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� | P a g e 1Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
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Clinical HYPNOTHERAPY
in Cancer Care
Table of Contents Introduction……………………………………………………………………………………………..3
Clinical Hypnotherapy & PNI……………………………………………………………………………4
How Hypnosis is Used in Cancer Treatment……………………………………………………..……4
Hypnosis as an Immunotherapeutic Approach………………………………………………………..5
Evidence to Support This Treatment…………………………………………………………………..6
Clinical Hypnotherapy Uses
Chemotherapy…………………………………………………………………………………..7
Radiation…………………………………………………………………………………………8
Surgery…………………………………………………………………………………………..8
Quality of Life……………………………………………………………………………………………9
What To Expect………………………………………………………………………………………….10
Qualified Professional……………………………………………………………………………………11
Is This Intervention Right for Me?……………………………………………………………………….11
About Avinoam Lerner…………………………………………………………………………………..12
References………………………………………………………………………………………………13
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Email: [email protected] | www.AvinoamLerner.com
Cancer is all around us. We have all
been affected by it in one way or another. We
have seen the upsides, downsides and
struggles of cancer and know it is an ailment
that medicine has yet to conquer. We try our
best to believe in the strong minds and
research of modern medicine, but the truth is
that modern medicine despite its advances
continues to disappoint. Its paradigm separates
the person from the illness thus treating only the
symptom, failing to treat its root cause. It is time
to transcend the mechanistic-reductionist-
Newtonian view of disease
and recognize that illness is a
whole person event. As such,
if we are to improve cancer
outcomes, boost quality of life
a n d p r o v i d e i m p r o v e d
prognoses we must seek
interventions that are more
ho l i s t i c to comp lement
medical care.
It is time to explore clinical
h y p n o t h e r a p y a s a n
integrative intervention that
improves treatment efficacy
and recovery outcome by
increasing patient’s engagement. We can no
longer leave recovery up to fate or even in the
hands of trusted medical professionals. It is
essential that we leave no stone unturned and
explore every viable option.
Whether you are looking for answers for
a loved one or yourself, clinical hypnotherapy
has scientific evidence and years
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Clinical Hypnotherapy as an Effective Intervention for Cancer Recovery
of patient testimonials to support its use in
cancer management and rehabilitation.
C l i n i c a l h y p n o t h e r a p y &
psychoneuroimmunology (PNI)?
Psychoneuroimmunology (PNI) is the
study of the interactions between psychological
processes and the nervous and immune
systems of the human body. PNI describes how
psychological factors such trauma, attitude and
outlook can impact the functioning of the
immune system and therefore physical
resiliency. Research shows that psychological
state plays a role in many common diseases
and conditions, including heart disease,
diabetes, autoimmune disorders and cancer.
Mediated by the endocrine and nervous
systems, a person’s mental state and behavior
has an effect on his or her immune system
capacity fight and protect against disease. The
brain influences the functioning of the immune
system by controlling the autonomic nervous
system. In addition, the endocrine hormones
regulate body function and have an effect on
sleep, body temperature and activity. The
immune and nervous systems work together.
Our bodies have evolved to sense and respond
to danger and create an appropriate, adaptive
response. Research shows that the
interactions of the central nervous system and
immune systems are highly modulated by
behavior and psychological states (Ziemssen
2007). Our psychological status influences
immunity and disease.
Clinical hypnotherapy utilizes a technique
called induction to help patient enter the
hypnotic state. The hypnotic state is a state of
focused attention, absorption and heightened
suggestibility. Recent research suggests that
hypnos is can effect i ve l y change ou r
physiological and neurological state and
functions.
Clinical hypnotherapy utilizes practices
that are respectful of an individuals will.
Hypnosis can range in depth and experience
from light trance to a more complex and deep
trance. In addition, self-hypnosis can be utilized
for self-management. Light trance can help take
away the anticipatory anxiety associated with
cancer and restore confidence and autonomy in
treatment. Deeper trance can help support and
boost immune response and improve the
efficacy of medicine.
How is hypnosis used in cancer treatment?
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� | P a g e 4Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
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Hypnosis is used in cancer treatment for
a variety of reasons. Goals will be specific to
patient needs. They may need assistance with
resolving hopelessness, managing pain, and
lessening anxiety, preparing for surgery,
reducing nausea or any other multitude of
issues.
