Comparing hypnosis with Eastern meditation, Chi Kung, and Nei Kung

¶ … globalization and innovations in telecommunications are bringing healthcare practitioners together from all over the world in ways that have never before been possible. As these collaborative efforts and mature communities of practice continue to emerge, it is important to help Western practitioners understand the fundamental tenets of Eastern medicine and representative practices, just as it is important to help practitioners in China and elsewhere in the East understand the allopathic approaches that are most widely practiced in the West. To this end, this study compared the clinical use of hypnosis with the use of Eastern Meditation, Chi Kung, and Nei Kung. To achieve this comparison, a review of the relevant literature was combined with a qualitative meta-analysis of the peer-reviewed and scholarly literature concerning these treatment modalities which are applied in a series of vignettes to illustrate how these methods can be used in isolation or in combination to achieve superior clinical outcomes. These results of the research are then synthesized in the concluding chapter together with a summary of the research, salient findings and recommendations for allopathic practitioners concerning the use of alternative medicine.

Table of Contents

Chapter 1: Introduction

Statement of the Problem

Purpose of Study

Importance of Study

Scope of Study

Rationale of Study

Overview of Study

Chapter 2: Review of Related Literature

Chapter 3: Methodology

Description of the Study Approach

Data-gathering Method and Database of Study

Chapter 4: Data Analysis

Meta-Analysis

Representative Treatment Applications for Hypnosis, Eastern Meditation,

Chi Kung, and Nei Kung

Representative Treatment Vignettes

Chapter 5: Summary, Conclusions and Recommendations

A Comparison of Hypnosis with Eastern Meditation, Chi Kung, and Nei Kung

Chapter 1:

Introduction

Statement of the Problem

Clinicians who practice modern medicine in the West are increasingly recognizing the value of various mind-body methods in promoting healing and in the treatment of a wide range of diseases and bodily disorders. Some of these techniques, such as meditation and herbal therapies, are widely used in both the East and the West, but others, such as hypnosis, remain largely restricted to allopathic practitioners. Likewise, many Western practitioners are unaware of the use of other techniques with proven efficacy such as Chi Kung and Kei Kung that have been practiced in China for millennia. In this regard, Gielen, Fish and Draguns (2004) note that, "Generally speaking, indigenous Chinese healing (ICH) includes three major modalities, namely, acupuncture/moxibustion, qigong (vital energy work), and herbal medicine. Acupuncture and qigong are unique to Chinese culture, whereas herbal medicine has been developed in other cultures as well" (p. 191).

Because resources are scarce by definition, it is important for healthcare providers in any setting to use their available resources to their maximum advantage, and the use of these healing techniques alone or in combination have been shown to provide a wide range of positive clinical outcomes in a cost-effective fashion. Although some Western practitioners may be reluctant to use alternative medicine methods in their healing repertoire, this reluctance may be based on a misunderstanding or a lack of awareness of how these methods can be used to good effect (Hsu, 1999). Unfortunately, the precise operations of many of these alternative medicine approaches remain better described than understood, particularly among Western practitioners, making their widespread adoption more complicated still. For instance, Gielen and his associates (2004) emphasize that, "Indigenous Chinese healing (ICH) is a time-tested tradition that has endured for 3000 years. It is also a human-honored medical modality that is not based on generalizations from in vitro experimentation as is conventional biomedicine. Instead, as other approaches involved in traditional Chinese medicine (TCM), ICH is derived from one billion people's folk-friendly experiences of in vivo applications" (p. 191). In this environment, identifying similarities and differences between hypnosis, Eastern Meditation, Chi Kung, and Nei Kung that can promote the appropriate use of these techniques in clinical settings represents a timely and important enterprise as discussed further below.

Purpose of Study

The purpose of this study was two-fold:

1. To provide a comparison of hypnosis with Eastern Meditation, Chi Kung, and Nei Kung through a review of the relevant literature; and

2. To identify how these methods can be used by healthcare practitioners to achieve improved clinical outcomes for various conditions.

Importance of Study

Not only is the United States becoming an increasingly multicultural society, it is also growing older much more rapidly than existing healthcare resources, and this rapidity of growth will mean that the demand for healthcare services will likely outpace any corresponding growth in the healthcare community. Indeed, there are already acute shortages of nurses of all types in the United States, and many experts suggest that the problem has reached crisis proportions. For example, Cohen, Ehrlich-Jones, Burns and Frank-Stromborg (2005) report that, "Although nursing shortages have occurred previously, the current nursing shortage is different because of the attrition of nurses from the practice setting due to increased retirements; the unpredictability of continued, full-time employment even during a time of a nurse workforce shortage; the increased number of emerging roles; and the demand for nurses to fill these and existing roles. Supply and demand of nurses has greatly changed as the aging nurse workforce retires, decreasing the supply, and the breadth of career opportunities for young women broadens, decreasing the number of women who desire to enter the profession" (p. 88). Further demands on this already overburdened system in the future will require a multidisciplinary approach that uses the most cost-effective approach that is known to work, even if the precise reasons for such efficacy remain unknown or understudied. Indeed, to the extent that hypnosis as well as the other meditative approaches examined herein can be used to help patients become healthier faster is the extent that their use should be seriously considered by practitioners of all theoretical persuasions.

Scope of Study

This study examined the use of hypnosis as it is typically used in clinical practice in the West, but the use of Eastern Meditation, Chi Kung, and Nei Kung in both the East and the West is provided.

Rationale of Study

As noted above, healthcare resources are already stretched to their limits, and the Healthcare Reform Act will likely result in further disruptions in the delivery of healthcare services as the bugs are worked out of the system and clinicians learn how to navigate the new bureaucracies. In this environment, many healthcare providers may be reluctant to expand their current range of treatment modalities unless they can be convinced that these alternative treatment methods are efficacious. Moreover, even assuming that Western healthcare providers accept the efficacy of alternative medicine approaches, they may be reluctant to use them simply because they are unaware of how they are used or for what conditions various treatment modalities are best suited. According to Gielen, Fish and Draguns (2004), the field of psychotherapy was born in the 19th century as a result of the Western practice of separating the mind, body, and spirit into distinct and separate entities. As a result, not only are the mind, body, and spirit separated, but the way in which we approach healing of each of these entities is separated as well. Western medicine has taken this separation to the extreme, with health care specialization even targeting specific body systems or diseases (e.g., cardiology or oncology). Many non-Western cultures approach healing completely differently, both considering the body holistically and also recognizing interactions among mind, body, and spirit.

As society becomes more globalized and multicultural, it will become essential for those who provide health care services to understand the way in which other cultures approach healing. These approaches may include issues varying from the reasons why people seek professional advice to the practices they adopt in order to participate in the healing process (Gielen et al., 2004). Therefore, providing a timely comparison of hypnosis, with which many Western practitioners are already familiar, with the use of Eastern Meditation, Chi Kung, and Nei Kung just makes good business sense. Based on the dearth of relevant studies in the Western press concerning these treatment modalities, though, the comparison will also draw on anecdotal accounts and empirical observations taken from other resources as well. Taken together, this approach was deemed useful in achieving the above-stated research purpose, at least in a general fashion.

Overview of Study

This study used a five-chapter format to achieve the research purpose stated above. Chapter one of the study was used to provide an introduction of the issues under consideration, as well as a statement of the problem considered by the study as well as the study's purpose, importance, scope and rationale. Chapter two of the study was used to deliver a review of the relevant peer-reviewed and scholarly literature concerning hypnosis, Eastern Meditation, Chi Kung, and Nei Kung. The study's methodology is more fully described in chapter three which provides a description of the study approach, the data-gathering method and the database of study that was consulted. The penultimate chapter consists of a qualitative meta-analysis of the data developed during the research process and chapter five presents the study's conclusions, a summary of the research and salient recommendations.

Chapter 2:

Review of Related Literature

Chapter Introduction

This chapter provides a review of the literature concerning hypnosis, Eastern Meditation, Chi Kung, and Nei Kung and how these methods are used to treat various ailments and improve physical and mental functioning. A summary of the review concludes the chapter.

Hypnosis

In his study, "Cognitive Hypnotherapy in the Management of Pain," Dowd (2001) reports that, "Several theories have been proposed to account for the effect of hypnosis. State theories assume that the hypnotic trance is qualitatively different from all other human experiences. From this perspective, trance capacity is supposedly a fairly stable trait that exhibits substantial individual differences. Nonstate theories, often referred to as social learning, social psychological or cognitive-behavioral theories of hypnosis propose that hypnotic phenomena are related to social and psychological characteristics such as hope, motivation, expectancy, belief in the therapist, desire to please the therapist, a positive initial trance experience, and the definition of the situation as hypnosis" (p. 87). According to Baker (1990), "Modern research has contributed very little new to our understanding or utilization of hypnosis.... Today, some 200 years after the discovery of artificial somnambulism, researchers are divided on even such basic issues as the veridicality of hypnotic phenomena and whether or not hypnosis exists as a state. About the only point on which there seems to be a general consensus is that, if it exists, hypnosis is not sleep" (p. 37).

