Clinical Behavioral Medicine: Some Concepts and ProceduresThis book is an effort to integrate some clinical observations, theoretical concepts, and promising clinical procedures that relate psychological variables to physiological variables. My primary emphasis is on what psychological and behavioral concepts and procedures are most likely to enable us to influence physiological functions. The book covers ques tions that have fascinated me and with which I have struggled in daily clinical practice. What types of people are most at risk for physical disor ders or dysfunctions? Why do some people present psychosocial con flicts somatically and others behaviorally? What is the placebo effect and how does it work? How do you arrange the conditions to alter maladap tive belief systems that contribute to psychopathology and patho physiology? Do beliefs have biological consequences? When I was in private clinical practice, and even today in my medi cal school clinical practice situation, I set aside one day each week to puzzle over the theoretical questions that my clinical experience gener ates. Often isolating these underlying theoretical questions provides guidance into the most relevant empirical literature. I have found that this weekly ritual, which I started in private practice many years ago, appears to increase my clinical efficacy or at least makes clinical work more exciting. I find the unexamined clinical practice hard to endure. Kurt Lewin once said, "There is nothing so practical as a good theory. |
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... , Behavioral Medicine Clinic and Stress Disorders Research Laboratory Eastern Virginia Medical School Norfolk , Virginia PLENUM PRESS • NEW YORK AND LONDON Library of Congress Cataloging in Publication Data Wickramasekera , lan.
... , Behavioral Medicine Clinic and Stress Disorders Research Laboratory Eastern Virginia Medical School Norfolk , Virginia PLENUM PRESS • NEW YORK AND LONDON Library of Congress Cataloging in Publication Data Wickramasekera , lan.
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Contents
WHAT KINDS OF PEOPLE ARE AT HIGH RISK TO DEVELOP CHRONIC STRESSRELATED SYMPTOMS? | 1 |
Hypnotic Ability | 4 |
HighHypnotic Ability | 5 |
LowHypnotic Ability | 10 |
Habitual Catastrophizing Panicking Cognitions | 14 |
Sympathetic ReactivityNegative Affectivity Neuroticism | 16 |
Major Life Changes andIor Daily Hassles | 19 |
Daily Hassles | 20 |
References | 154 |
THE DIAGNOSIS AND PSYCHOPHYSIOLOGICAL MANAGEMENT OF CHRONIC PAIN AND ANXIETY | 155 |
Acute and Chronic Pain | 156 |
Illness Behavior Syndrome and Chronic Pain | 159 |
A Theory of the Acquisition of Chronic Pain and Anxiety | 160 |
Hypnotic Ability | 161 |
Negative Affectivity | 163 |
Rationales for the Use of Psychological and Behavioral Procedures with Pain | 164 |
Coping Skills | 21 |
Discussion | 22 |
Some Predictions from the Model | 24 |
References | 26 |
CLINICAL BEHAVIORAL MEDICINE AND ITS CUTTING EDGES Biofeedback Behavior Therapy and Hypnosis | 33 |
The Origins of Behavioral Medicine | 37 |
Psychophysiological Stress Management Skills for Pain Anxiety and Sleep Disorders | 41 |
Common Features of Biofeedback Behavior Therapy and Hypnosis | 44 |
Potentiating the Placebo Effect | 45 |
Quantitative Dependent Variables | 46 |
Wider Application | 47 |
References | 48 |
HYPNOSIS Scientific Status and Clinical Relevance | 55 |
Current Theories of Hypnosis | 57 |
Parameters of Hypnosis | 58 |
Characteristics of High Hypnotizables | 61 |
Psychopathology Pathophysiology Healing and Hypnotic Ability | 64 |
Increasing Hypnotic Ability | 71 |
Summary of Clinical Implications | 73 |
References | 74 |
CROCKS QUACKS AND SHRINKS | 79 |
Crocks and Quacks | 85 |
Why Skills Taught by Psychotherapists May Be Promising Alternatives to Pills for Some Patients | 90 |
References | 93 |
WHAT IS THE PLACEBO EFFECT AND HOW DOES IT WORK? | 97 |
Theories of the Placebo | 100 |
Origins of the ConditionedResponse Model | 102 |
Unconditioned Stimuli | 105 |
Conditioned Stimuli | 106 |
The Placebo as a Conditioned Response | 107 |
Components of the Conditioned Placebo Response | 110 |
The CognitiveVerbal Component | 111 |
The Physicochemical Component | 112 |
Historical Aspects | 114 |
Acquisition Phase | 115 |
Consolidation Phase | 117 |
Placebo Responding | 118 |