The skilled clinician promotes the
treatment of the whole person. He or she will
help patients engage and harness the creativity
and intelligence of their mind to revive and
strengthen the immune response, increase
resiliency and quality of life.
Providing patients a safe and effective
way to play a more active role in their care and
recovery, they can recognize their own drive
and purpose for continuing and overcoming the
adversity of disease. Clinical hypnotherapy
helps to identify, substantiate and verbalize a
reason to continue and to overcome. Clinical
hypnotherapy works in conjunction with
conventional medicinal treatment and is
appropriate to begin at any point during the
cancer treatment.
Hypnosis as an immunotherapeut ic approach to recovery:
The human immune system is comprised of
specialized cells, hormones, organs and
psychological factors, including behavior. The
immune system is capable of responding to
foreign cells, objects and bacteria and creating
an appropriate response to destroy it. In
addition, the immune system is able to adapt to
small changes in foreign cells and address
them. Evidence shows that there is a high level
of interaction between the biological response
of the body and the psychological function of
the central nervous system (Kiecolt-Glaser
1999).
Immmunotherapy utilizes the body’s own
immune system to help recognize cancer cells
and strengthen the immunologic response.
Immunotherapy is also known as biological
therapy. In traditional medicine, doctors use
drugs and proteins called antibodies to target
cancer cells. This form of treatment is used
with the goal of increasing the body’s
immunologic efficacy and destroying invading
cancer cells. Most of these drugs are man
made.
Research shows that behavior changes
can be used to improve immunity. Immunity is
very dependent on sleep cycles and outside
substances. Research also shows that chronic
depression doubles the risk of cancer in the
elderly (Penninx 1998). The behavioral property
of depression weakens the immune system,
making the individual more susceptible to
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� | P a g e 5Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
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cancer cell spread. Mood and emotional state
are more correlated to immune changes than
coping attitudes. For this
Immmunotherapy utilizes the body’s own
immune system to help recognize cancer cells
and strengthen the immunologic response.
Immunotherapy is also known as biological
therapy. In traditional medicine, doctors use
drugs and proteins called antibodies to target
cancer cells. This form of treatment is used
with the goal of increasing the body’s
immunologic efficacy and destroying invading
cancer cells. Most of these drugs are man
made.
Research shows that behavior changes
can be used to improve immunity. Immunity is
very dependent on sleep cycles and outside
substances. Research also shows that chronic
depression doubles the risk of cancer in the
elderly (Penninx 1998). The behavioral property
of depression weakens the immune system,
making the individual more susceptible to
cancer cell spread. Mood and emotional state
are more correlated to immune changes than
coping attitudes. For this reason, addressing
emotion and mood is essential for proper
hypnotic treatment. Hypnosis has been shown
to naturally increase the production and power
of immune cells, particularly lymphoid natural
killer cells. In an exciting research study,
changes to the psychiatric mood, thought
processes and emotions were correlated with
improved lymphoid natural killer cells (Fawzy
1990). By improving psychiatric outlook,
immunity is improved. Hence, hypnosis is a
valid immunotherapeutic approach to cancer
treatment.
What evidence supports this treatment?
For the las t th i r ty years, many
researchers have investigated hypnosis as a
treatment intervention to determine the impact
of hypnosis on cancer. Research has
investigated many endpoints, from pain to
depression, to survivorship and quality of life. In
investigating length of survival, a randomized
controlled trial of patients with breast cancer
found a positive impact on survival when
utilizing hypnosis (Spiegel 1989). The test
groups participated in intervention of group
sessions for one year in congruence to their
standard medical treatment. The study found
that the median survival time was over a year
and a half longer in the hypnosis intervention
group. The researcher repeated this study many
years later with a larger sample size and found
similar outcomes (Spiegel 2007).
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� | P a g e 6Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
Email: [email protected] | www.AvinoamLerner.com
Clinical hypnotherapy use for-
Chemotherapy:
One of the main treatment options for
individuals dealing with cancer is chemotherapy.
Chemotherapy utilizes pharmaceutical drugs to
treat cancer cells throughout the body.
