Preliminary evidence that vagus nerve stimulation is a promising treatment for refractory depression, post traumatic stress disorder, and inflammatory bowel disease – an opportunity for mindfulness approach, meditation and hypnotherapy.

The vagus nerve represents the main component of the parasympathetic nervous system, which oversees bodily functions. It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers. It is the tenth cranial nerve, extending from its origin in the brainstem through the neck and the thorax down to the abdomen. Due to its long path through the human body, it has also been described as the “wanderer nerve”.

The vagus nerve has several different functions.

The four key functions of the vagus nerve are:

  • Sensory: From the throat, heart, lungs, and abdomen.
  • Special sensory: Provides taste sensation behind the tongue.
  • Motor: Provides movement functions for the muscles in the neck responsible for swallowing and speech.
  • Parasympathetic: Responsible for the digestive tract, respiration, and heart rate functioning.

Vagus nerve functions can be broken down into seven categories.

One of these categories is balancing the nervous system.

The nervous system can be divided into two areas: sympathetic and parasympathetic. The sympathetic side increases alertness, energy, blood pressure, heart rate, and breathing rate. The parasympathetic side, which the vagus nerve is heavily involved in, decreases alertness, blood pressure, and heart rate, and helps with calmness, relaxation, and digestion. As a result, the vagus nerve also helps with defecation, urination, and sexual arousal.

Other vagus nerve effects include:

  • Communication between the brain and the gut: The vagus nerve delivers information from the gut to the brain.
  • Relaxation with deep breathing: The vagus nerve communicates with the diaphragm. With deep breaths, a person feels more relaxed.
  • Decreasing inflammation: The vagus nerve sends an anti-inflammatory signal to other parts of the body.
  • Lowering the heart rate and blood pressure: If the vagus nerve is overactive, it can lead to the heart being unable to pump enough blood around the body. In some cases, excessive vagus nerve activity can cause loss of consciousness and organ damage.
  • Fear management: The vagus nerve sends information from the gut to the brain, which is linked to dealing with stress, anxiety and fear. These signals help a person to recover from stressful and anxious situations.

There is preliminary evidence that vagus nerve stimulation is a promising treatment for refractory depression, post traumatic stress disorder, and inflammatory bowel disease. Treatments that target the vagus nerve increase the vagal tone and inhibit cytokine production. The stimulation of vagal afferent fibers in the gut influences monoaminergic brain systems in the brain stem that play crucial roles in major psychiatric conditions, such as mood and anxiety disorders.

Furthermore, there is preliminary evidence for gut bacteria to have beneficial effect on mood and anxiety, partly by affecting the activity of the vagus nerve. Since, the vagal tone is correlated with capacity to regulate stress responses and can be influenced by breathing, its increase through meditation and other modalities likely contribute to resilience and the decrease in mood and anxiety symptoms.

An increasing number of studies have shown benefits with relaxation-related treatment of Irritable Bowel Disease (IBD). For example, a randomized controlled trial of a relaxation-training intervention compared to a control group has shown decrease in pain as well as decreased anxiety levels and improvements in quality of life (206). Also, mindfulness-based therapy (207), a comprehensive mind-body program (208), meditation (209), mind-body alternative approaches (210), yoga (211), and relaxation response-based mind-body interventions (212) have shown to be beneficial for IBD patients. In addition, hypnotherapy, which increases vagal tone (213), has been effective in the treatment of IBD (12).

Read in depth:

Front. Psychiatry, 13 March 2018 | https://doi.org/10.3389/fpsyt.2018.00044

Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders

Sigrid Breit1†, Aleksandra Kupferberg1†, Gerhard Rogler2 and Gregor Hasler1*

  • 1Division of Molecular Psychiatry, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
  • 2Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
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A Mind–Body Approach to Pediatric Pain Management

Children 2017, 4, 50

Review


Melanie L. Brown 1,2,*, Enrique Rojas 1 and Suzanne Gouda 1

1 Department of Pediatrics, The University of Chicago, Chicago, IL 60637, USA erojas@peds.bsd.uchicago.edu (E.R.); Suzanne.Gouda@uchospitals.edu (S.G.)

