Hypnosis, Biofeedback, Relaxation Techniques in Application to adolescent behavior problems Hypnosis, Biofeedback, Relaxation Techniques in Application to adolescent behavior problems Dr. Suchit Tamboli Developmental Pediatrician Chiranjiv Clinic & Child Development Center Ghumare Lane, Ahmednagar Maharashtra State Ph – / VISIT US AT :

Skills rather than Pills

Self Regulation  Intent of complementary medicine  Self regulation facilitate a child’s natural, developmental drive for mastery & autonomy  Empowers patients to focus their minds to positively affect their bodies  Encourage to acquire knowledge & take ownership of their own problem

Self Regulation  Voluntary modulation of selected physical function  Directed use of mental imagery  Self monitoring  Positive self talk  Awareness of body mind relations

 Mind is most potent tool available to attain goal of health  Mind is Healer & slayer  What we think, feel & perceive have profound implications for health & Longevity

 Self-hypnosis  Biofeedback  Diaphragmatic breathing  Progressive muscle relaxation  Autogenic  Cognitive – behavioral therapy Pediatric Self-Regulation Techniques

Chronic/recurrent pain Recurrent abdominal pain, headaches. Acute pain Medical procedures, trauma, Burns, Anxiety & stress disorders, Obsessive - compulsive disorder, Trichotillomania Disorders of elimination Enuresis, Encoparesis Pediatric Problems Responsive to Self - Regulation Techniques

Sleep disorders Autonomic nervous system dysregulation Hypertension, Neuromuscular rehabilitation Habit disorders Thumb -sucking, Bruxism, Habit cough, Nail biting Pediatric Problems Responsive to Self - Regulation Techniques

Tics and Tourette syndrome, Pruritus, Warts Learning disorders, Seizure, attention disorders Impulse control problems, Anger management, Disruptive behavior Feeding & swallowing problems, Dysphagia, Cyclic vomiting, Anorexia, Bulimia Chronic illness, Asthma, Juvenile rheumatoid arthritis, Sickle cell anemia, Malignancies, Diabetes mellitus Dysfluencies Pediatric Problems Responsive to Self - Regulation Techniques

Physical (Somatic ) Classification of relaxation therapies 1. Progressive Muscular relaxation (Jacobson) 2. Wolpe’s Abbreviated progressive relaxation training 3. Modification of relaxation techniques 1. Hypnosis 2. Biofeedback 3. Self awareness 4. Imagery 5 Autogenic training 6 Meditation 7.Yoga and Pranayam Psychological (Cognitive)

  Definition   Main components   History   Current philosophies   Indications   Applications   Autogenic training Hypnosis

  State of attentive focused concentration with suspension of some peripheral awareness   State of awareness within which an individual experiences heightened suggestibility   Fantasy imagery, absorbed attention reflects Natural developmental tendencies   Sensation of relaxation,wellbeing & enhanced self control Hypnosis

  Not a sleeplike state   Cannot be forced to do things against their will   Heightened awareness of physical sensations & increased self control   Facilitates innate creativity & imaginary skills to construct helpful solutions to problems Hypnosis: Myths & Misinterpretation

  Controlled alteration of ones attention   Absorption   Dissociation   Suggestibility Hypnosis: Main Components

  NEO DISSOCIATION MODEL   Activates subsystems of control   results in an altered state of consciousness   Reversible amnesia   SOCIAL PSYCHOLOGICAL VIEW   Suggestibility, positive attitudes & expectations Hypnosis : Current Philosophy

  Goal : attitude of hope in the context of mastery   Learns to focus on creating a solution   To discover & use resources for inner control   Susceptibility   High : greater theta activity output in frontal & parietal lobes   Low : increase theta activity in posterior locations Hypnosis

INDICATIONS   Motivated to learn & practice   High hypnotizability   Illnesses exacerbated by stress & anxiety   Not frightened, not obsesses with loss of control   Treatment of dissociative disorders Hypnosis CONTRAINDICATIONS  Epilepsy  Depression

Hypnosis : Applications  Anxiety & phobias  Psychotherapy of dissociate & conversion disorders  Restructure the memories of event  Cigarette smoking  Relieves pain by reducing anxiety  Post surgical, burns  Chronic pain cancer, duodenal ulcer  Obesity  Alone does not cure  Use with cognitive behavioral therapy

Definition Philosophy Principle Current technique used Beneficiary : age, developmental strength, natural talent and interest Specific assessment 4 to 6 sessions 30 min each Contra indication Application Biofeedback

Use of electronic or electromechanical equipment (computer based) to measure & then feedback information about physiological process External psycho physiological feedback Technique of learning voluntary control over automatically, reflexively regulated body functions Biofeedback

Help patients become aware of their ability to control physiological changes in their bodies so that they can learn to control these changes in their every day life without biofeedback Improvement of ability to discern and cultivate lowered levels of sympathetic nervous system arousal and subjective sensation of relaxation Technique : awareness and control of breathing, modulation of muscle tension levels and peripheral temperature Biofeedback : Goals

Why successful in children More enthusiastic Learn more quickly Less skeptical about self control More confidence in special abilities More psycho physiologic liability Enjoy practice sessions More reliable at symptom monitoring ADHD, DEPRESSION,COGNITIVE IMPAIRMENT DO NOT RESPOND Biofeedback

Muscle activity : electromyography Peripheral temperature: thermography Heart rate : photoplethsmography Breathing : pneumography Electrical brain activities : electroencephalography Biofeedback equipments

Drug abuse Chronic insomnia Tic disorders Tension headache Migraine Computerized biofeedback : game display format ……. Intrinsically motivating Desired therapeutic outcome : decreased muscle tension, slow diaphragmatic breathing Biofeedback : Applications

Take Home Message   Relaxation techniques : powerful tools   Enhancing control over behavior, perception, somatic functions & cognition   Useful adjuvant therapy   Useful in reducing stress & anxiety   SKILLS rather than PILLS

Dr. Suchit Tamboli Developmental Pediatrician Dr. Suchit Tamboli Developmental Pediatrician visit us at : visit us at :