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Principles and Practice of Stress Management: Hypnosis, Autogenic Training, and Biofeedback
Paul Lehrer, PhD
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People tend to react to stress in very individual ways. The psychophysiological principle of 'individual response stereotypy' describes a response pattern that may predispose some people to stress-related disease. Similarly, some people respond to stress with stereotyped thought patterns, and others with stereotyped behaviors. DSM-IV is a compendium of such stereotyped thought and behavioral patterns, and approximately 70% of visits to primary care physicians are related in some ways to stress.
Indeed, stereotyped behavior may be a hallmark of maladaptiveness. Variability, with some cyclical components, may be a sign of health. In physiology, the structure of various systems may determine specific amplitudes and frequencies of specific modulatory reflexes, which
often are depressed during stress. The technique of heart rate variability biofeedback will be demonstrated, where breathing maneuvers can easily produce profound physiological and psychological changes, and increase immunity to stress.
Just as there are individual response patterns, there also are some specific effects of various stress management treatments. Muscle relaxation, biofeedback, autogenic training, and hypnosis will be discussed, as will the interplay between these methods and principles of hypnosis. Personality patterns play a large role in response to particular treatments. Hypnotizability and Internality are inversely related to biofeedback response, but positively related to response to most other stress management methods. The interplay among these various approaches will be discussed and evaluated.
Paul Lehrer, PhD is Professor of Psychiatry at the University of Medicine and Dentistry of New Jersey in Piscataway, NJ. He received his PhD in clinical psychology at Harvard University in 1969, where he began his career-long study psychophysiological effects of various relaxation and biofeedback techniques for managing stress and disease. He has served as President of the Association for Applied Psychophysiology and Biofeedback, the International Stress Management Association (USA), and the International Society for the Advancement of Respiratory Psychophysiology. His mentors have included some of the giants in the stress management field, including Edmund Jacobson, Wolfgang Luthe, Jay Haley, and David Shapiro. This eclectic background is evident in his editorship of the widely used text, Principles and Practice of Stress Management (NY: Guilford, 2007, 3rd edition). His most recent research has been on the ways that adaptive and homeostatic processes are manifest in heart rate variability, and in ways that stress-related symptoms and various forms of physiological dysregulation can be powerfully affected by heart rate variability biofeedback: a technique that can easily be applied as a component in hypnotic therapy. He has published over 100 articles on these and related topics, and is actively involved in research, clinical practice, and teaching. He currently is conducting a multcenter study of heart rate variability biofeedback as a treatment for asthma.
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