2 Department of Pain, Palliative Care and Integrative Medicine, Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA

* Correspondence: melanie.brown@childrensmn.org

https://www.mdpi.com/2227-9067/4/6/50/htm1

Academic Editor: Hilary McClafferty

Abstract: Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control(CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind–body techniques that are often used in the adult population for pain and symptom management. In addition to providing significant pain relief, several studies have reported reduced use of opioid medications when mind–body therapies are implemented. Mind–body medicine is another approach that can be used in children with both acute and chronic pain to improve pain management and quality of life.

Received: 1 March 2017; Accepted: 13 June 2017; Published: 20 June 2017

From the Review:

3.2. Selected Mind–Body Approaches
3.2.1. Meditation and Mindfulness. Over the past few decades, mindfulness has emerged as a fundamental component of numerous therapies and interventions for a wide spectrum of clinical aliments [55]. Mindfulness, described as “the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment”, is a meditation practice with ancient Buddhist origins that focuses on experiencing the present moment unobstructed by bias or judgmental thinking in an effort to improve cognitive and emotional well-being [56]. One such application of mindfulness is Kabat Zinn’s Mindfulness-Based Stress Reduction (MBSR), a group intervention first introduced in 1990 that focuses on mindfulness meditation training as a complimentary therapy to the standard medical treatment of chronic pain and illness [57–64]. Research has suggested that mindfulness can improve symptoms associated with medical illnesses and increase quality of life [65]. From a neuroscientific perspective, magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) studies have been conducted in hopes of identifying the neural mechanisms that are responsible for the efficacy of mindfulness meditation in pain relief [66–73]. In one study, thirteen skilled Zen mediators, each having had a minimum of 1000 hours of meditation experience, were recruited and experimentally exposed to pain via thermal stimuli while in an MRI [70]. During exposure to pain, the meditators exhibited increased brain activation in the insula, thalamus, and midcingulate cortex; areas associated with the sensory aspect of pain. Additionally, decreases in brain activity were observed within the hippocampus, amygdala, and caudate; areas responsible for there collection, emotion, and appraisal components of pain, respectively. The authors concluded that the participants were completely aware of the sensation of pain but were able to inhibit the appraisal and emotional responses of pain. In other words, changes in the perception of pain were facilitated through the cognitive and affective components of the pain matrix rather than through the sensory properties of pain. Furthermore, the differences in brain activity were found to be inversely proportional to meditation skill level, establishing a correlation that supports the authors’ hypothesis in regards to meditation’s therapeutic effect on pain. As for neurophysiological findings, structural MRI results overlapped with the fMRI results: meditators were found to have thicker grey-matter in the same pain-related regions of the brain where changes in functional activity were observed [66,68,69]. In terms of overall clinical outcome research, controlled trials of adults suffering from various forms of chronic pain (chronic low back pain, chronic headache/migraine, chronic neck pain, arthritis, cancer, and fibromyalgia) have indeed demonstrated improved pain ratings in regards to multiple dimensions of pain including intensity, acceptance, functional limitations, quality of life, and psychological well-being [62]. Nonetheless, mindfulness as it relates to pain in children has not been extensively studied and although mindfulness meditation has shown to be beneficial in classroom and school settings for improving psychological distress [74–77], more research is required in order to determine whether the same effects can be translated in children and pediatric medicine.
3.2.2. Hypnosis. Hypnosis as a form of therapy has a long history and has been widely used across various disciplines of health care. While the current research establishes hypnosis as a beneficial treatment for the management of pain in regards to both acute medical conditions, such as trauma and post-operative care, and chronic medical conditions, such as cancer and sickle cell anemia [78–80]; it is only since the 1980s that it has been meaningfully applied to pediatric care [81,82]. In general, hypnosis includes three phases: induction, suggestion, and emergence [82]. During induction, the provider encourages patient relaxation by asking them to imagine a calm and serene setting on which they can focus all of their attention. Next, the patient is given therapeutic suggestions to achieve the desired effect. Lastly, the patient is asked to leave their imagined setting and to return to normal consciousness. Hypnosis for pain management follows this same protocol with a focus on suggestions that either turn down or decrease pain perception or increase pain thresholds [83]. Given the significance of the suggestion stage of hypnosis, an important factor in clinical outcomes is the degree to which an individual is responsive or susceptible to hypnotic suggestions—a trait that is often referred to as hypnotizability. Of note, studies that have attempted to measure hypnotizability among children via the Children’s Hypnotic Susceptibility Scale and the Stanford Hypnotic Scale for Children have shown a positive correlation between hypnotizability [84,85] and age, thus suggesting that hypnosis may be an especially viable form of therapy for pain management in the pediatric population [82]. Taking a neuroscientific approach, neuro-imaging studies have attempted to measure the effects of hypnosis on the neuroanatomy and the neuro-cognitive functions of the brain in the context of pain [85–88]. In other words, many researchers have set out to investigate how hypnosis affects the brain’s neural-networks and physiology that in turn, are responsible for the perception of pain within an individual. This “pain matrix”, as it has been described, is comprised of specific areas of the brain that collectively produce the experience of pain. In the simplest summary of the current literature, the components of the pain matrix include: the prefrontal cortex, frontal lobes, anterior cingulate cortex, primary and secondary somatosensory cortices, thalamus and insula. The cerebellum, though not technically a component of the pain matrix, also plays a role. Using fMRIs to measure brain activity during hypnosis, researchers have concluded that by influencing activity in the various components of the pain matrix, hypnosis is indeed able to have a collective therapeutic effect on pain. Research focusing on clinical and experimental outcomes has also yielded positive results. A meta-analysis performed in 2000 of 18 studies found hypnosis to have a moderate to large analgesic effect[78]. When compared to groups receiving standard treatment and groups receiving no treatment, 75% of participants receiving hypnotic suggestion experienced a greater analgesic effect. Furthermore, the effect was seen with both clinical and experimental pain with no significant difference between the two settings. Hypnosis is a tool that carries minimal risk when used appropriately for pain management. It can be used by patients as well as practitioners. The goal is often to instruct the patient on the hypnotic technique so that hypnosis will become a tool of empowerment that the patient is able to use themselves at appropriate times for symptom management. It is important to note that hypnosis should only be performed by an appropriately trained practitioner and only to treat conditions that the practitioner is competent to treat.

