Although the hypnotic induction of relaxation, amplification of positive experience, expansion of awareness, and somatosensory changes described in Chapter 9 can kindle the brain, these procedures are not specifically utilized to develop antidepressive pathways. Their goals are to disrupt the depressive cycle and to alter the depressive affect. Positive mood induction is systematically devised to counter depressive pathways and to develop antidepressive pathways. Before describing the approach, the scientific underpinnings and theoretical rationale for developing antidepressive pathways are briefly reviewed.

I became interested in the antidepressive phenomena after reading the paper by Gary Schwartz and colleagues in the mid 1980s. Schwartz, Fair, Salt, Mandel, and Klerman (1976) provided electromyographic evidence to demonstrate that depressive pathways can be developed through conscious negative focusing. This finding led Schwartz (1984) to hypothesize that if it is possible to produce depressive pathways through negative cognitive focusing, then it should be possible to develop antidepressive or “happy pathways” by focusing on positive imagery. Although Schwartz’s method of studying the relationship between cognition and brain functioning was primitive by current standards, his study was a landmark in the history of neuroscience. He was able to empirically demonstrate that cognition can mediate and alter brain responses. More recently, there has been a proliferation of electrophysiological and functional neuroimaging studies supporting the hypothesis that cognitive processes such guided imagery, cognitive restructuring, and hypnotic suggestions can alter brain functioning.

From their reviews of the imagery and sensory perception literature, Finke (1985) and Kosslyn (1988, 1994) have supplied strong evidence that the formation of a mental image in the brain resembles that of the actual perception of the corresponding
external stimuli. Thus by the generation, manipulation, and scanning of mental images one can change the neural sensory processing mechanisms (for review, see Baer, Hoffman, & Sheikh, 2003). In the realm of CBT in the treatment of depression, Goldapple, Segal, Garson, Lau, Bieling, Kennedy, and Mayberg (2004) have provided functional neuroimaging evidence that cognitive restructuring produces specific cortical regional changes in treatment responders. Szechtman, Woody, Bowers, and Nahmias (1998) have demonstrated that when highly hypnotizable subjects claim to be experiencing hallucinations, the observed brain activity is extremely like that resulting from true sensory stimulation. Similarly, Kosslyn, Thompson, Constantini-Ferrando, Alpert, and Spiegel (2000) showed that hypnosis can modulate color perception. These investigators observed that hypnotized subjects were able to produce changes in brain function (measured by positron emission tomography [PET] scanning) similar to those that occur during visual perception. Rainville, Duncan, Price, Carrier, and Bushnell (1997) found the hypnotic suggestion of decreased pain to produce reduced regional cerebral blood flow in the anterior cingulate. In a separate controlled study, Rainville (see Bloom, 2005) demonstrated that words and images affect changes in regional blood flow in the brain structures associated with pain perception. Hypnotic suggestions also seem to suppress the Stroop Conflict (Raz, 2004; for review see Bloom, 2005). These findings support the claim that hypnotic suggestions can produce distinct neural changes correlated with real perception. From the foregoing evidence, it would not be unreasonable to infer that positive affect and images repeatedly induced by hypnosis and substantiated by regular personal training and exercise can produce some cortical changes in depressed patients.

Moreover, empirical evidence suggests that moods, both naturally occurring and experimentally manipulated, influence behavior (Gendolla, 2000; Baumeister & Vohs, 2004). Positive affect is the hallmark of well-being. Lyubomirsky, King, and Diener (2005) have provided extensive experimental, longitudinal, and correlational evidence to show that positive affect leads to adaptive approach and prosocial behaviors. Positive emotions also facilitate creative problem solving (Isen, 1999). People experiencing positive emotions are more open to processing new types of information and have greater flexibility (Fredrickson, 1998). Research also shows that positive emotions help to broaden the scope of attention (Fredrickson & Branigan, 2004

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