According to Cavendish (1970), hypnosis is "The inducing of a sleep-like trance by repeated commands and mental concentration in which the subject acts only on the suggestion of the hypnotist: in such a trance state subjects are able to recall long-forgotten experiences: from the Greek hypnos meaning 'sleep'; it is also termed mesmerism after F.A. Mesmer (1734-1815), an early pioneer of hypnotism. Hypnotism is often used therapeutically to treat nervous disorders" (p. 1379). Likewise, Brown and Fromm (1986) report that, "The historical roots of hypnotherapy reach back to tribal rites and the ancient practices of witch doctors. Its scientific history begins at the end of the 18th century, with Mesmer" (p. 3). Other practitioners besides Mesmer have been credited with the development of modern hypnosis, including Sigmund Freud in his development of psychoanalytic theory (Zahourek, 2001). Indeed, clinicians during Freud's period in history employed hypnosis to provide surgical anesthesia, a period when chemical anesthesia was not yet available (Zahourek, 2001). In addition, hypnosis was also effectively used during both world wars to treat what was termed "battle fatigue" at the time, a mental disorder that is typically referred to as post-traumatic stress disorder today (Zahourek, 2001). An extension of hypnosis, hypnotherapy is a form of therapy that incorporates hypnosis into the treatment protocol but the applicability of this technique is typically restricted to certain types of patients and requires specialized training on the part of the clinician. In this regard, Kelly, Kress and Mccormick (2004) report that, "Researchers have speculated that hypnotherapy may only be useful with highly suggestible clients. Furthermore, the use of hypnotherapy requires specialized training for the counselor to ensure competent practice" (p. 185).

In his book, They Call It Hypnosis, Baker (1990) notes that, "In many ways the concept of hypnosis is analogous to some other mysteries that have confused and confounded scientists in the past -- such as phlogiston, the ether wind, and 'N-rays'" (p. 12).

In this regard, Baker adds that, "For any graduate student assigned the subject of hypnosis for his thesis or dissertation, one can only feel pity. The research literature surrounding the topic is a veritable quagmire of disagreements, pro and con experimental results, claims and counterclaims. If there is any path leading out of the current swamp it is difficult to find. Much of what has been published on the subject is neither reliable nor valid" (1990, p. 15).

As Baker points out, perhaps the only real issue concerning hypnosis that has gained a consensus among practitioners and researchers is that the hypnotic state is not the same thing as sleep. "Curiously enough, the word itself is derived from the Greek word hypnos, meaning sleep. If one has had a little personal experience with hypnosis, it is easy to understand why sleep and the behavior called hypnosis are associated. On numerous occasions in my practice as a professional psychologist, when working with clients who have not had enough sleep the night before or who are not overstimulated with caffeine, the instant I suggested slow deep breathing and muscle relaxation, they fell asleep. Some even snored. To communicate with a client -- and communication is the essence of the hypnotic relationship -- quite frequently the hypnotist must insure that the client is awake and is attending to the therapeutic or experimental message. When people are asleep they are beyond the hypnotist's reach" (p. 15).

One of the ways hypnoanalysis differs from the orthodox use of hypnosis in psychotherapy is that the relationship with the hypnotist is subjected to analysis. In palliative psychotherapy no attempt is made to analyze the transference. Rather, efforts are extended toward expanding the illusion of power and invincibility inherent in the hypnotist. Therapeutic benefits are often effected in the medium of such an interpersonal relationship, and suggestive, reassuring, persuasive and reeducational arguments may be absorbed by the patient. Unfortunately, no real dynamic change occurs in the patient's psyche, nor does he ever get to understand his deepest dynamic trends. The ego is not strengthened to a point where the person can achieve security and self-esteem without exploiting neurotic impulses. Consequently, when hypnotic therapy is terminated and the relationship with the hypnotist is brought to a halt, the patient may experience a relapse of his illness. In hypnoanalysis an effort is made to produce a real change in the strength of the ego, and to effect a reorganization of the patient's basic character structure. These aims are attempted through an analysis of the interpersonal relationship (Wolberg, 1996, p. 394).

Because hypnotic therapy has traditionally been so rooted in an authoritarian relationship to the hypnosist, an analysis of the relationship may occasion some surprise, since it would seem to jeopardize the very foundations on which hypnosis depends. Nevertheless, such an analysis does not interfere with hypnotizability even though the motivations which condition hypnotizability may be subjected to investigation. Hypnosis is an intimate interpersonal relationship and is bound to incite profound emotional feelings in the patient. At the start the latter will display his customary demands, expectations and fears which he habitually demonstrates in his relationships with people. In addition to these habitual responses, he will experience an onrush of irrational transference feelings which frighten him and which he will strive to repress. The latter are the product of past experiences and conditionings so anxiety laden that they have been relegated to unconscious oblivion. In his ordinary interpersonal contacts he is able to throw up various defenses against such feelings, to detach himself or to replace his strivings with those of a more acceptable nature. Resistance against these feelings is intense. In psychoanalysis a main task is dissipation of transference resistances. Many months may pass before the patient permits himself to come sufficiently close to the analyst to experience irrational attitudes and impulses. (Wolberg, 1996, p. 394).

Hypnotherapy is a quick, inexpensive and proven method for helping people stop smoking, lose weight, get rid of warts and eczema, reduce the length and pain of childbirth, cope with medical procedures and recover from surgery a whole lot faster. Yet hypnosis is still the stuff of raised eyebrows and skeptical comments and, all too often, a source of dread. "When I tell people what I do, some of them are afraid of looking into my eyes," says Caroline Miller, Ph.D., dean of academic studies at the American Institute of Hypnotherapy in Irvine, Calif., and editor of the American Board of Hypnotherapy Journal. "In our experience, and according to certain studies, the more intelligent and imaginative a person is, the easier it is for him or her to be hypnotized. However, many people still believe that only weak-willed, compliant people 'let' themselves be hypnotized." (Sandroff, 1999a, p. 73).

The fear and distrust of hypnosis is, in part, the legacy of Austrian doctor Franz Anton Mesmer (1733-1815), the flamboyant pioneer of hypnosis who believed in so-called animal magnetism and "mesmerized" the flocks of patients who sought his cures for nervous disorders. His work was condemned by the medical establishment and served as a model for several Svengali characters in popular fiction. The more neutral term hypnosis, derived from Hypnos, the Greek god of sleep, was coined by the English physician James Braid in 1843. The most impressive early work in hypnosis was done in the mid-1800s, when leading London physician John Elliston and Scottish surgeon James Esdaile, who worked in India, performed 1,800 operations on hypnotized patients in the days before chemical anesthesia. In the early 20th century, Sigmund Freud used hypnosis with his psychoanalytic patients but eventually rejected the technique in favor of free association and dream analysis. Even so, hypnosis remained in use by psychiatrists and was eventually recognized as a viable therapeutic technique by the American Medical Association in the 1950s. (Sandroff, 1999a, p. 73).

Hypnosis can also ease the stress of invasive diagnostic tests. In a Stanford University study, subjects undergoing heart tests (angioplasty, arteriography) who were taught hypnosis had significantly more stable heart rates and blood pressure, fewer procedural interruptions and reported experiencing less pain and anxiety. Although they had access to patient-controlled intravenous pain medication, the hypnosis group used only about one-tenth the medication of those who had not had hypnosis and were able to leave the recovery room sooner. (Sandroff, 1999a, p. 73).

Eastern Meditation

According to King and Coney (2006), "Meditation has been practised for at least 2,500 years, over which time divergent approaches have evolved that aim to converge upon a similar goal" (p. 200). The process of meditation offers a wide variety of attentional control and relaxation techniques that may be broadly categorised into three main groups as described in Table __ below:

Table

Three Categories of Meditation

Category

Description

Reductive/concentrative approaches (e.g., Transcendental Meditation)

Concentrative approaches instruct the meditator to restrict focus of attention to a single stimulus such as a word, symbol, sound, object or sensation. It is an outer-directedness approach that aims to interiorize an external form (a symbol, for example). There is a relinquishing of spontaneity insofar as the meditator is encouraged to draw focus back to the single stimulus if attention wanders while ignoring the nature of any distraction.

Receptive/expressive approaches (e.g., Shamanism)

An inner directedness typifies the receptive/expressive approach whereby attention is receptive or open to promptings of the meditator's inner thoughts. It is an expressive process, the aim of which is to relinquish expectations and preconceptions so as to develop a spontaneity free from external influences such as traditional or societal belief systems. The meditator learns to be open to his inner experience through undistracted receptivity.

Expansive/mindfulness approaches (e.g., Insight Meditation)

The final category of meditation encourages neither an inner nor outer directedness, but a 'self emptying' through not identifying with anything that is perceived. This style of meditation aims to develop stillness of mind, detachment from psychological acting, non-judgmental observation of internal and external stimuli as they arise, and a minimization of goal directed mental activity. These aims are taught with the idea of leading the meditator to insight through a detached observation of experience.

Source: King & Coney, 2006, p. 201

Concentrative approaches instruct the meditator to restrict focus of attention to a single stimulus such as a word, symbol, sound, object or sensation. It is an outer-directedness approach that aims to interiorize an external form (a symbol, for example). There is a relinquishing of spontaneity insofar as the meditator is encouraged to draw focus back to the single stimulus if attention wanders while ignoring the nature of any distraction. In contrast, an inner directedness typifies the receptive/expressive approach whereby attention is receptive or open to promptings of the meditator's inner thoughts. It is an expressive process, the aim of which is to relinquish expectations and preconceptions so as to develop a spontaneity free from external influences such as traditional or societal belief systems. The meditator learns to be open to his inner experience through undistracted receptivity. These two orientations may be contrasted with the expansive/mindfulness approach that encourages neither an inner nor outer directedness, but a 'self emptying' through not identifying with anything that is perceived. This style of meditation aims to develop stillness of mind, detachment from psychological acting, non-judgmental observation of internal and external stimuli as they arise, and a minimization of goal directed mental activity. These aims are taught with the idea of leading the meditator to insight through a detached observation of experience (King & Coney, 2006, p. 201).