Placebo Responding and Hypnotizability | 119 |
Parameters of Placebo Learning | 122 |
Phenomena of Conditioning | 124 |
Predictions from the Model | 125 |
Testing the Model | 128 |
Conclusion | 129 |
INITIAL PATIENT INTERVIEW | 135 |
Priorities and Procedures | 137 |
References | 142 |
PSYCHOPHYSIOLOGICAL ROLE INDUCTION OR THE TROJAN HORSE PROCEDURE | 143 |
Psychophysiological Demonstrations | 144 |
Educational Model | 147 |
CoInvestigator | 149 |
Out of the ClosetThe Psychotherapy Candidate | 150 |
Data on the Effects of the Psychophysiological Role Induction | 153 |
Hypnosis for Pain | 166 |
Biofeedback for Pain | 167 |
Behavior Modification for Pain | 171 |
Clinical Guidelines for a Psychophysiological Approach to a Chronic Pain Patient | 174 |
Role Induction for Chronic Pain Patients | 175 |
Case Study of a Chronic Pain Patient | 177 |
Summary and Conclusion | 179 |
References | 180 |
HIGHRISK PROFILE Assessment Patient Feedback and Therapy Planning Assessment Questions and Assumptions | 185 |
Discussion of Assessment Questions | 188 |
HighHypnotic Ability | 196 |
LowHypnotic Ability | 200 |
High Catastrophizing Panicking Cognitions | 202 |
Neuroticism Negative Affectivity and Excessive Sympathetic Reactivity | 205 |
Major Life Changes | 208 |
Hassles | 211 |
Support Systems | 212 |
Coping Skills | 215 |
Therapy Planning | 217 |
Case Study of a LowHypnoticAbility Patient | 218 |
Case Study of a HighHypnoticAbility Patient | 223 |
References | 229 |
SELFHYPNOSIS AND THE COMMON COMPONENTS OF OTHER STRESSREDUCTION TECHNIQUES A Theory | 233 |
Psychological Stress | 235 |
Common Procedural Components | 237 |
Common Therapeutic Mechanisms | 240 |
Allocentric Mode of Perception | 241 |
Cognitive Control of Physiology | 242 |
Sensory Restriction and Enhanced Hypnotizability | 243 |
Muscle Relaxation and Enhanced Hypnotizability | 245 |
Summary | 247 |
References | 248 |
APPENDIXES | 255 |
PROBLEMS WITH HYPNOSIS AND CRUCIAL CLINICAL CONCEPTS | 257 |
BRIEF PROCEDURES TO ASSESS HYPNOTIC ABILITY AND ATTITUDE | 259 |
UNOBTRUSIVE PROCEDURES | 265 |
EEC Alpha Density and Hypnotic Ability | 266 |
Experience Inventories | 269 |
WICKRAM EXPERIENCE INVENTORY | 271 |
Wickrams Modification of the Spiegel Hypnotic Induction Procedures | 275 |
INFORMAL CLINICAL TESTING FOR HYPNOTIC ABILITY WITH TEST SUGGESTIONS | 277 |
SUBJECTIVE RESPONSE INQUIRY | 281 |
WICKRAMASEKERAS DIAGNOSTIC INTERVIEW FOR HEADACHE | 283 |
HYPNOTIC PROCEDURE TO REDUCE HEADACHE PAIN | 285 |
IN VITRO DESENSITIZATION SD PROCEDURE | 287 |
BACKGROUND QUESTIONNAIRE | 289 |
BEHAVIORAL MEDICINE CLINIC AND STRESS DISORDERS RESEARCH LABORATORY Statement of Procedures | 291 |
BEHAVIORAL MEDICINE CLINIC AND STRESS DISORDERS RESEARCH LABORATORY Assessment for Admission | 293 |
PSYCHOPHYSIOLOGICAL PROFILE | 295 |
297 | |
301 | |
Other editions - View all
Clinical Behavioral Medicine: Some Concepts and Procedures I.E. Wickramasekera No preview available - 2013 |
Clinical Behavioral Medicine: Some Concepts and Procedures I.E. Wickramasekera No preview available - 2013 |
Common terms and phrases
Abnormal Psychology active ingredients acute alter anxiety arousal associated autogenic training Barber baseline behavior therapy behavioral medicine beliefs biofeedback biological Bowers catastrophizing chronic pain CLEM Clinical and Experimental cognitive component conditioning coping skills disease disorders drugs EMG feedback emotional Evans example Experimental Hypnosis Eysenck factors frontal EMG functions hassles headache high-hypnotic ability Hilgard hypnotic ability hypnotic susceptibility hypnotizability increase information processing inhibit International Journal Journal of Abnormal Journal of Clinical learning low-hypnotic ability major life changes mechanisms Meichenbaum mental mind-body dichotomy negative neuroticism nocebos overlearned patient perception person physicians physiological placebo effect placebo response potentiate predict present problems procedures Psychiatry psycho psychophysiological psychosocial Psychosomatic psychotherapy reduce relaxation reliably respondent conditioning risk Science self-hypnosis sensory restriction social support somatic stimuli stress stressors studies suggestions techniques tension headache tests therapeutic therapist tion treatment UCSs unconscious variables verbal Wickramasekera York