Chemotherapy is not targeted to one area of the
body, but instead the medication reaches the
whole body. For this reason, chemotherapy can
attack cancer cells that have metastasized
(spread) to other parts of the body, away from
the original tumor. The goals of chemotherapy
are to cure the cancer, kill cancer cells that may
have spread, slow the cancer’s growth and
keep the cancer from spreading. Because the
medication is meant to kill cancer cells and the
chemo circulates throughout your entire body,
chemotherapy can cause some ver y
unpleasant and adverse side effects. Chemo
targets fast growing cancer cells, but has an
affect on normal, healthy cells as well. The
normal cells that are most often damaged are
blood-forming cells in the bone marrow, hair
follicles, and cells in the mouth, gastrointestinal
tract and reproductive system. Common side
effects include fatigue, hair loss, increased
bruising, reduced immunity, nausea and
vomiting.
Research has found that cl inical
hypnotherapy is effective in reducing side
effects associated with chemotherapy. In a
systematic review of evidence (Richardson
2007), six randomized controlled trials were
reviewed to determine the effect of clinical
hypnotherapy on chemotherapy outcomes for
adults and children. The researchers found that
hypnosis is a clinically valuable treatment for
reducing chemotherapy related nausea and
vomiting. As nausea and vomiting are typically
some of the most unpleasant side effects
experienced by patients, hypnotherapy should
be incorporated to treatment in conjunction with
chemotherapy. Not only does c l in ica l
hypnotherapy reduce s ide effects o f
chemotherapy, but it has been linked to
improved survivorship. An individual’s response
to chemotherapy correlates with overall
prognosis and survival. The better the patient is
compliant with chemotherapy and the better the
outcomes of chemotherapy, the greater the
tumor regression and patient survival. Hypnosis
improves an indiv idual ’s to lerance for
chemotherapy, which increases compliance
with treatment and overall outcomes.
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� | P a g e 7Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
Email: [email protected] | www.AvinoamLerner.com
Radiation:
Radiation therapy uses high-energy
particles or waves to destroy cancer cells. It is
one of the most common treatments for many
types of cancers. Radiation kills cancer cells by
breaking up the DNA inside the cancer cells. By
disrupting the DNA, the cancer calls are not
able to grow and divide, which causes cell
death. Side effects include fatigue, skin
changes, and long-term damage to otherwise
healthy body parts.
Utilizing clinical hypnosis during radiation
treatment has been shown to reduce fatigue. A
research study done in 2009 examined the
effectiveness of cognitive-behavioral therapy
and hypnosis to treat radiation related fatigue in
individuals undergoing radiation for breast
cancer (Montgomery 2009). The researchers
examined two groups of women: one group
received standard medical care while the other
group received standard medical care in
addition to cognitive-behavioral therapy and
hypnosis. Fatigue was measured weekly using
a standardized outcome measurement tool. The
researchers found that there was a significant
effect on the intervention group, as the
participants’ fatigue did not increase over the
course of the treatment. The group of women
receiving standard medical care had a linear
increase in fatigue during their treatment. This
study suggests the effectiveness of clinical
hypnotherapy for controlling and preventing
radiation related fatigue.
Surgery:
Surgery offers the greatest chance for a
cure for many cancer patients. Surgery
removes all or part of a tumor, while trying to
avoid damage to healthy tissues. Surgery can
be performed for many reasons, including:
diagnostic, palliative, staging, reconstructive
and curative. As with any type of medical
procedure, surgery has risks and side effects.
Risks include bleeding, anesthesia drug
reactions, damage to other tissues, blood clots,
infection and pain.
Again, research has shown the benefits
of hypnotherapy while undergoing cancer
surgery. In 2007, researchers investigated
whether a br ief pre-surgical hypnosis
intervention would decrease anesthesia and
analgesic use during surgery and side effects
after surgery (Montgomery 2007). The
researchers assigned women scheduled to
undergo excision breast biopsy or lumpectomy
to a 15 minutes pre-surgical hypnosis session
or to a control group that participated in
nondirective listening. They found that patients
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in the hypnosis group required less pain
medication during surgery than patient sin the
control group. Because of this, the overall cost
was significantly lower ($772.71 less per
patient) in the control group for the hospital. In
addition, the hypnosis group patients reported
less pain intensity, nausea, fatigue, discomfort
and emotional upset.
Another study investigated the use of
hypnosis and guided imagery in a sample of 36
head and neck cancer surgery patients (Rapkin
1991). The experimental group received
hypnotic intervention in addition to their usual
medical care. Postoperative hospitalizations for
the group that received hypnosis were
significantly shorter than for the control group.