During the 1960s and 1970s, Fuller (2001) reports that, "Many Americans eventually moved beyond flirtation with Eastern concepts and took up the actual practice of meditation. Thick Nhat Hanh's books on mindfulness, for example, are found on coffee tables and nightstands across the country. Vajrayana, Zen, and Vipassana meditation centers have sprouted up across the country. The Hare Krishnas also drew sizable numbers into the practice of Eastern meditation. However, the movement popularly known as Transcendental Meditation (TM) was undoubtedly the most successful at teaching Americans to use Eastern meditation practices. Its founder, Maharishi Mahesh Yogi, orchestrated TM's efforts to teach a simplified form of yoga at college campuses, corporate offices, and suburban conference centers. The practice of TM consisted of two 15- to 20-minute periods each day during which the practitioner was taught to sit comfortably, relax, and recite a one-syllable mantra. The purpose of the mantra was to help individuals let go of their preoccupation with the outer world and turn their attention inward" (p. 84).

According to McCoy (2010), "Meditation is of the established alternative therapies. Meditative techniques are the result of various cultures around the world. It has been deep-rooted in the customs of the world's great religions. Eastern Meditation offers various techniques in which one can reach 'enlightenment', and 'self-discovery'. The general belief associated with eastern meditation techniques are the belief that 'the universe and I are one.' Powers of positive thinking, clearing the mind of all the past stress factors and focusing on a solitary thought during meditation, are common practices of Transcendental meditation, the most common and widely known form of eastern meditation. Eastern meditation, is often practiced to reduce the effects of stress, high blood pressure, drug addictions, pain management and vast other chronic illnesses and disorders. Transcendental Meditation is the technique believed to be significantly superior to other forms of meditation and relaxation. Other forms of eastern meditation are yoga and qigong, as well as transformational meditation, guided meditation and prayer meditation" (para. 3).

Recently, more and more people from the eastern countries, such as China, are residing within the western countries of USA and UK, bringing with them their cultural traditions and distributing their knowledge of meditation techniques. The healing powers claimed by those who practice eastern meditation, the stress reduction, and the peacefulness that comes from regular practice of eastern forms of meditation, have inevitably resulted in new practices associated with other major religions of the west, such as Christianity. The intention of "Christian Yoga" is to use the method of Yoga, for a "Christian" meditation. Christian Zen- very similar to 'Christian yoga', the student of 'Christian Zen' will meditate while practicing Japanese Zen and attempt to reach 'enlightenment', during focusing on their specific prayer. One may "practice Zen as a way of deepening and broadening his/her Christian faith." Additionally, the Christian may practice the eastern form of 'prayer meditation' in which they will focus on their prayer to God in order to free their mind of the days stress and tension. (McCoy, 2010).

Transformation meditation is the art of teaching ones self to make positive changes in behaviors and thoughts. These positive behaviors and thoughts directly effect ones reaction or function in any situation. Eastern meditation has been scientifically proven to create psychological benefits, e.g.:-

~ Reducing anxiety

~ Reducing stress

~ Reducing the need and use of prescription drugs

~ Reducing the use of alcohol and other substances

~ Useful in smoking and weight reduction programs

Additionally, some proven Physical Health Benefits are:

~ progress for asthma sufferers

~Strengthens the immune system and reduces viruses

~Reduces cardiovascular problems

~Increases blood flow to the heart

~Increases performance

~Reduces chronic pain

~Lowers blood pressure

"Meditation is a form of contemplation that involves concentrated practice. Meditation refers to many types of practice, such as vipassana, or insight meditation, visualization, and mantra. Contemplation includes meditation as well as spontaneous and unstructured moments when we experience a connection with the unity of things" (Miller, 1994, p. 3). These various types of meditation are described more fully in Table __ below.

Representative Types of Meditation

Meditation Type

Description

Vipassana (insightful meditation)

The principal Therav-da Buddhist meditative practices of meditative quiescence (P-li: samatha) and contemplative insight (P-li: vipassan?) are rarely practiced by the immigrant laity, for these are generally thought to require a monastic way of life and rigorous training that are not feasible for the householder. On the other hand, the laity as well as monastics do commonly engage in the practice of individual and group chanting, which primarily entails paying homage to and taking refuge in the Buddha, Dharma, and Sangha. The formal meditation practices of quiescence and insight meditation, traditionally practiced primarily by monks and nuns, have been appropriated by the modern vipassan?, or insight meditation, movement, which began to spread during the latter half of the twentieth century throughout South Asia and the West. Asian and Western monastic vipassana teachers generally promote the traditional views of Therav-da Buddhism, as well as the monastic ideals of detachment and renunciation. The various forms of vipassana meditation are based on, or at least inspired by, the meditation techniques preserved in the P-li writings of Therav-da Buddhism. The primary P-li source for these methods is the Satipat.t.h-na-sutta, or the Buddha's Discourse on the Applications of Mindfulness, which is correctly regarded as the primary treatise on insight meditation in early Buddhism. The first stage of this meditative training in insight is cultivating mindfulness of the respiration (Prebish & Baumann, 2002, p. 38).

Visualization

Mantra

Sources: As indicated

Although meditation comes in a variety of forms, for various reasons, traditional and eastern meditation have the same common goals, To change behaviors and thoughts which will result in a more positive lifestyle, reduce stress and give a deeper and stronger self-awareness through 'enlightenment'. Meditation drives us towards our true nature. Our daily life is filled with many distractions that inhibit our abilities to train our souls. We can physically and psychologically train our bodies to perform to the best of our abilities, so why not achieve training for our mind and soul also? Eastern meditation practices teach one to condition their soul and mind to achieve a perfect balance that results in self-healing or at the very minimum, a more positive lifestyle. (McCoy, 2010).

From a psychophysiological perspective, meditation is the intentional self-regulation of attention, in the service of self-inquiry, in the here and now. Most descriptions of meditation expressed in behavioural terms, include the following components: (1) relaxation, (2) concentration, (3) altered state of awareness, (4) suspension of logical thought processes, and (5) maintenance of self-observing attitude (Perez-De-Albeniz & Holmes, 2000). Traditionally meditation has been practised within a religious context. Only in modern times have the techniques of meditation been extracted from their spiritual and philosophical context and applied to the promotion of individual well-being. Most literature in scientific journals and research about meditation has been based on this personal health-enhancing aspect (Perez-De-Albeniz & Holmes, 2000).

Meditation is claimed to produce an integrated response with peripheral circulatory and metabolic changes subserving central nervous activity. The physiological effects include:

1. Increased cardiac output;

2. Slow heart rate;

3. Muscle relaxation;

4. Apparent cessation of CO[sub 2] generation by muscle;

5. Decreased renal and hepatic blood flow;

6. Increased cerebral flow;

7. Decreased respiratory frequency;

8. Significantly decreased sensitivity to ambient CO[sub 2];

9. Less O[sub 2] consumption;

10. Increased skin galvanic resistance;

11. Decreased spontaneous electrodermal response;

12. EEG synchrony with increased intensity of slow alpha in central and frontal regions;

13. Increased theta waves in frontal areas of the brain;

14. Enhancement of brain stem auditory evoked response;

15. Increased alpha and beta coherence; and,

16. Shift in hemispheral dominance with greater activation of the centres in the right hemisphere to which non-verbal, intuitive, spatial, holistic, non-sequential qualities are attributed (Perez-De-Albeniz & Holmes, 2000, p. 49).

For example, Lazarus (2005) emphasizes that, "Some experts, however, caution that meditation can be harmful. One can meditate in positive or self-destructive ways. Each individual is different and should consult a guru or a teacher if she experiences discomfort or has concerns" (p. 87). Likewise, Perez-De-Albeniz & Holmes (2000) advise that, "Not all effects of the practice of meditation are beneficial" (p. 49). In support, these researchers cite the results of Shapiro's (1992) study that found that 62.9% of the subjects reported adverse effects during and after meditation and 7.4% experienced profoundly adverse effects. The length of practice (from 16 to 105 months) did not make any difference to the quality and frequency of adverse effects. These adverse effects were relaxation-induced anxiety and panic; paradoxical increases in tension; less motivation in life; boredom; pain; impaired reality testing; confusion and disorientation; feeling 'spaced out'; depression; increased negativity; being more judgmental; and, ironically, feeling addicted to meditation .

Other adverse effects described (Craven, 1989) are uncomfortable kinaesthetic sensations, mild dissociation, feelings of guilt and, via anxiety-provoking phenomena, psychosis-like symptoms, grandiosity, elation, destructive behaviour and suicidal feelings. Kutz et al. (1985) described feelings of defencelessness, which in turn produce unpleasant affective experiences, such as fear, anger, apprehension and despair. Sobbing and hidden memories and themes from the past, such as incest, rejection, and abandonment appeared in intense, vivid forms and challenged the subject's previously constructed image of their past and themselves.

According to Yuasa, Kasulis and Shigenori (1987), "Physiological psychology is not yet sufficiently able today to elucidate the mechanism of the mind-body relation found within Eastern meditation. We have entered into a hypothetical region where the darkness of the unknown still enshrouds us" (p. 199).

