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Autogenic-feedback training: a potential treatment for orthostatic intolerance in aerospace crews.

Postflight orthostatic intolerance has been identified as a serious biomedical problem associated with long-duration exposure to microgravity in space. High priority has been given to the development of countermeasures for this disorder that are both effective and practical. A considerable body of clinical research has demonstrated that people can be taught to increase their own blood pressure voluntarily, and that this is an effective treatment for chronic orthostatic intolerance in paralyzed patients. The current pilot study was designed to examine the feasibility of adding training in control of blood pressure to an existing preflight training program designed to facilitate astronaut adaptation to microgravity. Using an operant conditioning procedure, autogenic-feedback training (AFT), three men and two women participated in four to nine training (15-30-minute) sessions. At the end of training, the average increase in systolic and diastolic pressure, as well as mean arterial pressures, that the subjects made ranged between 20 and 50 mm Hg under both supine and 45 degrees head-up tilt conditions. These findings indicate that AFT may be a useful alternative treatment or supplement to existing approaches for preventing postflight orthostatic intolerance. Furthermore, the use of operant conditioning methods for training cardiovascular responses may contribute to the general understanding of the mechanisms of orthostatic intolerance.

Adult↗

[Clinical experience in communication in autogenous psychotherapy and hypnosis].

Questions relating to communication and metacommunication during two forms of directive psychotherapy (Schultz's autogenous training and hypnosis) are examined. The concept of rigidity and cognitive flexibility with regard to the physician-patient relationship is discussed: abstract-concrete dynamics, abstract generalisation of diagnosis, linguistic egocentricity, stereotypical adaptation to conventional language. Some attention is devoted to Heider's balance theory as the first approach to psychological understanding of the therapeutic relationship. The communicative and metacommunicative process described by the Palo Alto (California) school is discussed. Autogenous psychotherapy and hypnosis extend through the concepts of symmetrical relation and inferior complementarity. The criteria for reaching these objectives are stated, along with the pragmatic methods devised for decoding messages and gaining access to metacommunication. Three clinical cases treated through autogenous training and one with hypnosis are analysed with respect to communication and from the relational standpoint. The patient's messages are decoded, the ambiguity of the communication is detected, and the physician's possible answers are examined at both the technical and the emotive level. It is felt that the correct use of the communicational perspective greatly extends the possibilities of autogenous training and hypnosis. It is not a question of combining relational and autogenous management, but of using the Palo Alto discoveries in the more complete understanding of cases in which psychotherapy is employed.

Adult↗

Psychosomatic aspects of skin diseases from the standpoint of immunology.

The psychosomatic aspects of skin disease were studied both clinically and experimentally, from the standpoint of immunology. We found that emotional stress has a great influence on the immune system, as was manifested in skin disease. Skin test in allergic patients significantly improved with autogenic training and relaxation. For clarification of the effects of autogenic training and relaxation, various parameters were simultaneously assessed during the treatment. The serum levels of histamine and dopamine-beta-hydroxylase fluctuated, as determined by the microvibration test. The levels of IgE and findings on the PK test varied only slightly. Before the onset of urticaria, there were changes in the life-style and considerable stress in daily life as well as exposure to an allergen. Using mice subjected to stress, the functions of T cells and macrophages were evaluated. Stress appeared to have a definite influence on the functions of these cells, as related to the important role of the immune system and skin. Thus, the role of stress in clinical disease must always be given consideration.

Adult↗

Reducing motion sickness: a comparison of autogenic-feedback training and an alternative cognitive task.

Eighteen men were randomly assigned to three groups matched for susceptibility to Coriolis motion sickness. All subjects were given six Coriolis Sickness Susceptibility Index (CSSI) tests separated by 5-d intervals. Treatment Group I subjects were taught to control their own autonomic responses before the third, fourth, and fifth CSSI tests (6 h total training). Group II subjects were given "sham" training in an alternative cognitive task under conditions otherwise identical to those of Group I. Group III subjects received no treatment. Results showed that Group I subjects could withstand the stress of Coriolis acceleration significantly longer after training. Neither of the other two groups changed significantly.

Adult↗

The relative efficacy of autogenic phrases and autogenic-feedback training in teaching hand warming to children.

