**3. External movement**

As indicated above, according to Jensen et al. [78], hypnosis can be viewed as a use of suggestions for creating changes in thoughts, feelings, or behaviors when the clinician views the client as having enough theta power to be able to respond to those suggestions. Jensen indicates that "hypnotic strategies, then, could include (1) *any* strategy that enhances slow oscillations (using traditional hypnotic inductions, but also any technique that has been or is ultimately shown to increase slow oscillations) and/or being aware of behavioral signs indicating an increase in or adequate level of theta, coupled with (2) suggestions that enhance existing connections among neuron assemblies (e.g., those consistent with the subject experiencing of himself or herself with useful images or having a positive view of the future) or that create new ones" ([78], p. 15). It is, therefore, relevant to note that there is an increase in theta activity and a corresponding increase in either alpha activity or a global increase in spectral power (including within the alpha and theta bands) during exercise [140, 141]. Fascinatingly, there is even evidence of a higher degree of both alpha and theta activity during eyes-closed restful wakefulness in proficient athletes [142].

These converging lines of thought together with Dietrich [143, 144] support the connection between hypnosis, meditation, and acute exercise, which all result in prefrontal hypoactivation. Consequently, we now address the presence of increased theta activity following specifically structured bodily movement, focusing on several specific examples involving different degrees of diagonal movement.

### **3.1 Diagonal movement**

It has been suggested that rhythmical bilateral diagonal body movement improves motor and cognitive functions [145, 146], such as creativity and cognitive flexibility, similar to findings for hypnosis/mediation. However, no study that we are aware of has actually examined electrophysiological changes during diagonal body movements. The diagonal axis has the role of a metaphorical rule-breaker in relation to *the way of thinking*, as suggested by the definition of "diagonal thinking" as a mixture of logical (i.e., vertical) and creative (i.e., lateral) thinking [147]. Diagonal movements are widely used in disciplines based on whole-body movements such as tai chi, and recent paradigms such as Quadrato Motor Training, which will be discussed below.

Shapiro [148, 149], in her original description of EMDR, proposed that its directed eye movements mimic the saccades of rapid eye movement sleep (REM), known to be electrophysiologically related to synchronous theta waves [75, 150]. In addition, Stickgold [151, 152] proposed that the repetitive redirecting of attention during EMDR induces a neurobiological state similar to that of REM sleep. Additional study findings have supported the hypothesis that EMDR promotes the

**81**

*Inner Navigation and Theta Activity: From Movement to Cognition and Hypnosis…*

transfer of episodic memory to semantic memory, which will then be consolidated

Rimbert et al. [5] reported modulation in sensorimotor beta and theta activity during real movement and motor imagery; Marson et al. [161] also found biphasic modulation of alpha activity related to the second part of vertical movements (*each movement was composed of two parts, a forward and comeback period, the biphasic response in the comeback period during vertical movement).* More specifically, the decreased alpha activity was observed immediately after the start of the comeback period, and, consequently, there was an increase in the same frequency band tied to the end of the movement. The decreased alpha activity observed immediately after the end of the second movement could reflect a decrease in internalized attention, as decreased alpha activity is classically related to decreased focus on internal states and amplified processing of environmental information through sensorial inputs,

<sup>4</sup> More specifically, as Pagani et al. [154] detail, delta activity is related to slow wave sleep, which in turn is related to transferring edited memories from the hippocampus to the neocortex, as well as to stimulating the integration of these into neocortical neuronal networks, while theta activity is related to REM sleep. Bilateral stimulation typical of EMDR causes immediate slowing of the depolarization rate of neurons from the dominant waking state frequency of around 7 Hz to about 1.5 Hz. Interestingly, as Pagani [154] further noted, animal research has demonstrated that low-frequency (5 Hz) stimulation can cause a depotentiation of amygdala AMPA receptors involved in the retention of traumatic memory and 900 stimuli at 1–5 Hz depotentiated synapses mediating memory, suggesting that memories aroused during therapy are reactivated, replayed, and encoded into existing memory networks. Interestingly, delta activity occurs as waves during bilateral stimulation in other frequency waves (such as beta) and is related to eye movements. Lastly, Pagani et al. [154] suggested that the consolidation of emotional memory in the neocortex during an EMDR session, which often results in a sudden symptoms disappearance, is associated with periods in which slow (1.5 Hz) and faster (theta-alpha) activity are elicited by

<sup>5</sup> Similarly to EMDR, also binaural beat, which requires bilateral stimulation, by presenting two slightly different wave forms to each ear via stereophonic headphones, thus generating a third "beat" frequency, was found to be related to hypnotic susceptibility and theta activity ([154–156], yet see [42]), suggesting in turn also complex dynamic interactions between the two hemispheres [157]. For example, beat frequencies in theta and alpha range both increased interhemispheric coherence selectively at alpha frequencies [158].