Chi Kung

Together with acupuncture/moxibustion and herbal medicine, the other modality used in indigenous Chinese healing is Chi Kung (Rivera, Nash, Wah & Ibrahim, 2008). A study by Leung and Singhal (2004) notes that, "Qigong (pronounced 'Chi Kung') is an ancient art of self-healing practiced by millions of people in China for thousands of years. 'Qi' means vital energy and 'Gong' means discipline" (p. 313). The origins of chi kung vary from authority to authority, with most maintaining that the practice is millennia old while others suggest its origins are much more contemporary. For example, Sivin (2009) points out that, "For most non-Chinese, qigong is a mysterious exercise that combines patterned breathing and movement in order to increase health, happiness, and (according to some) wisdom. Westerners who study qigong are usually told that it is a discipline thousands of years old, that the regimen they practice happens to be the only authentic version, and that their teacher is its only authentic exponent" (p. 1069). This author adds, though, that, "Modern qigong was launched in the 'Liberated Zone' of Southern Hebei on 3 March 1949, when cadre Huang Yueting proclaimed the adoption of the name qigong to designate a set of body training exercises which a team of clinicians had been researching under his leadership in the previous few years. The creation of qigong was a political act: while destroying the 'feudal' social and symbolic context of traditional masters, the new medical institutions sought to reclaim their knowledge of body techniques and to train a new corps of 'medical workers' to teach and practise them in a socialist institutional setting." What the "authentic exponents" have been transmitting, in other words, is some version of a Party official's invention, a new combination of breathing, meditation, and gymnastics cleansed of what the Chinese Communist Party's doctrine execrates as superstition, but which occidentals tend to think of as ancient wisdom. This is a story of alternating growth and prohibition, of a boom that attracted millions of practitioners, a fever indeed of profit-making, and finally a notorious repression that ended the boom in China by 2000.

David Palmer, a scholar of anthropology and religious studies, originally planned to do a field study of qigong practice. After reaching some depth as a practitioner of several methods, he has traced the history of qigong in socialist China. There is already a large literature on qigong. This book goes further in showing how its evolution -- and devolution -- were part of the dizzying metamorphosis of Chinese society, politics, and culture between 1949 and 1999. These are the main lines of his narrative: "Qigong moved out of Hebei onto the national scene only with the ideological turn against Western influence in 1953-61. Those in the Party who insisted China could find its own way in the world, guided by Marx, Engels, and Mao, attacked those who saw a need for China to depend more on modern science and technology and less on doctrinal correctness. Many high officials who had been treated with qigong in Hebei appreciated it as a means to health that was intrinsically Chinese, accessible to everyone in a very poor country, and more politically manageable than Western medicine. But in 1961-64 Chairman Mao attacked the Party leaders who had promoted qigong. Qigong books ceased to appear from 1965 to the late 1970s; qigong-clinics were among the many institutions that closed down during the Great Proletarian Cultural Revolution. Deng Xiaoping's Four Modernizations (1977) gave priority to modernization, including scientific research. The simplicity, efficacy, and cheapness of qigong made it an important topic of study.

A new kind of qigong sprang up in which masters externalized their qi, focusing it on patients and curing them, often at a great distance. Foreign observers saw them induce mass trance, holy rolling, speaking in tongues. The individual no longer need become adept; the master did the healing. As a 1991 book put it, qigongs "advanced level is shown by Extraordinary Powers: penetrating vision, distant vision, distant sensation, the ability to immobilise one's body, to fly miraculously, to cross walls, to soar spiritually, to call the wind and bring the rain, to know the past and the future" -- skills familiar from gongfu movies. Some taught all comers to perform healing and paranormal feats with their own qi.

Many high-ranking scientific and political figures such as Qian Xuesen (H. S. Tsien), the creator of the Chinese missile and space programs, defended these innovations as technical breakthroughs. They backed "fundamental research" on qigong against the opposition of others equally eminent. New societies and university courses proliferated. As millions entered qigong movements, some became highly efficient commercial enterprises, their managers trained using Harvard Business School methods. These innovations yielded fabulous wealth to their founders. Their recruiting of Party members, their high official connections, and the wealth that government organs collected for "supervising" them made serious regulation practically impossible.

By the beginning of the 1990's, the problems had become too serious to ignore. Demonstrations of "extraordinary powers" had failed in publicly embarrassing ways; "qigong psychotic reaction," delusional or suicidal, had formally entered the Diagnostic and Statistical Manual of Mental Disorders. Enrollments began to drop. Qigong seemed to many just one more corrupt attraction of a tumultuously changing society with no ideals left but getting rich. Li Hongzhi, master of the quickly expanding Dharma Wheel Qigong movement (Falungong), with strong backing within public security agencies, unexpectedly bucked the trend with a reformed "moralistic, messianic and apocalyptic doctrine." It-based practice on truth, compassion, and forbearance; suffering became a means to salvation. By 1995 Li was claiming to be the "omniscient and omnipotent saviour of the entire universe" (p. 225). His movement was the largest in China, although he denied that it was a variety of qigong. It was only a matter of time before this fiercely autonomous doctrine -- which expected adepts to stand up to repression -- collided with the Party bureaucracy's demand for subservience and predictability.

A series of peaceful demonstrations against verbal attacks by government operatives led on 24 April 1999 to a quiet sit-in outside the Beijing residential quarter of the highest leadership. It ended without incident, but in July the outcome was a national crackdown on Falungong and then restrictions on all qigong organisations and practices that ended support within the Party. "Most masters stopped their activities, took a low profile, went underground, or emigrated to the West." Although limited personal practice was still legal, "the sector ceased to exist as a vibrant social space" (p. 280). This was not, as Palmer makes clear, simply a blow of dictatorship against personal freedom, or a democratic rebellion against the Communist Party. The qigong movement was invented by officials, and their support fertilized its many metamorphoses. The rise of charismatic masters introduced a strong element of what Palmer calls religiosity that was incompatible with Party control. In most movements disciples experienced this dimension only in their intimate relations with their teachers, but Falungong moved it to the center. That inevitably precipitated a debacle" (Sivin, 2009, p. 1070). This point is echoed by Gielen et al. (2004) who note, "Qigong is exactly the same thing as chi-kong or chi-gong, which was the English translation before the Communist Chinese took over Mainland China and changed the language system. The translations chikong and chi-gong are still used by many Chinese people around the world except in Mainland China. The power of mind and spirit can be generated by guided imagery, visualization, and other special techniques" (p. 201).

Notwithstanding the foregoing controversy, most authorities agree that chi kung has been around far longer than the mid-20th century. For instance, Alexander emphasizes that, "The Chinese have been using the chi kung system as a stress-buster for thousands of years. But unlike other Eastern systems such as t'ai chi and kung fu, chi kung (sometimes also known as Qi Gong) is not a martial art. It is a holistic system combining breathing techniques with precise movements and mental concentration and its aim is total well-being - and an incredible energy boost" (p. 18).

"Chi kung has been practised openly in the West for only the past 10-15 years and there are still relatively few practitioners of the art. Hopefully this will change: if chi kung can deliver all its promises, it could make us all healthier, happier, brighter and even sexier (Alexander, 1996, p. 18).

According to Schnauzer (2006), "Qigong (pronounced chee gong) is an ancient Chinese system of gentle self-healing exercises that include healing postures, movements, sounds, breathing techniques, and meditation. Qi in Chinese means vital energy or life force, and gong means practice or skill. The purpose of these self-healing exercises is to prevent or dissolve blockages of energy, stimulate the circulation, and correct imbalances" (p. 53). The result is increased physical and emotional well-being and a marked strengthening of the immune system. Developed over 5,000 years ago by monks and other healers, Qigong was carefully guarded. The techniques passed only from family to family and from master to student. It is only in the last 30 years or so that we in the West have been given the opportunity to learn this healing modality. Qigong is a simple, practical, and beneficial healing program. It can be practiced by all age groups and many of the exercises can be done standing or sitting. With over 30 million practitioners worldwide, Qigong is a popular technique and is gradually earning the respect of Western medical authorities (Schnauzer, 2006, p. 54).

Qigong is currently being studied by the National Institutes of Health, and more and more hospitals across the country are incorporating it in their complementary medicine and wellness programs. Some of the benefits of Qigong include the following:

1. A strengthening and a spreading of energies evenly along the meridians;

2. Improving blood circulation;

3. Reinforcing the immune system;

4. Reestablishing the equilibrium in emotions and calming the cerebral cortex, inducing serenity;

5. Bringing harmony to breathing and body movements; and,

6. Increasing the flexibility of joints (Schnauzer, 2006, p. 54).

The healing art consists of physical and mental exercises to regulate mental processes and enhance physical functioning, and is made up of five components: visualization, meditation, relaxation, deep breathing, and target circulation. Throughout history, numerous types and styles of Qigong have evolved, falling under four categories: healing, martial-art, philosophical (Taoist), and spiritual (Buddhist). Despite the variations, all styles have a similar philosophy, which is based on the ancient Chinese idea that vital energy exists in all matter in the universe and humans can circulate and exchange it with the environment by means of voluntarily induced physical and mental action. The two distinct styles of Qigong practice are classified as internal and external, or moving and static. The internal Qigong involves meditation and breathing techniques with visualizations in order to guide the vital energy, while external Qigong includes a sequence of movements accompanying meditation (Leung & Singhal, 2004).

The study by Leung and Singhal focused on the relationship between personality and meditative Qigong because this form of meditation is believed to have a positive impact on health. In Qigong meditation, the practitioner visualizes a flow of Qi energy circulating through his/her body. This process is based on repetitive, positive, reinforcing suggestions, which may promote health and a sense of well-being (Leung & Singhal, 2004).