This study suggests that hypnosis can act
prophylactic-ally, by reducing postoperative
complications and reducing hospital stays.
Quality of life:
Quality of life is generally assessed with
standardized outcome measurement tools and
can include a great many parameters including
physical and psychological health, sexual
function, pain, independence, financial status
and more. Individuals should not underestimate
the importance of quality of life in cancer
treatment and journey. A research study (Liossi
2001) examined the impact of individualized
hypnosis on quality of life in 50 terminally ill
cancer patients. Hypnosis showed significant
outcomes over general support. Those that
received hypnosis treatment had less
depression and anxiety overall.
Depression affects nearly half all of all
patients during their cancer treatment.
Research shows that episodic depression
increases an individual’s risk of cancer by nearly
20% (Dalton 2002). Depression has been
shown to shorten survival rates and significantly
increases suicidal rates. In addition, depression
decreases patient compliance. As research
shows the efficacy of hypnosis in reducing
depression, hypnosis should be incorporated
into cancer treatment.
Several clinical trials have shown the
benefit of hypnosis to reduce pain in both
ch i l d ren and adu l t s . When u t i l i z i n g
hypnosisduring a procedure or immediately
preceding an operation, the self-report of pain is
less than those not utilizing hypnosis. In
addition, hypnosis is shown to be effective in
reducing chronic pain associated with cancer
(Kwiatkowski 2012).
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� | P a g e 9Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
Email: [email protected] | www.AvinoamLerner.com
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� | P a g e 10Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
Email: [email protected] | www.AvinoamLerner.com
What to Expect
In a clinical hypnotherapy session, you
can expect to be assisted into a state of
focused attention and comfort. Once in this
state, you wi l l work wi th the c l in ica l
h y p n o t h e ra p i s t t o e n g a g e w i t h t h e
Subconscious Mind. When immersed in the
hypnotic experience, you are more receptive to
healthy new suggestions and thoughts, which
allows you to act on these positive thoughts in
your day-to-day life. Clinical hypnotherapy is
safe, non-invasive and holistic intervention with
no undesired side effect.
Hypnosis is much more than what is
portrayed in the movies or even by stage
hypnotists. A professional hypnotherapist will
ensure your safety, confidentiality and moral
integrity. He or she will help you address issues
and life aspects necessary for attaining your
goal in a meaningful and respectful way.
Hypnosis is not a state of deep sleep
but one of focused attention and relaxation,
which may explain why someone’s eyes may
be closed. The hypnotic state produces a
feeling of well-being where you can more readily
embrace new ideas that are not in conflict with
personal values. While physically very relaxed,
you are utilizing a great deal of thinking and
mental activity, focusing on specific topics,
memories and ideas. Your brain utilizes a
significant amount of neurologic activity. You
can expect to leave the session feeling relaxed,
motivated and hopeful.
Qualified professional:
A Clinical Hypnotherapist is a specialist
in hypnosis. This professional utilizes the healing
power of hypnosis to allow proper functioning of
the immune system and improve the efficacy of
other medicinal interventions.
Is this intervention approach right for me?
If you feel that there more to cancer than
just what takes place in your body; and that
there must be more that you can do to improve
your cancer treatment and outcomes, you must
consider clinical hypnotherapy. If you are ready
to take control of your cancer recovery, explore
viable innovative options to better health, then
you will benefit from clinical hypnotherapy. I
encourage you to be your own advocate along
your cancer journey. I encourage you to explore
all plausible, research-based treatments to
holistically address your cancer diagnosis. Tap
in to and harness the power o f your
subconscious mind. Take control of your cancer
journey.
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� | P a g e 11Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
Email: [email protected] | www.AvinoamLerner.com
A v i n o a m L e r n e r i s a c l i n i c a l
hypnotherapist specializing in Cancer care and
the author of The New Cancer Paradigm.
His innovative approach to cancer
recovery highlights the multidimensional nature
of our being and the need to treat illness not
only on the level of the body but also on the
level of Mind. He offer patients seeking to play a
more active role in their care, a practical,
meaningful and effective path to engage the
creative power of their Mind to revive their
body’s innate immune response and strengthen
its capacity to defend and fight cancer.
