Question: 

Dear Belleruth,
I'm feeling anxious about the economy, worrying about losing my job, my health insurance, etc. etc.  I don't want to dwell on this, as I believe that my thoughts could manifest the very events I'm worrying about.
Any tools, affirmations, guided imagery to help with this?

Thanks,
Kathy

Answer:
Dear Kathy,
I’m so glad you asked this in the way that you did.  It gives me a chance to hopefully offer some reassurance and at the same time, rant and carry on about one of my favorite pet peeves. 

First off, let me say that I’m sorry you’re faced with these very real concerns. These are dicey times and no way am I minimizing this aspect of your question. A lot of really good, capable people are in this worrisome situation with you.

Researchers from the Department of Psychiatry at Brigham and Women's Hospital/Harvard Medical School reviewed the evidence on the efficacy of biofeedback for the two most prevalent headache conditions--migraine and tension-type headache.

Two recently published meta-analyses yielded data from 150 outcome studies - randomized controlled trials as well as uncontrolled quasi-experimental designs. Of these, 94 studies were selected for inclusion, going by predefined criteria. Meta-analytic integrations were carried out separately for the two conditions of interest.

Researchers from the University of Hartford reviewed the findings to see if a high level of hypnotic suggestibility (considered a stable individual trait) is necessary for a hypnotic pain intervention to relieve headache pain.

Higher suggestibility has been found to be associated with greater relief from hypnotic pain interventions, and although individuals in the high suggestibility range show the strongest response to hypnotic analgesia, people of medium suggestibility (who represent approximately one third of the population) also have been found to obtain significant relief from hypnosis.

The researchers conclude that high hypnotic suggestibility is not necessary for successful hypnotic pain intervention for headache – medium suggestibility works too .  But the available evidence does not support the efficacy of hypnotic pain interventions for people who fall in the low hypnotic suggestibility range.  According to some studies, these subjects may benefit from imaginative analgesia suggestions (guided imagery), or suggestions for pain reduction that are delivered while the person is not under hypnosis.

Citation:  Milling LS. Is high hypnotic suggestibility necessary for successful hypnotic pain intervention? Current Pain and Headache Reports. 2008 Apr;12 (2): pages 98-102. This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

A review and meta-analysis of studies investigating the effects of biofeedback on tension headaches was undertaken by researchers at Philipps-University of Marburg in Marburg, Germany.

A literature search identified 74 outcome studies, of which 53 were selected according to predefined inclusion criteria. Meta-analytic integration resulted in a significant medium-to-large effect size (d = 0.73; 95% confidence interval = 0.61, 0.84) that proved stable over an average follow-up phase of 15 months.

Biofeedback was found to be more effective than headache monitoring, placebo, and relaxation therapy conditions.  The strongest improvements resulted for frequency of headache episodes.  Further significant effects were observed for muscle tension, self-efficacy, symptoms of anxiety, depression, and analgesic medication.

Most effective of all was biofeedback in combination with relaxation. Effects were particularly large in children and adolescents. The review concluded that biofeedback constitutes an effective, evidence-based treatment option for tension-type headache.

Investigators from Philipps-University of Marburg in Germany did a meta-analysis of the efficacy of biofeedback (BFB) in treating migraine. A computerized literature search of the databases Medline, PsycInfo, Psyndex and the Cochrane library, enhanced by a hand search, identified 86 outcome studies, of which 55 studies met the inclusion criteria.

Hungarian researchers find that the popular European technique of Autogenic Training is helpful in all three kinds of headache: migraine, tension, and a combination of the two.

Hungarian researchers investigated the effects of auto-suggestion, using cognitive and symbol therapy elements with auto-suggestion, on three kinds of headache (migraine, tension and combined). The assumption was that since headache is prolonged and exacerbated by depression and anxiety, and these conditions are ameliorated by autosuggestion, that this technique could be valuable for relieving headache for multiple reasons.

Twenty five female patients with migraine, tension-type headache or mixed headache participated in an eight-month follow-up study. Headache frequency, analgesic, antimigraine and anxiolytic drug consumption were measured by means of a headache diary.

Researchers at the Himalayan Institute of Medical Sciences in Uttaranchal, India find in a randomized, controlled trial that biofeedback-assisted diaphramgmatic breathing plus systematic relaxation yields greater longterm benefits for migraine sufferers than propanalol..

Researchers at the Himalayan Institute of Medical Sciences in Uttaranchal, India, evaluated the effectiveness of biofeedback assisted diaphragmatic breathing and systematic relaxation for those suffering from migraine. They also compared the longterm benefits of these techniques with those of propranolol.

There were 192 migraine patients who were randomly distributed into two groups. The propranolol group received propranolol 80 mg/day while the biofeedback group received electromyogram (EMG) and temperature biofeedback assisted diaphragmatic breathing and systematic relaxation training, accompanied by home practice for 6 months.