Qigong meditation has been shown to be beneficial to patients' feelings of wellness when suffering from arthritis, hypertension, dizziness, and chronic pain (Kuang, Wang, Xu, & Qian, 1991; Wu et al., 1999). Moreover, Qigong meditation has been found to have a positive impact on postworkout anxiety (Jiang, 1991), improvement in respiratory capacity in asthma patients (Reuther & Aldridge, 1998), heroin detoxification (Li, Chen, & Mo, 2002), stroke recovery (Kuang et al., 1986), sleep disorders (Wang, 2002), and senile dementia (Yan et al., 2000). The mechanisms of these effects are not well-known, however one theory is that there is a relaxation response whereby autonomie activity is controlled and causes a decrease of sympathetic activation (Benson, Greenwood, & Klemchuk, 1975). Benson, Malhotra, Goldman, Jacobs, and Hopkins (1990) showed that Tibetan monks could vary their metabolic rate at will while meditating. Furthermore, studies of Yoga-based relaxation show that sympathetic activity is lessened by guided relaxation compared to nonrelaxed states (Arambula, Peper, Kawakami, & Gibney, 2001; Lazar et al., 2000; Vempati & Telles, 2002).

A growing body of evidence suggests that meditation, in its various forms, will have a positive impact on psychological health associated with anxiety, panic, and negative affect by increasing positive thinking, self-confidence, and self-efficacy (Shapiro, 1992). Meditation has been described as equivalent to a repetitive dose of positive emotional experiences, and may be as beneficial as an interpersonal therapeutic encounter (Kutz, Burysenko, & Benson, 1985). Miller, Fletcher and Kabat-Zinn (1995) showed that an 8-week mindfulness meditation program produced clinically and statistically significant improvements in the subjective and objective symptoms related to anxiety disorders. Similar findings have shown that meditation may enhance functional status and well-being, and reduce psychological distress (Deckro et al., 2002; Jiang, 1991; Miller et al., 1995; Reibel, Greeson, Brainard, & Rosenzweig, 2001). Elderly Qigong meditators with chronic illnesses have reported greater physical and psychological well-being, including decreased clinical depression and increased self-efficacy (Lewis, 2000; Sandlund & Norlander, 2000; Tsang, Mok, Au Yeung, & Chan, 2003; Tsang, Cheung, & Lak, 2002).

The brief foregoing review suggests that meditation has a relationship with physical and mental health, and this relationship is beneficial in nature. However, there has been little research done investigating whether or not meditation has a relationship with personality characteristics, despite the fact that there is a known relationship between personality and general health (Francis, 1999). As a result we were interested in whether or not Qigong meditation is connected with overall good health due to its relationship with personality characteristics over a long period of time. To this end, we designed a study to investigate the relationship between the number of years practicing Qigong meditation and levels of extraversion and neuroticism.

Eighty Qigong practitioners (45 male, 35 female, age range 23-68, mean age = 47.5 years), were recruited as participants after providing informed consent. The majority of participants were practicing Qigong meditation at least once a day, and many of them had practiced other forms of meditation regularly for at least a year in the past ten years. The study inclusion criteria were that they must have practiced for over 12 months and at least once a day in frequency. We reasoned that this would ensure proper representation of the population of Qigong practitioners, and would eliminate those who were just "experimenting" with the Qigong meditation. We excluded those who had used any psychotic drugs in the past ten years or who had a history of neurological disorders or mental illness. The participants were recruited over the Internet from Canada, the United States, and Europe, and a small number from personal visits to Qigong organizations and classes in Toronto, Canada.

Seventy-four nonpracticing individuals (29 male, 45 female, age range 28-73, mean age = 42 years), were also recruited as above. Twenty participants reported practicing Qigong meditation for less than 12 months. The control group of participants was similar to the Qigong group in terms of age, gender, marital status, education level, occupation, handedness, and geographical location of residence.

The Eysenck Personality Inventory (EPI) was chosen to measure the level of Extraversion and Neuroticism as well as Social Desirability (Lie-Scale). A Lie - Scale score of over 5 out of 9 questions was used as the criterion for further exclusion.

The questionnaires consisted of an online survey webpage and the Eysenck Personality Inventory (EPI). The webpage survey was advertised on different web sites, including the Qigong Institute, the Newsgroup for Qigong Science and Research, and the Social Psychology Studies online service. Participants who responded via the online survey provided either an email address or a set of unique characters to identify themselves. Informed consent was established by pressing the "I agree to participate" button. After completion, participants pressed the "Submit" button to send the information to our database. A "thank-you" message and the results of the EPI were provided automatically.

Four tests were performed on the data. A Spearman correlation test was done to determine the relationship between the number of years of Qigong practice and the level of Neuroticism (N-score). There was a significant negative relationship between the number of years of Qigong practice and the level of Neuroticism [r = -3.23, p < 0.0001]. A partial correlation test was done to see if age, gender and education level were contributing factors. After controlling for these variables, the correlation between the number of years of practice and N-score remained significant [r = -.2184, p < 0.004]. A t-test was done and revealed a significant difference in N-Score between the Qigong group and comparison group (mean Qigong group = 7.14, mean comparison group = 10.15) [t (152) = -4.07, p < 0.0001]. Finally, linear regression analysis was used to demonstrate the strength and the predictability of the relationship between the number of years of Qigong practice and the N-score. The findings were significant [r^sup 2^ = .069, p < 0.001]. The relationship between the number of years of Qigong practice and the level of Extraversion (E-score) was not significant.

The findings of this study show that there is a negative relationship between Qigong meditation and neuroticism. Even after controlling for potential confounding variables: age, gender, and education level, the data still supported the hypothesis that the Qigong practitioners were significantly less neurotic. However, the present findings do not suggest that the numbers of years of Qigong practice are related to extraversion.

These data provide support for the suggestion that Qigong meditation may serve as a stabilizing agent for mental health by decreasing practitioners' neuroticism. However, we are cautious about this claim because our results do not suggest a causal relationship between these variables. The present findings are consistent with previous research showing that non-Qigong meditation was related to lower neuroticism scores (Tjoa, 1975). As well, transcendental meditation has been shown to be negatively correlated with neuroticism (Williams, Francis, & Durham, 1976).

A common characteristic of neuroticism is elevated anxiety (Eysenck, 1988), and there is evidence to suggest that meditation can have long-term beneficial effects in the treatment of people with anxiety disorders (Miller et al., 1995). Other evidence suggests that meditation can lower anxiety and reduce worry (Davidson et al., 2003; Gillani & Smith, 2001). In the case of Qigong meditation, studies have reliably shown that anxiety can be significantly reduced (Lee, Jeong, Oh, Ryu, & Chung, 1998; Li, Chen, & Mo, 2002).

To achieve and retain qi homeostasis, there are several approaches. The first approach is to rely on the extrinsic qi, which is emitted by the qigong practitioner, and apply it to the patient so that the patient's vital energy state can be brought back to balance immediately. Although this approach can produce an instant effect, this effect cannot last long without the restoration of the patient's intrinsic qi, which is the major concern of the second approach. To that end, both the practitioner and the patient engage in the mutual endeavor of learning how to equilibrate the qi toward greater integration with the Tao (the harmonious configuration). The second approach includes (at least) two steps. One is to let the practitioner demonstrate how to perform movementoriented qigong for accelerating and channeling the intrinsic qi from meridians to the qi-blocked areas. The other is to teach patients how to practice meditation-oriented qigong in order to cultivate qi and regulate their energy state for health. Moreover, during meditation, patients can also learn how to elicit the power of their mind and spirit/soul that mobilizes healthy qi to ailing areas. As can be seen here, in contrast to other TCM modalities, qigong operates on mind, spirit, and body. In fact, without engaging mind and spirit in the production and preservation of qi, either the movement-oriented or the meditation-oriented qigong (including tai chi) exercise would be downgraded to a level of ballet or snooze respectively. In support of this argument, electroencephalogram (EEG) studies have shown that the brainwave patterns (indicating the functional states of the brain) of meditation-oriented qigong and sleep or snoozing are different. As Green and Green (1986) observed in conducting biofeedback on experimental participants, altered states of consciousness are not only correlated with the practice of meditation-oriented qigong but may also serve as an intervening variable between qigong and its effects on the human body. In a similar vein, action consciousness (Lei, 1989) is aroused while conducting the movement-oriented qigong.

A recent study conducted at the Harvard Medical School (Kerr, 2002), which included a randomized controlled trial as well as ethnographic research and in-depth interviews, revealed that biomedical researchers viewed qigong as a nonspecific "mind-body" practice that combines relaxation and exercise. On the other hand, qigong masters framed the same practice as a "mind-in-body" intervention that uses specific movements and visualization to direct qi or vital/subtle energy to specific areas of the body. If qigong can be seen as a mind-body intervention, another study conducted at the Harvard Medical School pointed out that mind-body interventions reduce sympathetic nervous system activation, increase parasympathetic nervous system activity, and thereby restore homeostasis (Jacobs, 2001). In terms of homeostasis, the aforementioned two types of consciousness, from the perspective of the general system theory (Laszlo, 1979), can function as feedback for the human homeostatic system's self-regulation, or as a bridge in the mind-body loop. Furthermore, the engagement of the mind and the spiritual dimension together with the body in qigong practice entails a transcendental intuition that enables a person to transform the experience of being an ordinary mortal to that of becoming a human at a higher level (Lei, 1991).

