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,*,Yacov Ezra M.D,Hypnosis,What is hypnosis?,Another state of consciousness note sleep.,The EEG is similar to awake state.,Profound concentration,absorption.,Activation of limbic structure.,Hypnosis,Absorption,in an activity,Trance,Relaxation,Guided,imagery,Meditation,Mindful-,ness,“,Limbic modulators,”,History,Shamans,Franz Anton Mesmer(1734,1815),James Braid(1795,1860),Jean-martin Charcot(1825-1893),Milton Erickson(1901-1980),All hypnosis is self hypnosis,Negative self hypnosis,Who controls?,Hypnosis stages,Induction,Suggestion,The ability to produce hypnotic effects.,Related to imagination,concentration&intelligence.,Enables better control of autonomic reactions.,Can be tested and measured.,90%of the population has good enough ability.,Suggestibility,Demonstration,Inductions,Progressive relaxation,Eye fixation,Rhythmic activity,Connecting to bodily feelings,Suggestions,Pacing and leading,Reframing,Mirroring,Narrative coherence,Suggestions,Positive speaking,Yes set,Choice illusion,Non verbal suggestions,De hypnotization,Formal counting,Post hypnotic suggestions,Headaches spectrum,“Commando unit syndrome”,Tension type headaches,Migraine,Secondary headaches,Insight,Insight,Insight,Insight,Body,Body,Body,Body,Mind,Mind,Mind,Mind,Headaches-example,Listening to all the pain components,Pacing,Questions about specific fears,Pacing,Questions about triggers,leading,Comprehensive explanation,Reframing,Headaches-example,The brain causes muscle tension,Dissociation,Reorganization by using patients language,Coherence -narrative,Imaging?,Non verbal suggestions,Choosing between two options,Choice illusion,Example two cell phones,Loss of consciousness,Pseudo seizure,Panic attacks,Syncope,+,Epilepsy,Insight,Insight,Insight,Insight,body,body,body,body,mind,mind,mind,mind,Joining and influencing the patient by using carefully verbal and non verbal,suggestions,Empowerment,Enhancing communication,Differentiating true from pseudo events,Enhancing cooperation,Ethics,Cost,The advantages,Regression analyses between regional cerebral blood flow(rCBF)and self-ratings confirm the hypothesized involvement of the anterior cingulate cortex(ACC),the thalamus,and the ponto-mesencephalic brainstem in the production of hypnotic,Altered central somatosensoryprocessing in chronic pain patients with,“,hysterical,”,anesthesia,A.Mailis-Gagnon,MD;I.Giannoylis,BSc;J.Downar,BSc;C.L.Kwan,MSc;D.J.Mikulis,MD;,A.P.Crawley,PhD;K.Nicholson,PhD;and K.D.Davis,PhD,Abstract,Objective:,The authors hypothesized that central factors may underlie sensory deficits in patients with,nondermatomal somatosensory deficits(NDSD)and that functional brain imaging would reveal altered responses in,supraspinal nuclei.,Background:,Patients with chronic pain frequently present with NDSD,ranging from hypoesthesia to,complete anesthesia in the absence of substantial pathology and often in association with motor weakness and occasional,paralysis.Patients with pain and such pseudoneurologic symptoms can be classified as having both a pain disorder and a,conversion disorder(Diagnostic and Statistical Manual of Mental Disorders,IV classification).,Methods:,The authors,tested their hypothesis with functional MRI(fMRI)of brush and noxious stimulation-evoked brain responses in four,patients with chronic pain and NDSD.,Results:,The fMRI findings revealed altered somatosensory-evoked responses in,specific forebrain areas.Unperceived stimuli failed to activate areas that were activated with perceived touch and pain:,notably,the thalamus,posterior region of the anterior cingulate cortex(ACC),and Brodmann area 44/45.Furthermore,unperceived stimuli were associated with deactivations in primary and secondary somatosensory cortex(S1,S2),posterior,parietal cortex,and prefrontal cortex.,Finally,unperceived(but not perceived)stimuli activated the rostral ACC,.,Conclusions:,Diminished perception of innocuous and noxious stimuli is associated with altered activity in many parts of the,somatosensory pathway or other supraspinal areas.The cortical findings indicate a neurobiological component for at least,part of the symptoms in patients presenting with nondermatomal somatosensory deficits.,NEUROLOGY 2003;60:1501,1507,Pain modulation,Hypnosis decreased both pain sensation and the unpleasantness of noxious stimuli.Noxious stimulation caused an increase in regional cerebral blood flow in the thalamic nuclei and anterior cingulate and insular cortices.,fMRI study of hypnotizability from the lab of Dr.David Spiegel,Stanford U.(,Prof Pesach Lichtenberg),Salience Network,dorsal anterior cingulate cortex(dACC),Includes orbital frontoinsula paralimbic structures,involving homeostasis and emotions.,Salience Network,This network chooses the relevant and interesting stimuli which are relevant to survival.It directs the attention to those stimuli.,Examples,:,Pain,Hunger,Familiar faces,conflict reduction,The three steps relaxation technique,Progressive relaxation with appropriate suggestions,Practicing at hom
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