There are few well-controlled biofeedback temperature training studies in the literature that have used children as subjects. The purposes of this study were (1) to evaluate whether children can learn to increase hand temperature, controlling for methodological factors that have been overlooked in previous experiments, and (2) to determine whether adding thermal biofeedback to autogenic phrases results in improved ability to produce voluntary increases in hand temperature over the use of autogenic phrases alone. Twenty-six subjects (ages 9-11) were divided into two groups of 13 subjects each. All subjects participated in four 35 to 45-minute sessions consisting of a stabilization phase, a training phase, and a post-training phase on 4 consecutive days. One group was trained to increase finger temperature with autogenic phrases only, and the other was trained with autogenic phrases plus thermal feedback. None of the subjects in either group learned to increase hand temperature significantly within sessions. There was a consistent and reliable decreasing trend within each session; however, finger temperature did increase (.27 degrees F) for the first 8 minutes of the training phase. There was a significant increase in hand temperature from day 1 to days 3 and 4, and there were significant increases in temperature during the stabilization phase alone. There were no differential effects of treatments. Methodological issues concerning stabilization, the potential confounding effect of boredom and fatigue, and different training methods for children are discussed.

Autogenic Training↗

Autogenic feedback training improves pilot performance during emergency flying conditions.

Studies have shown that autonomous mode behavior (AMB) is one cause of aircraft fatalities caused by pilot error. In AMB cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. The following study, conducted under the auspices of the U.S. National Aeronautics and Space Administration's (NASA) Ames Research Center, examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours.

Accidents, Aviation↗

[Hypnosis and modified hypnotherapeutic methods. Indications and results in hospitalized and ambulatory patients].

164 patients were treated hypnotherapeutically. The therapeutical methods used were heterohypnosis and the so-called gestufte Aktivhypnose (graded active hypnosis), a method which is closely related to autogenous training. In most patients independent continuation of the application of guiding principles in autogenous training was envisaged for stabilizing the results of the hypnotherapy and also achieved. The indications include a wide range of psychovegetative syndromes, including addictions. Especially syndromes showing predominantly vegetative symptoms and a relatively insignificant neurotic component responded most positively to this type of treatment. The results were less satisfactory in patients suffering from pronounced personality disorders. Hynotherapy now supplements psychotherapeutical treatment, hitherto mainly orientated to behaviour therapy, in such a way, that psychotherapy in a general hospital can be realized more effectively.

Autogenic Training↗

Thermal biofeedback in the treatment of intermittent claudication in diabetes: a case study.

The objective of the present case study was to examine the therapeutic effects of thermal biofeedback-assisted autogenic training on a patient with non-insulin-dependent diabetes mellitus (NIDDM), vascular disease, and symptoms of intermittent claudication. The patient received thermal biofeedback from the hand for five sessions, then from the foot for 16 sessions, while hand and foot skin temperature were monitored simultaneously. In addition, the patient was instructed in autogenic training and practiced daily at home. Follow-up measurements were taken at 12 and 48 months. Within-session foot temperature rose specifically in response to foot temperature biofeedback and starting foot temperature rose between sessions. Posttreatment blood pressure was reduced to a normal level. Attacks of intermittent claudication were reduced to zero after 12 sessions and walking distance increased by about a mile per day over the course of treatment. It would appear that thermal biofeedback and autogenic training are potentially promising therapies for persons with diabetes and peripheral vascular disease.

Biofeedback, Psychology↗

[Effect of autogenic respiratory training on labor pain. Use of the Vaona algometer].

In our research we have evaluated the effects produced by obstetric psycho-prophylaxis on women previously prepared by us. To carry out this research we used a method of pain evaluation, quickly and easily administered: Vaona algometer, based on the association between the visual analogue and the scale of greys. The results of the research allow us to confirm that the RAT method, applied during labour, thanks to the positive influence on neuromuscolar relaxation and the psychological aspects of the women, induces a favourable modulation on the perception of pain.

Autogenic Training↗

Hypnotic treatment of chronic pain.

This article reviews controlled trials of hypnotic treatment for chronic pain in terms of: (1) analyses comparing the effects of hypnotic treatment to six types of control conditions; (2) component analyses; and (3) predictor analyses. The findings indicate that hypnotic analgesia produces significantly greater decreases in pain relative to no-treatment and to some non-hypnotic interventions such as medication management, physical therapy, and education/advice. However, the effects of self-hypnosis training on chronic pain tend to be similar, on average, to progressive muscle relaxation and autogenic training, both of which often include hypnotic-like suggestions. None of the published studies have compared hypnosis to an equally credible placebo or minimally effective pain treatment, therefore conclusions cannot yet be made about whether hypnotic analgesia treatment is specifically effective over and above its effects on patient expectancy. Component analyses indicate that labeling versus not labeling hypnosis treatment as hypnosis, or including versus not including hand-warming suggestions, have relatively little short-term impact on outcome, although the hypnosis label may have a long-term benefit. Predictor analyses suggest that global hypnotic responsivity and ability to experience vivid images are associated with treatment outcome in hypnosis, progressive relaxation, and autogenic training treatments. The paper concludes with a discussion of the implications of the findings for future hypnosis research and for the clinical applications of hypnotic analgesia.