This extraordinary experience can help a person to compassionately go over and beyond the secular life stress, and at the same time to tap the parasympathetic nervous system, which in turn boosts the person's immune function. Though this kind of experience does not sound as if it were scientific in the Western sense, it has been documented in some best-sellers written by Yale and Harvard medical professors, such as Love, medicine and miracles (Siegel, 1990), Timeless healing (Benson, 1996), and Power healing (Galland, 1998). In a case as such, quantum physics instead of the traditional Newtonian physics may be a better frame of reference for the study of qi. In the process of qigong intervention, the brain serves as an underlying mechanism or the hardware for the "mind," which functions as the software. The brain's involvement in the qigong intervention has been indicated by the qigong-induced reproducible changes in transcranial Doppler sonography, EEGs, stimulus-induced 40 Hz oscillations, and near-infrared spectroscopy findings (Litscher, Wenzel, Niederwieser, & Schwartz, 2001).

Taken together, the results of these studies suggest that Qigong meditation is closely related to a relaxation response, which may be correlated with lower levels of neuroticism by virtue of an overall reduction in anxiety over time. The relationship between meditation and personality characteristics is an important area for continued research.

Here are some of the ways Qi Gong can benefit dancers.

1. EASING ACHES AND PAINS Dancers are often taught to move in ways that are not intuitive or natural to the body. The result is tight muscles and joints that block the energy flow, which can eventually lead to chronic pain and fatigue. Qi Gong helps you reconnect with the way your body wants to move in order to release tension, allowing the body to heal itself.

2. DEEPENING THE BREATH Certain types of Qi Gong emphasize breathing exercises more than others. But they all acknowledge the connection between a person's quality of breath and their state of physical and mental health. Slowing down and breathing consciously, for example, relaxes the mind and body, which can be helpful when attempting to center yourself before a performance.

3. INCREASING ENDURANCE Since Qi Gong is all about the cultivation of energy, says McQuade, it "puts more fuel in your tank." For those dancers who take multiple classes a day followed by a rehearsal or a performance, it would be invaluable to tap into a profound, natural source of long-lasting energy.

4. INSPIRING CREATIVITY Lynd and McQuade both say that Qi Gong has allowed them to improvise and choreograph in more genuine ways than before. "Sometimes when you're dancing you can fall into a rut," says Lynd. "With Qi Gong you get to that really still place inside of yourself and then the movement flows right out of you. You're not thinking, you're just moving. You're not dancing, you are being danced."

Many dancers have excellent technique, but few have that extra something that draws eyes to them like a magnet. Qi Gong helps dancers integrate mind, body, and spirit so that they are completely present onstage. "Qi Gong allows dancers to trust their bodies to go beyond pure technique and tap into their inner power and beauty," says McQuade. "Then the movements become larger than the sum of the parts of the choreography."

McQuade warns that dancers may dismiss Qi Gong as being too simple for them at first, since many of the exercises involve moving very slowly or not at all. "I was so used to judging the value of movement by how complicated it is from the outside," McQuade says. "But the more I started slowing down, the more I discovered all of the incredible movement that happens on the inside." (Samuels, 2007, p. 30).

One Chi Kung exercise called The Abdominal Breath is performed as follows:

1. Stand with your feet about shoulder-width apart, your knees slightly bent.

2. Relax your shoulders. Imagine a string runs from the top of your head to the ceiling, holding you upright but not rigid. Place your hands gently over your stomach, just below your navel.

3. Take in a slow steady breathe through your nose, allowing your abdomen to swell out like a balloon as you breathe. Hold the breath gently.

4. Then exhale, allowing the breath to come out slowly through your mouth as the stomach subsides.

This form of breathing directs chi, or vital energy, right around the body. As you become more proficient imagine health-giving energy flooding into your lungs as you breathe in and stale, spent energy pouring out as you exhale. (Alexander, 1996a, p. 35).

"There is no doubt that everyone could benefit, from a child to an 80-year-old,' insists psychologist and stress expert Dr. Malcolm Kirsh, who has been practising and teaching chi kung for five years. 'Chi kung makes you understand yourself better and you learn how to tackle problems physically as well as mentally.' Experiments have shown that during chi kung the breathing rate calms and drops and people's brain waves drop into the theta level, allowing them to stay alert yet deeply calm. The basic technique for better breathing is the abdominal breath. This will probably seem very strange at first but persevere, even if just for a few minutes every day.

1. Stand with your feet about shoulder-width apart, your knees slightly bent. Make sure you are totally relaxed. Place your hands gently over your stomach, just below your navel.

2. Take in a slow, steady breath through your nose, allowing your abdomen to swell out like a balloon as you breathe. Hold the breath gently.

3. Then exhale, allowing the breath to come out slowly through your mouth as your stomach subsides.

This form of breathing directs chi - vital energy - right around the body. As you get more proficient, you can boost the power of this breathing by visualising 'good', health-giving energy flooding into your lungs and then to your whole body as you breathe in; and stale, spent energy pouring out as you breathe out.

The Chinese Taoists say that breathing like this will enliven the metabolism and invigorate all the cells of the body, the result being increased health and supposedly an extra shot of beauty as well. (Alexander, 1996b, p. 18).

Some of the benefits that are believed to accrue to the practice of chi kung can be generalized into the following five categories:

1. Curing illness and promoting health.

2. Enhancing vitality and developing internal force.

3. Promoting youthfulness and longevity.

4. Expanding the mind and the intellect.

5. Spiritual cultivation.

Many chi kung types focus on only one or two of the above categories, but a few cover all the five. For example, most types of medical chi kung aim mainly at curing illness, virtually all sexual types of chi kung emphasize solely on youthfulness, whereas Shaolin Cosmos Chi Kung touches on all the above five categories of benefits (Wong, 2009).

Nei Kung (also Neigong)

Nei Kung is an internal system of Chi Kung, employing slow, deep breathing and requiring a relaxed physical stance and mental attitude. (The external approach to cultivating chi is characterized by heavy breathing and rapid diaphragmatic exercises.) Nei Kung practice charges up the body's energy. The effects in the initial Workshop are dramatic, and the profound extent of the training often becomes apparent as early as the first two weeks of regular practice. Nei Kung has been refined, and handed down from Master to Master since the time of Yellow Emperor (2696 -- 2598 b.c.e.). It evolved from the Taoists' search for a way to rejuvenate and heal the body, to increase internal strength and energy. There is a saying in China that if you pursue the Ch'uan (fighting technqiue) without practicing (Nei) Kung, when you reach old age you will not have anything to show for your efforts. Great importance is traditionally placed on the study of Nei Kung in conjunction with Tai Chi Chuan. In order to attain a high level of ability in Tai Chi, one must know and practice Nei Kung diligently (Chuan, 2010, para. 3).

Despite the multitude of styles and genealogies of practice, qigong can be differentiated into two types -- external and internal. The external form, yinggong (sometimes referred to as hard qigong) tends to emphasize hard qi and hard bodies that can withstand much force and perform superhuman feats. This martial form tends to be practiced not so much in public parks but in arenas such as streets, sites of acrobatic displays, and even in military compounds. The masters and practitioners are primarily men, and masculine displays of power are a factor in the performance of qigong" (p. 321).

According to Chen (2003), "The internal and meditative form, neigong, tends to attract female practitioners" (p. 71). "It is not unusual to find practitioners of both genders and all backgrounds practicing this form in parks; however, internal forms of cultivation and qigong also greatly appeal to male practitioners, as they promote the circulation of qi and blood, crucial steps toward enhancing male potency and preventing pathologies such as seminal emission or sexual impotency" (p. 71).

Seminal emission, also termed shenkui, is a form of yang deficiency due to semen loss or suoyang (another culture-bound syndrome, also known as koro, which refers to the near-fatal fear of genital retraction). Though an already extensive range of aphrodisiacs and a male potency -- enhancing pharmacopoeia exists, qigong practice is by comparison more effective in the long-term and a cheaper alternative. In sum, both forms of qigong address masculine desires for hard, impenetrable bodies and self-generating potency (Brownell & Wasserstrom, 2002, p. 321).

Internal martial arts, or Nei Kung (or Nei Gong) concentrate on the cultivation, development and application of internal energy - generally Chi, but also Shen and Jing, known collectively as Nei Jia. This is in opposition to the 'hard' martial arts styles which concentrate on conventional strength, speed and conditioning. The art of cultivating and controlling such energy is known as Qi Gong or Chi Kung; all internal martial arts contain some element of Chi Kung which can also be practiced as an indepenedent discipline.

In addition to combat applications the internal styles can be of great benefit to health and spiritual development, and in many schools (particularly of Tai Chi) these aspects are emphasised above and beyond learning to actually fight. This does not mean, however, that they are not devastatingly effective when used for combat. Actually, the distinction between hard and soft martial arts is a very blurred line, as all kung fu contains the same principles, and kind of Chi Kung is practiced in the majority of kung fu schools. It basically boils down to a difference of direction and emphasis - in hard martial arts you begin with basic physical techniques that you an use straight away, and over many years, if you are a dedicated student, you will come learn the more advanced aspects which work with the internal energies; in an internal martial arts school you begin by learning to cultivate and direct internal energies, and if you are a dedicated student then after many years you will learn how to apply what you have learned in combat.

The main internal martial arts are Bagua, also known as Pa Kua or Bagua Zhang, Hsing I or Xing Yi, and Taijiquan or Tai Chi.