Recommendation – Read Full Review

https://www.mdpi.com/2227-9067/4/6/50/htm

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Wishing you a great 2019…

May your curiosity and zest for life help you in overcoming challenges
and be humbled with gratitude in quiet, reflective moments.
What kind of routines are you practicing? Have they ever worked for you? Has life become stale because procrastination has kept you in a stuck state?
Or have you been seriously considering changing tack, take a new, fresh approach for 2019?
You probably know that a certain routine (i.e. playing it safe, being afraid of change and uncertainty) can be a prison that holds you captive to an uninspiring, dissatisfactory life. Seriously, ask yourself if you can afford or would like to continue with unhelpful routines?
The difference lies within the routine itself.
Some routines (behaviours) are destructive.
Others maintain (seemingly too much effort to change) the status quo.
The bottom line is: “What are you getting from your routines?” Perhaps more of what you don’t want? Seriously…STOP!… for a moment and ponder if you can afford to continue like this.
However, your routine can also be the catapult to new levels of fulfillment and a more meaning – and purposeful life. Better performing routines (life skills) can be established quite easily.
Hypnosis & Meditation can trigger insights with an upward spiral of accomplishment, success and life balance.
Why is that?
Because the experience of Hypnosis & Meditation practice enables you to have a closer look at yourself, the relationship you have with yourself, others and the environment. It allows you to gain greater awareness leading to a brighter, more positive outlook on life.
Hypnosis & Meditation allow for new insights…or as we call it at Satori Self Development a “satori” moment.
“Satori” moments are these rare and special occasions during which many contributing aspects seem (to be) perfectly aligned allowing for insights (lightbulb) to occur. The insights can be significant and vary from person to person. However, the newly found knowledge fosters a different, more positive and engaging approach to life in general and human interactions. This can be reflected and experienced through greater self-awareness and confidence. This is normally accompanied by higher energy levels promoting and enhancing personal growth and wellbeing.
Hypnosis & Meditation can open new doors and access previously hidden human qualities and resources. We already know that the most precious ones are kept hidden from view (just like gemstones) and reside inside of our minds at the unconscious level.
If you are tired of outdated routines which no longer deliver the desired outcomes… and you are ready to let go of them…then, perhaps curiosity gets the better of you in experiencing something different? And, if you are interested or feel the need for change please call us, Achim & Vittoria on 0407 906 999 or 4647 4868. We are here to help and support and would be privileged to be of service to you.
Achim & Vittoria are certified government accredited Clinical Hypnotherapists and hold degrees in Chemistry, Biochemistry, Microbiology and extensive knowledge/ experience in Neuroscience and Pharmacology. Achim holds a Master of Arts in Applied Buddhist Studies and Master of Arts in Health and Social Wellbeing. Both have 20 years of combined experience in Hypnotherapy / Coaching.