Analgesia↗

[Personality profile of asthmatics and its changes in the course of various treatment methods].

Our study of 30 Asthmatics showed an increase in the neurotic triangel (MMPI-Saarbrücken) and good agreement with the personality profile of neurotics with psychosomatic tendencies. To measure the effect of a 4-week- treatment-course on the personality structure of the patients, the FPI-scale was used, where only a slight change was found in the scale "Nervosität" (FPI 1 measures psychosomatic conflicts). Part of the patients who were also treated with "autogenes Training", the change was somewhat larger but not statistically significant, as compared to the group of patients without "autogenes Training". The treatment-course itself, judging only by the medical evaluations, was proved to be highly effective with statistical significance. A possible explanation for the discrepancy between the two findings could be the difference between the methods of investigation and/or the attitude of the patients to their Asthma because many of them emphasize the somatic aspect of their illness, wishing to ignore or deny a possible psychosomatic explanation.

Adult↗

Plasma catecholamines during behavioral treatments for Raynaud's disease.

We have previously demonstrated that the vasospastic attacks of Raynaud's disease can be induced despite blockade of efferent digital nerves and that feedback-induced vasodilation is mediated through a non-neural, beta-adrenergic mechanism. Here, we sought to determine the role of sympathetic activity, as measured by plasma epinephrine and norepinephrine, during finger temperature feedback and autogenic training. Thirty-one female patients with idiopathic Raynaud's disease were randomly assigned to receive finger temperature feedback or autogenic training over 28 days. Half of each group began and finished training during the follicular phase of the menstrual cycle, the other half during the luteal phase. During training, significant temperature elevations were shown by feedback patients but not by autogenic patients. There were no significant effects for norepinephrine and epinephrine for either group. Cycle phase did not interact with training effects or with catecholamines. These findings do not support the role of decreased sympathetic activation in behavioral treatments for Raynaud's disease.

Adult↗

Stress management techniques: are they all equivalent, or do they have specific effects?

This article evaluates the hypothesis that various stress management techniques have specific effects. Studies comparing various techniques are reviewed, as well as previous literature reviews evaluating the effects of individual techniques. There is evidence that cognitively oriented methods have specific cognitive effects, that specific autonomic effects result from autonomically oriented methods, and that specific muscular effects are produced by muscularly oriented methods. Muscle relaxation and/or EMG biofeedback have greater muscular effects and smaller autonomic effects than finger temperature biofeedback and/or autogenic training. EMG biofeedback produces greater effects on particular muscular groups than progressive relaxation, and thermal biofeedback has greater finger temperature effects than autogenic training. Disorders with a predominant muscular component (e.g., tension headaches) are treated more effectively by muscularly oriented methods, while disorders in which autonomic dysfunction predominates (e.g., hypertension, migraine headaches) are more effectively treated by techniques with a strong autonomic component. Anxiety and phobias tend to be most effectively treated by methods with both strong cognitive and behavioral components.

Autogenic Training↗

A randomized controlled trial of Japanese patients with obsessive-compulsive disorder--effectiveness of behavior therapy and fluvoxamine.

BACKGROUND: The aim of this study was to confirm and compare the efficacy of fluvoxamine (the only licensed SSRI for treatment for OCD in Japan) and behavior therapy in treating Japanese patients with OCD. In addition, we investigated predictors of these treatments. METHODS: Thirty-one outpatients meeting the DSM-III-R criteria for OCD without any axis I disorder were randomly assigned to one of three treatment conditions: BT (behavior therapy +/- pill placebo), FLV [autogenic training (a psychological placebo for OCD) +/- fluvoxamine] and control group [autogenic training (psychological placebo) +/- pill placebo] for 12 weeks of treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Clinical Global Impression-Improvement Scale (CGI-I) were administered blindly at baseline and week 4, 8 and 12. RESULTS: Twenty-eight patients completed this study. Patients in the BT and FLV groups showed significantly more improvement than those in the control group in the mean score of total Y-BOCS; moreover, the BT group showed significantly more reduction in total Y-BOCS score at the end of treatment than the FLV group (BT > FLV, p < 0.01). Patients with lower baseline total Y-BOCS, past history of a major depressive episode and absence of cleaning compulsion improved more with fluvoxamine. CONCLUSIONS: We confirmed the effectiveness of behavior therapy and fluvoxamine for Japanese patients with OCD. Behavior therapy improved the condition of OCD patients more than fluvoxamine.

Adolescent↗