Magnetic Resonance Imaging (MRI), the other position emission tomography (PET). A third paper is a comprehensive review of the empirical findings on the clinical use of hypnosis in pediatric oncology. The research study using MRI technology is extraordinary, because it is the first to document differences in brain morphology between high hypnotizable and low hypnotizable individuals. Arguably, if its findings replicate, the study could be one of the most important developments in scientific hypnosis since the genesis of the Stanford scales 45 years ago. The PET study notes differences in brain activation during intentionally simulated and hypnotically experienced paralysis. The review article examines empirical work addressing the efficacy of hypnosis for procedural pain in pediatric oncology.
Acupuncture treatment uses ultrafine needles which are inserted into specified points on the skin (acupoints). Acupuncture can help alleviate pain and inflammation, possibly through the increased release of pituitary beta-endorphins and ACTH. Hypnosis can also help alleviate pain syndromes, and may have centrally mediated immunomodulatory effects. The use of these 2 treatments simultaneously may potentially assist and augment the effects of each another. Two case reports where both treatments are used together are presented: One showing how hypnosis can help in the treatment of painful acupoints, the other how the response to acupuncture may be augmented by hypnosis in the treatment of headache. Controlled trials of this combined treatment are warranted.