Randomized Trial of a Hypnosis Intervention for Treatment of Hot Flashes Among Breast Cancer Survivors

Randomized Trial of a Hypnosis Intervention for Treatment of Hot Flashes Among Breast Cancer Survivors

Hypnosis is a mind-body therapy that has few negative adverse effects and that may be of significant benefit in reducing the frequency and severity of hot flashes in breast cancer survivors. Several small studies have suggested that hypnosis intervention may have a positive effect on the reduction of hot flashes. An early study by Stevenson and Delprato 1. reported that four women were able to reduce self-reported hot flashes by 41% to 90% from baseline when provided with instruction in relaxation, self-suggestions of cool thoughts, and temperature biofeedback.
Aim of this study: Hot flashes are a significant problem for many breast cancer survivors. Hot flashes can cause discomfort, disrupted sleep, anxiety, and decreased quality of life. A well-tolerated and effective mind-body treatment for hot flashes would be of great value. On the basis of previous case studies, this study was developed to evaluate the effect of a hypnosis intervention for hot flashes. Patients and Methods: Sixty female breast cancer survivors with hot flashes were randomly assigned to receive hypnosis intervention (five weekly sessions) or no treatment. Eligible patients had to have a history of primary breast cancer without evidence of detectable disease and 14 or more weekly hot flashes for at least 1 month. The major outcome measure was a bivariate construct that represented hot flash frequency and hot flash score, which was analysed by a classic sums and differences comparison. Secondary outcome measures were self-reports of interference of hot flashes on daily activities. Results: Fifty-one randomly assigned women completed the study. By the end of the treatment period, hot flash scores (frequency  average severity) decreased 68% from baseline to end point in the hypnosis arm (P < .001). Significant improvements in self-reported anxiety, depression, interference of hot flashes on daily activities, and sleep were observed for patients who received the hypnosis intervention (P < .005) in comparison to the no treatment control group. Conclusion: Hypnosis appears to reduce perceived hot flashes in breast cancer survivors and may have additional benefits such as reduced anxiety and depression, and improved sleep.

  1. Stevenson DW, Delprato D: Multiple component self-control program for menopausal hot flashes. J Behav Ther Exp Psychiatry 14:137-140,1983 

J Clin Oncol 26:5022-5026.  2008 by American Society of Clinical Oncology
Gary Elkins, Joel Marcus, Vered Stearns, Michelle Perfect, M. Hasan Rajab, Christopher Ruud, Lynne Palamara, and Timothy Keith
From the Department of Psychology and Neuroscience, Baylor University, Waco; Scott and White Memorial Hospital and Clinic, Department of Psychiatry and Behavioral Sciences, Temple; Cancer Treatment and Research Center, San Antonio; and University of Texas at Austin, TX; University of Arizona, Tucson, AZ; and the Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.