A conundrum in Alzheimer's disease (AD) is why the long-term use of acetylcholinesterase (AChE) inhibitors, intended for treatment of dementia, results in slowing neurodegeneration in the cholinergic basal forebrain, hippocampus, and cortex. The phospho-tau cascade hypothesis presented here attempts to answer that question by unifying three hallmark features of AD into a specific sequence of events. It is proposed that the hyperphosphorylation of tau protein leads to the AD-associated deficit of nerve growth factor (NGF), then to atrophy of the cholinergic basal forebrain and dementia.
View Article and Find Full Text PDFGrounded in clinical examples, the text focuses on the challenges posed by working at a historical moment that, if fully taken in, presents us all-patients and analysts/therapists-with "more than mind can endure." This "too muchness" makes it particularly difficult to maintain our consulting rooms as "safe" spaces. The basic question: how to preserve a sense of safety in our clinical work while we simultaneously remain open to the disruptive and often unrepresentable dangers that surround and infiltrate us.
View Article and Find Full Text PDFAn online survey of 691 clinicians who use hypnosis was conducted in 31 countries to gain a broad real-world picture of current practices, views, and experiences in clinical hypnosis. Among 36 common clinical uses, stress reduction, wellbeing and self-esteem-enhancement, surgery preparations, anxiety interventions, mindfulness facilitation, and labor and childbirth applications were the most frequently rated as highly effective (each by ≥70% of raters) in the clinicians' own experience. Adverse hypnosis-associated effects had been encountered by 55% of clinicians but were generally short-lived and very rarely judged as serious.
View Article and Find Full Text PDFDr. Inna Khazan is the preeminent authority on integrating biofeedback with mindfulness. She wrote Biofeedback and Mindfulness in Everyday Life for biofeedback clients, individuals seeking self-improvement, clinicians, performance coaches, and students.
View Article and Find Full Text PDFResearch on the efficacy of hypnosis applications continues to grow, but there remain major gaps between the science and clinical practice. One challenge has been a lack of consensus on which applications of hypnosis are efficacious based on research evidence. In 2018, 6 major hypnosis organizations collaborated to form the Task Force for Establishing Efficacy Standards for Clinical Hypnosis.
View Article and Find Full Text PDFAppl Psychophysiol Biofeedback
September 2022
Breathing at the resonance frequency (~ 6 breaths per min) produces resonance effects on baroreflex gain, blood pressure, vascular tone, and therapeutic benefits. Evgeny Vaschillo and Paul Lehrer have emphasized that the stimulation frequency is critical for producing resonance effects in the cardiorespiratory system. Although clinicians overwhelmingly use paced breathing to increase HRV, other promising methods exist.
View Article and Find Full Text PDFAppl Psychophysiol Biofeedback
June 2022
Lehrer and Woolfolk are major figures who have led the field of stress management for four decades. Here they have assembled a gifted team of expert authors, ranging from Jonathan Smith on relaxation to Alice Meuret and Thomas Ritz on capnometric training to Shirley Telles and colleagues on yoga for stress management. The text Principles and Practice of Stress Management has long provided the most comprehensive scientifically informed resource for understanding stress and stress management.
View Article and Find Full Text PDFAlzheimer's disease (AD) is a progressive neurodegenerative disorder that is increasingly viewed as a complex multi-dimensional disease without effective treatments. Recent randomized, placebo-controlled studies have shown volume losses of ~0.7% and ~3.
View Article and Find Full Text PDFWhiteness is a condition one first acquires and then one -a malignant, parasitic-like condition to which "white" people have a particular susceptibility. The condition is foundational, generating characteristic ways of being in one's body, in one's mind, and in one's world. Parasitic Whiteness renders its hosts' appetites voracious, insatiable, and perverse.
View Article and Find Full Text PDFInt J Clin Exp Hypn
August 2021
Physiological monitoring provides a useful access into the patient's affective state during hypnotically assisted therapeutic sessions. Physiological monitoring identifies autonomic dysregulation and can also display the process of restoring autonomic regulation via hypnosis and other quieting strategies. Commonly used modalities for physiological monitoring are identified, and clinical illustrations of how psychophysiological monitoring can be used in hypnosis and hypnotically assisted psychotherapy are provided.