For a person who practices a hard martial arts style, whether that is kung fu or anything else, learning the internal arts will greatly improve your fighting ability and enable you to accomplish things that you had thought impossible. Practicing the internal martial arts can be particularly effective for helping to develop power, stamina, sensitivity and the kind of natural application of technique that is often thought of as being innate talent. As the internal martial arts often take a long time to learn a person studting a 'hard' martial art who wishes to harness the immense power of Chi would probably be best advised to concentrate on Qi Gong rather than one of the internal martial arts, however if you practice Kung Fu then it is not too difficult to integrate the teachings of the internal martial arts into your usual style, thus gaining real benefits at a stage where a student studying only the internal martial arts would not yet have developed a high enough level of skill to be competent in combat (Internal Martial Arts - Nei Kung, 2010).

According to Waller (1999), neigong addresses the way in which people move their bodies and:

1. It is the how, the nature of the movement, not the actual movement itself.

2. There are dozens of neigong - each representing a layer of detail and understanding.

3. Each component increases internal power and improves the qi flow.

4. Neigong teaches the body to return to a natural condition of wholeness.

5. It creates the delivery mechanism for fa jing (energy release) by developing bow tension within the body.

6. Neigong is internal.

7. Initially the neigong practice is an obvious change to the way in which tai chi is performed.

8. In time, the neigong becomes internalised and less apparent.

9. To an observer, the neigong may seem invisible.

10. Neigong is part of what makes tai chi an internal martial art; all the work is going on beneath the surface.

11. Each neigong represents a physical and energetic change in the body; a subtle quality that serves to integrate and unify the structure.

12. Internal skills help to attain whole body movement.

Chapter 3:

Methodology

Description of the Study Approach

a number of successful treatment protocols have been reported in the peer-reviewed and scholarly literature, but there remains a paucity of studies specifically concerning the use of hypnosis, hypnotherapy and Ericksonian techniques for this purpose. Therefore, this study used a meta-analysis approach to extrapolate the findings from a wide range of relevant studies to identify best practices approaches for use by clinicians for this purpose. The goal of a meta-analysis is to obtain further insight and understanding into a modeled phenomenon by comparing parameter estimates obtained independently in different empirical studies (Vanhonacker, 1996). In this regard, Dimatteo and Rosenthal report that, "Meta-analysis allows the combining of numerical results from a few or many studies, the accurate estimate of descriptive statistics and the explanation of inconsistencies as well as the discovery of moderators and mediators in bodies of research findings" (p. 59).

The application of the meta-analysis technique has allowed researchers to arrive at conclusions that are more accurate and more credible than can be presented in any one primary study or a single nonquantitative, narrative review; in fact, these authors note that the meta-analysis methodology was first used to investigate a medical problem. "This is perhaps appropriate," they emphasize, "because inquiries in the field of biomedicine often demand immediate answers to complex and multifaceted questions in which existing data may be quite variable and clinical steps depend upon reconciliation of disparate findings" (Dimatteo & Rosenthal, 2001, p. 59). The outcome of a well-conducted meta-analysis, therefore, can provide researchers new insights by synthesizing results across multiple studies, including those involving the use of hypnotherapy (Baskin & Enright, 2004). Finally, while many meta-analyses are quantitative in design, a number of researchers have also successfully used the technique for qualitative studies as well (Neuman, 2003).

Data-gathering Method and Database of Study

The critical review of the peer-reviewed literature was accomplished using a variety of resources, including EBSCO/Medline, Questia, as well as university and public libraries. Because of the paucity of relevant and timely scientific studies concerning the alternative medicines examined herein, other online resources from practitioners were also incorporated where appropriate to provide anecdotal and empirical observations from the field concerning the efficacy and treatment modalities recommended for these techniques.

Chapter 4:

Data Analysis

Comments

Handbook of Culture, Therapy and Healing. Contributors: Uwe P. Gielen - editor, Jefferson M. Fish - editor, Juris G. Draguns - editor. Publisher: Lawrence Erlbaum Associates. Place of Publication: Mahwah, NJ. Publication Year: 2004. Page Number: 191.

In Chinese, qigong can be separated into qi and gong. Qi is a polysemic word, which may denote the vital/subtle energy, whereas gong means work or function. Thus, qigong literally means to work on vital/subtle energy in order to capitalize on its healing function. The theoretical rationale underlying qigong practice is deeply rooted in the classical Chinese cosmology introduced earlier, which considers each human being as a microcosmic energy system synergistically embedded in the macrocosm, such as the ecological environment. These macro- and microcosms constitute a unified energy field and interchange energy constantly based on the operational principle of homeostasis, or dynamic balance and harmony. Granted that diseases arise in the unbalanced qi, the ultimate goal of applying qigong is to achieve and maintain homeostasis and to eliminate and prevent disease.

Authors report that this complementary healthcare approach reflects Chinese people's dialectical reasoning. This means that medical modalities based on different mechanisms (e.g., the biophysical mechanisms that acupuncture/moxibustion is based on, the electrophysiological mechanisms that qigong is based on, and the biochemical mechanisms that herbal medicine is based on) can be synthesized into a therapeutic approach to certain disorders. Another reflection of Chinese people's dialectical thinking regarding indigenous healing can be seen in the convergence on the same theoretical foundation of these three healing modalities despite their methodological divergence. This theoretical foundation in terms of philosophy of life, premises of health, and purpose of treatment serves as the common thesis for the three antithetical modalities.

Chi kung workshop at the Harlem YMCA

New York Amsterdam News, Apr 26-May 2, 2007

The practice of chi kung (pronounced "chee koong") has been somewhat of a mystery for many years, but is noticeably gaining in popularity and is now even being recognized by the medical community as a potential tool to enhance the healing process.

Practitioners begin to notice immediately the calming effect it can have on the nervous system, the ideal point at which to begin the work of cultivating and increasing energy and improving health.

An Examination of the Relationship between Qigong Meditation and Personality. Contributors: Yvonne Leung - author, Anthony Singhal - author. Journal Title: Social Behavior and Personality. Volume: 32. Issue: 4. Publication Year: 2004. Page Number: 313+.

A neuroimaging study of Tibetan Buddhist meditation showed an increase in regional cerebral blood flow (rCBF) in the cingulate gyrus, inferior frontal cortex, dorsolateral prefrontal cortex (DLPFC) and thalamus. These results suggest meditation involves higher order cognitive processes associated with focusing attention, and perhaps involves an altered sense of spatial perception.

These results correlate with other studies showing electroencephalographic (EEG) indications of heightened attentional focus and deep relaxation. Other evidence suggests that meditation leads to increases in activation in anterior areas of the left hemisphere, believed to be the areas involved in pleasant emotion, which can also lead to improved immune function.

Qi Gong: The Chinese Art of Rejuvenation. Contributors: Shayna Samuels - author. Magazine Title: Dance Magazine. Volume: 81. Issue: 11. Publication Date: November 2007. Page Number: 30.

Qi is the Chinese word for energy or life force, similar to what Indian yogis call prana. Gong means to work, or to gain skill through practice. Qi Gong (also spelled QiGong, Qigong, or chi kung) has existed as part of Chinese medicine for thousands of years, along with herbs, acupuncture, and massage. It works to rejuvenate the body, mind, and spirit through a variety of physical postures, movement sequences, breathing exercises, and meditation techniques.

This practice can be particularly helpful to dancers, who naturally have a lot of qi.

Summer Exercises to Stretch the Mind. Contributors: Ronni Sandroff - author. Magazine Title: Vegetarian Times. Issue: 262. Publication Date: June 1999. Page Number: 54

Author cites interview with Dr. Bruce Eichelberger, a licensed acupuncturist in Roseburg, Ore., who has been practicing and teaching qi gong for more than 25 years, qi gong (a.k.a. chi kung) can be practiced by almost any age or fitness level. Qi gong means "energy cultivation," and practitioners say that benefits include increased stamina, better digestion, improved circulation, more restful sleep, balanced internal energy, reduced stress and anxiety and enhanced resistance to disease.

Chi kung is easier to learn than tai chi.

Alexander, J. (1996a)

Exponents of eastern practices such as chi kung say that breathing fully can improve your moods, increase your resistance to illness, foster better sleep and even help you to resist ageing. In China, the effects of the breathing, which forms an integral part of the chi kung (or qi-gong) exercises, have been rigorously tested. Hospitals have cured patients of tuberculosis using chi kung.

Experiments have shown that chi kung exercises can increase lung capacity from an average of 428.5cc to 561.8cc. And while patients were actually performing the exercises, their lung capacity expanded to 1,167.8cc.

While the average person breathes around 16 times a minute, a chi kung follower can take just five or six breaths during the same period.

Chi kung feeds the brain, calms the nerves and has a measurable effect on a number of medical conditions - lowering heart and metabolic rates, normalising blood pressure and reducing the risks of cardio-vascular disease.

Understanding Tai Chi: An Interview with Michael Gilman. Journal Title: Annals of the American Psychotherapy Association. Volume: 11. Issue: 4. Publication Year: 2008. Page Number: 30+

Along with directing the Gilman Studio of Tai Chi Chuan, Gilman is the author of two popular books on Tai Chi Chuan, has published numerous articles, and produces a long running Tai Chi and Chi Kung series for public television. Author notes that Tai Chi is typically regarded as a general, tonic exercise. It helps the entire body in a very balanced way. For special problems, the Chinese tend to use Chi Kung, as it can be more directed toward specific targets.

The Chi Kung (Energy exercises) classes appeal to the people who are attracted to more traditional exercise programs, but with less stress and effort required. The ages tend to range from the 40s to 80s, mainly women. These students mostly come every morning for a non-stress workout to get their energy moving and to get centered for the rest of the day.