Avinoam guiding belief is that for true
and lasting recovery we must transcend the
mechanistic-reductionist-Newtonian view of
disease and recognize that illness is a whole
person event. As such he works with patients in
all stages at his Watertown MA office to
strengthen their body’s innate immune
response, increase physical and psychological
resiliency and enhance their outlook and
attitude toward a favorable outcome.
After earning his degree in Holistic
Hea l th f rom the R idman Co l lege fo r
Complementary Alternative Medicine in Israel in
2000, Avinoam was certified by the National
Guild of Hypnotists (NGH) as well as the
National Federation of Neuro-Linguistic
Programming (NLP) in the USA.
Much of Avinoam’s work is founded on
the work of Dr. Ernest Rossi as described in his
breakthrough book The Psychobiology of Mind
Body Healing and Dr. Al Barrios, a clinical
psychologist and a pioneer in the field of
immunotherapy.
Avinoam is also inspired by the work of
Stephen C.Parkhill, a noted hypnotherapist and
the author of Answer Cancer – The Healing of A
Nation.
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� | P a g e 12Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
Email: [email protected] | www.AvinoamLerner.com
References:
American Cancer Society (n.d) Retrieved November 14, 2014 from http://www.cancer.org.
Dalton SO, Boesen EH, Ross L, Schapiro IR, Johansen C (2002) Mind and Cancer: do Psychological factors cause cancer? Eur J cancer; 38: 1313-1323. Fawzy Fl, Kemeny ME, Fawzy NW, Elashoff R, Morton D, Cousins N, Fahey JL (1990) A structured psychiatric intervention for cancer patients. II. Changes over Time in immunological measures. Arch Gen Psychiatry 47(8): 729-35. Kiecolt-Glaser JK, Glaser R (1999) Psychoneuroimmunology and Cancers: fact or fiction? Eur J Cancer 35(11): 1603-7. Kwiatkowski Fabrice (2012) Hypnosis in cancer patients: can we do better?; Psychology – Selected Papers. Dr. Gina Rossi (Ed.), ISBN: 978-953-51-0587-9. Liossi C (2001). Efficacy of clinical hypnosis in the enhancement of quality of life of Terminally ill cancer patients. Contemporary hypnosis; 15(1): 34-8. Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH (2007) A randomized Clinical trial of a brief hypnosis intervention to control side effects in breast Surgery patients. J Natl Cancer Inst Sept 5; 99(17): 1304-12. Montgomery GH, Kangas M, David D, Hallquist MN, Green S, Bovbjerg DH, Schnur JB (2009). Fatigue during breast cancer radiotherapy: an intitial randomized study of cognitive-behavioral therapy plus hypnosis. Health Psychol 28(3): 317-22. Penninx BW, Guralnik JM, Pahor M, Ferrucci L, Cerhan JR, Wallace RB, Havlik RJ (1998) Chronically depressed mood and cancer in older persons. J Natl Cancer Inst; 90(24): 1888-93. Rapkin DA, Straubing M, Holroyd JC (1991). Guided imagery, hypnosis and recovery From head and neck cancer surgery: an exploratory study Int J Clin Hypn 39 (4): 215-26. Richardson J, Smith JE, McCall G, et. Al (2007). Hypnosis for nausea and vomiting in Cancer chemotherapy: a systematic review of the research evidence. Eur J Cancer Care. 16: 402-412. Spiegel D, Bloom JR, Kraemer HC, Gottheil E (1989). Effect of psychosocial Treatment on survival of patients with metastatic breast cancer. Lancet; 2: 211-22. Spiegel D, Butler L, Giese-Davis J, Koopman C, Miller E, DiMiceli S, Classen C, Fobair P, Carlson R, Kraemer H (2007). Effects of supportive-expression therapy on Survival of patients with metastatic breast cancer. Cancer; 11(5): 1130-8. Ziemssen T, Kern S (2007) Psychoneuroimmunology= cross-talk between the
immune and nervous systems. J Neurol. May: 254 Suppl 2:II8-11.
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� | P a g e 13Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
Email: [email protected] | www.AvinoamLerner.com
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� | P a g e 14Avinoam Lerner | 22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707
Email: [email protected] | www.AvinoamLerner.com
22 Mount Auburn Street, Watertown MA 02472 | Phone 617-564-0707 Email: [email protected] | www.AvinoamLerner.com
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