View Article and Find Full Text PDFJ Am Psychoanal Assoc
June 2020
Decades of research have produced no effective method to prevent, delay the onset, or slow the progression of Alzheimer's disease (AD). In contrast to these failures, acetylcholinesterase (AChE, EC 3.1.
View Article and Find Full Text PDFThe currently approved cholinesterase inhibitors (donepezil, rivastigmine, and galantamine) produce gastrointestinal toxicity which limits dosing to that which produces only about 25% to 35% CNS cholinesterase inhibition in Alzheimer's disease patients undergoing treatment, below the minimum therapeutic target of about 40% to 50% CNS inhibition considered necessary to treat cognitive impairment. A recent strategy for producing high-level CNS acetylcholinesterase (AChE) inhibition (50% or higher) is to co-administer a muscarinic anticholinergic with the AChE inhibitor to block the dose-limiting cholinergic overstimulation of the gastrointestinal system, allow more robust AChE inhibition in the CNS, and improve efficacy in the treatment of Alzheimer's disease. Unfortunately, most common muscarinic anticholinergics, including solifenacin, readily penetrate the CNS and are directly associated with long-term exacerbation of the underlying neuropathology of Alzheimer's disease and increased brain atrophy.
View Article and Find Full Text PDFAnn Palliat Med
September 2019
Hypnosis has a long history of use for anesthesia and pain management, as well as in assisting patient to prepare for medical procedures. This article reviews the history of hypnosis applications in clinical medicine and dentistry. Research on hypnotic susceptibility or hypnotic ability shows that the ability to respond effectively to hypnosis is a relatively stable trait, partially heritable, and measurable by means of several standard procedures.
View Article and Find Full Text PDFJ Am Psychoanal Assoc
April 2019
Hypnosis and biofeedback techniques are evidence-based psychophysiological therapies that can be applied with a wide variety of medical and mental health disorders. Research shows efficacy for anxiety, depression, post-traumatic stress disorder (PTDS), chronic pain, hypertension, fibromyalgia, and a host of other disorders. Hypnosis and biofeedback can also augment the effectiveness of psychotherapy.
View Article and Find Full Text PDFAnn Palliat Med
January 2018
This article presents a case study in which self-hypnosis, hypnosis-assisted psychotherapy, and palliative care strategies were provided within a multi-modal integrative treatment program for a 38-year-old woman with traumatic brain injury (TBI) secondary to motor vehicle accident. Self-hypnosis was helpful in anxiety reduction and pain management. Hypnosis-assisted psychotherapy was beneficial in de-sensitizing many post-traumatic memories, and in managing post-concussion pain, including neuropathic pain and post-traumatic migraine headaches.
View Article and Find Full Text PDFJ Am Psychoanal Assoc
December 2016
Int J Clin Exp Hypn
April 2018
Posttraumatic stress disorder is a psychophysiological disorder, characterized by the following: chronic sympathetic nervous activation; persisting perceptual/sensory vigilance for threats; recurrent distressing memories of the event, including intrusive memories, flashbacks lived as if in the present moment, and nightmares; and a persisting negative emotional state including fear and shame. The psychophysiological basis for this disorder calls for psychophysiologically based interventions. This article presents the case narrative of a 29-year-old national guardsman, exposed to combat trauma and later to civilian trauma in public safety work.
View Article and Find Full Text PDFIrreversible acetylcholinesterase (AChE) inhibition accumulates to high levels in the central nervous system (CNS) because AChE turnover in the brain is much slower than in peripheral tissues. As expected from this CNS selectivity, the irreversible AChE inhibitor methanesulfonyl fluoride (MSF) produces significant cognitive improvement in Alzheimer's disease patients without the gastrointestinal toxicity that plagues other AChE inhibitors. However, without dose-limiting gastrointestinal toxicity, one shortcoming of the prior human studies of MSF is that the upper limits of CNS AChE inhibition that might be tolerated could not be tested.
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