Alexander (1996b) Supercharge Your Life the Natural Way; Starting Today, Britain's Top Writer on Alternative Therapies Reveals How to Boost Energy Levels and Combat Stress. Newspaper Title: The Daily Mail. Publication Date: February 5, 1996. Page Number: 18.

Experiments have shown that during chi kung the breathing rate calms and drops and people's brain waves drop into the theta level, allowing them to stay alert yet deeply calm.

The Chinese Taoists say that breathing like this will enliven the metabolism and invigorate all the cells of the body, the result being increased health and supposedly an extra shot of beauty as wel

Wong, S. (2009). Chi kung. Shaolin Kungfu, Chi Kung and Zen. Retrieved from http://www.shaolin-wahnam.org/chikung.html.

Depending on how it is defined, there are two, three, four, five, six, hundreds of or thousands of types of chi kung. Some people divide chi kung into two types: quiescent and dynamic, or internal and external. Some into three types: quiescent, dynamic, and quiescent- cum-dynamic. Others into four types: standing, sitting, lying down, and moving. Still others into five types: Buddhist, Taoist, Confucian, medical, and martial. Some add populace chi kung to the five to make six types.

There are various schools of chi kung, such as Shaolin Cosmos Chi Kung, Shaolin Damo Chi Kung, Taiji Eighteen Steps Chi Kung, Flying Crane Chi Kung, Fragrance Chi Kung and so on. Sometimes, people may refer to different chi kung techniques as different types of chi kung, in which case there are thousands of them. Hence, it is understandable that there are also different levels of attainment in the various types of chi kung.

The Transmission of Chinese Medicine. Contributors: Elisabeth Hsu - author. Publisher: Cambridge University Press. Place of Publication: Cambridge, England. Publication Year: 1999. Page Number: 9, 13

Qigong is a compound word composed of two terms, qi and gong. Qi designates a dynamic force and quality in constant flux and flow. It is comparable to pneuma in Greek or prana in Indian philosophy. English renderings such as 'pneumatic stuff', 'air', 'vapour', and 'breath' all approximate to its meaning, but unsatisfactorily. Gong means effect, discipline, capability, achievement, and merit. Qigong (workings with the breath) refers to practices of nurturing and conducting the qi which enhance the efficiency of qi in the body.

Qigong, like the martial arts, is veiled in secrecy, often more conspicuously than Chinese medicine.

Qigong: The Art of Self-Healing. Contributors: Mary Schnauzer - author. Journal Title: Perspectives in Psychiatric Care. Volume: 42. Issue: 1. Publication Year: 2006. Page Number: 53+

The practice of Qigong can improve the flow of energy in the body by dissolving blockages to energy flow, stimulate the circulation, improve the immune system, and correct imbalances.

There have been testimonials to Qigong effects -- nurses with low back pain reporting they were able to sit all day at the conference without the use of muscle relaxants or pillows; menstrual cramps lessening to the point where there was no need for Tylenol or heating pads. Nurse educators saying teaching their students some very basic and simple Qigong exercises seemed to improve the students' attention span.

Table

Nei Kung

Author/Date/Title / Publication

Key Findings

Comments

Chinese Femininities, Chinese Masculinities: A Reader. Contributors: Susan Brownell - editor, Jeffrey N. Wasserstrom - editor. Publisher: University of California Press. Place of Publication: Berkeley, CA. Publication Year: 2002. Page Number: 321.

It is crucial to acknowledge the social relations of power in which the expression of qigong healing and power articulated a gendered cosmology of qi in addition to the "natural" cosmology.

In the 1990s particular individuals emerged as masters who embodied naturalized categories of masculinity.

Breathing Spaces: Qigong, Psychiatry, and Healing in China. Contributors: Nancy N. Chen - author. Publisher: Columbia University Press. Place of Publication: New York. Publication Year: 2003. Page Number: 191.

Neigong is internal qigong.

Qigong is the movement of internal energy.

Science and Civilisation in China. Volume: 6. Contributors: Joseph Needham - author, Lu Gwei-Djen - author, Nathan Sivin - editor. Publisher: Cambridge University Press. Place of Publication: Cambridge, England. Publication Year: 2004. Page Number: 76.

In ancient China, Taoists and physicians advocated several kinds of mild gymnastics that were generally called tao yin ("guiding and leading the vitalities"). The term nei kung (and kung fu) have been used more recently to describe inwardly directed work through the use of such gymnastics.

Possibly the exercises derived from the dances of ancient rain-bringing shamans, but in any case they were associated with the idea, as old in Chinese as in Greek medicine, that the circulatory system was liable to become obstructed, thus causing stasis

Neigong (2010), para. 3

Neigong, also spelled Nei Kung, neigung, or nae gong, is any of a set of Chinese breathing, meditation and spiritual practice disciplines associated with Daoism and especially the Chinese martial arts. Neigong practice is normally associated with the so called "soft style," "internal" or neiji? Chinese martial arts, as opposed to the category known as waigong?

or "external skill" which is historically associated with shaolinquan or the so called "hard style," "external" or waiji? Chinese martial arts. Both have many different schools, disciplines and practices and historically there has been mutual influence between the two and distinguishing precisely between them differs from school to school.

There is both martial and non-martial neigong. Well-known examples of martial neigong are the various breathing and focus trainings taught in some traditional Taijiquan, Baguazhang and Xingyiquan schools. An example of non-martial neigong is the discipline known as Daoyin.

Neigong.net http://neigong.net/

Neigong includes qigong breathing exercises, loosening exercises (daoyin) and different forms of energy (jing) exercises.

Neigong (neikung, neigung): internal exercise or skill.

Borrelli, J. (2009). Internal Chi Kung. http://www.neikungla.com/

Nei Kung is a powerful system of Martial Art chi kung based on the fundamental principles of the inner flow of vital energy, or CHI, utilized for centuries by the practitioners of Chinese medicine and acupuncture.

Nei Kung involves coordinating patterns of deep breathing with the execution of ten basic postures of precise body alignment. This brings together the highest levels of CHI KUNG, "energy training," with structural conditioning of the bones, connective tissue, joints and organs, as well as the musculature.

Accessible to virtually anyone at any age and any level of physical fitness, the truly amazing energy, flexibility and deep feelings of well being resulting from this practice must be experienced to be appreciated. Often referred to as INTERNAL CHI KUNG, Nei Kung is seldom taught outside of China.

Chi kung is also known as Qigong

Waller, S. (1999). Neigong. Retrieved from http://www.newcastle taichi.co.uk/Neigong.htm.

Neigong means 'internal power' or 'internal strength'. The training involves the cultivation of an unusual kind of physical strength which can be used to in self defence and everyday life.

It enables practitioners to transmit kinetic force. One of the most common forms of neigong is 'reeling silk'.

Neigong is 'internal power'; adding several layers of detail to the postural parameters used in qigong. Rather than focus mainly upon the skeleton, neigong looks at the elasticity of the body. It aims to draw power from the spaces between the vertebrae and the mobility of the joints, from the twisting and stretching of the rubbery organs and connective tissue. The neigong movement may look subtle and internal, yet the tai chi exercise should be providing a considerable workout. Qigong is about energy. Neigong is about energy too, but is so much more than that. It is about strength-building and power generation. The purpose of neigong is to change what is happening within the body; to work from the inside out. This will lead to improved health and a stronger body.

Neigong practices can transform the ordinarily tense human nervous system into a very fluid one in which there is virtually no time lag between conscious will and the body moving swiftly or delivering power.

Section Two: Representative Treatment Applications for Hypnosis, Eastern Meditation,

Chi Kung, and Nei Kung and Contraindications for Use

Table

Recapitulation of Representative Applications for Hypnosis, Eastern Meditation, Chi Kung and Nei Kung

Hypnosis

Eastern Meditation

Chi Kung

Nei Kung

Anxiety

Anxiety

Curing illness and promoting health

Increases internal power and improves the qi flow

Depression in general and unipolar nonendogenous depression specifically

Reducing the heart rate

Cultivates the flow of energy around the body.

Creates the delivery mechanism for fa jing (energy release) by developing bow tension within the body

Sexual disorders

Lowering blood pressure

Enhancing vitality and developing internal force

Whole body movements

Pain

Chronic pain

Low back pain / increasing the flexibility of joints

Teaches the body to return to a natural condition of wholeness

Warts

Heightening perception

Promoting youthfulness and longevity

Asthma

Asthma

Bringing harmony to breathing and body movements

Trichotillomani

Improving empathy

Expanding the mind and the intellect

"Battle fatigue"/PTSD

Reducing the need and use of prescription drugs

Spiritual cultivation

Reducing the use of alcohol and other substances

A strengthening and a spreading of energies evenly along the meridians

Useful in smoking and weight reduction programs

Improving blood circulation

Improving motor skills

Reinforcing the immune system

Relaxing the muscles

Reestablishing the equilibrium in emotions and calming the cerebral cortex, inducing serenity

Table

Contraindications and Other Treatment Considerations

Hypnosis

Eastern Meditation

Chi Kung

Nei Kung

Applicability is generally restricted to certain types of patients and requires specialized training on the part of the clinician.

Section Three: Representative Treatment Vignettes

Vignette No. 1: "Anne," 32-year-old, 6-months pregnant, suffering from low back pain and anxiety

Vignette No. 2: "Martin," 42-year-old white male, smokes 3 packs of cigarettes a day and wants to quit.

Vignette No. 3: "John," 16-year-old black male with self-esteem issues related to obesity and physical coordination problems.

Chapter 5:

Summary, Conclusions and Recommendations

Summary

Conclusions

Recommendations