. As mentioned above, activation of frontal areas and especially the anterior cingulate

that occurs during hypnosis matches well with the behavioral changes occurring in hypnotic state, such as the intensification of focused attention (for review see [159]). Importantly, the anterior cingulate has known anatomical connections with the frontal eye field and supplementary eye field and thus plays a prominent role in regulating eye movements, such as maintenance of visual fixation and suppression of reflexive saccades [159]. For example, classical behavioral marker of hypnosis, namely, the *hypnotically induced stare*, *is* a glazed look in the eyes accompanied by a highly reduced eye blinking rate and inimitable changes in the patterns of eye movements and pupil size [159]. Pupil size was recently found to be closely related to a variety of cognitive processes, such as decision-making [160]. In turn positive correlations were only found in the high-gamma band (60–100 Hz) and were similar in both wake and sleep conditions. Only a few recent studies have examined electrophysiological changes during diagonal movements. A rare pioneering study [161] has found increased frontal theta activity during the initiation of diagonal movement, compared to purely vertical movements, which were also studied. The increased frontal theta was possibly due to greater computational effort [86, 95, 140]. Source localization further showed that the increased frontal theta activity was generated in the middle frontal cortex. In addition, the authors found a biphasic pattern of frontoparietal alpha/

*DOI: http://dx.doi.org/10.5772/intechopen.92755*

during REM-like (4–6 Hz) states [153]4,5

beta modulations during vertical movements.

the alternation of bilateral stimulation and improved cognition.

### *Inner Navigation and Theta Activity: From Movement to Cognition and Hypnosis… DOI: http://dx.doi.org/10.5772/intechopen.92755*

transfer of episodic memory to semantic memory, which will then be consolidated during REM-like (4–6 Hz) states [153]4,5 .

As mentioned above, activation of frontal areas and especially the anterior cingulate that occurs during hypnosis matches well with the behavioral changes occurring in hypnotic state, such as the intensification of focused attention (for review see [159]). Importantly, the anterior cingulate has known anatomical connections with the frontal eye field and supplementary eye field and thus plays a prominent role in regulating eye movements, such as maintenance of visual fixation and suppression of reflexive saccades [159]. For example, classical behavioral marker of hypnosis, namely, the *hypnotically induced stare*, *is* a glazed look in the eyes accompanied by a highly reduced eye blinking rate and inimitable changes in the patterns of eye movements and pupil size [159]. Pupil size was recently found to be closely related to a variety of cognitive processes, such as decision-making [160]. In turn positive correlations were only found in the high-gamma band (60–100 Hz) and were similar in both wake and sleep conditions.

Only a few recent studies have examined electrophysiological changes during diagonal movements. A rare pioneering study [161] has found increased frontal theta activity during the initiation of diagonal movement, compared to purely vertical movements, which were also studied. The increased frontal theta was possibly due to greater computational effort [86, 95, 140]. Source localization further showed that the increased frontal theta activity was generated in the middle frontal cortex. In addition, the authors found a biphasic pattern of frontoparietal alpha/ beta modulations during vertical movements.

Rimbert et al. [5] reported modulation in sensorimotor beta and theta activity during real movement and motor imagery; Marson et al. [161] also found biphasic modulation of alpha activity related to the second part of vertical movements (*each movement was composed of two parts, a forward and comeback period, the biphasic response in the comeback period during vertical movement).* More specifically, the decreased alpha activity was observed immediately after the start of the comeback period, and, consequently, there was an increase in the same frequency band tied to the end of the movement. The decreased alpha activity observed immediately after the end of the second movement could reflect a decrease in internalized attention, as decreased alpha activity is classically related to decreased focus on internal states and amplified processing of environmental information through sensorial inputs,

*Hypnotherapy and Hypnosis*

networks [138].

athletes [142].

movement.

**3.1 Diagonal movement**

which will be discussed below.

**3. External movement**

As in the case of perceptual deprivation, different meditative states have also been found to be related to decreased DMN activity [73, 135–137]. Similarly, hypnosis was found to be related to decreased DMN activity [138] and suspending habitual modes of attention and achieving refined states of meta-awareness [139]. In fact, hypnotic induction increased subjective ratings of attentional absorption and decreased ratings of mind-wandering. Moreover, these changes were associated with decreased DMN activity and increased activity in prefrontal attention

As indicated above, according to Jensen et al. [78], hypnosis can be viewed as a use of suggestions for creating changes in thoughts, feelings, or behaviors when the clinician views the client as having enough theta power to be able to respond to those suggestions. Jensen indicates that "hypnotic strategies, then, could include (1) *any* strategy that enhances slow oscillations (using traditional hypnotic inductions, but also any technique that has been or is ultimately shown to increase slow oscillations) and/or being aware of behavioral signs indicating an increase in or adequate level of theta, coupled with (2) suggestions that enhance existing connections among neuron assemblies (e.g., those consistent with the subject experiencing of himself or herself with useful images or having a positive view of the future) or that create new ones" ([78], p. 15). It is, therefore, relevant to note that there is an increase in theta activity and a corresponding increase in either alpha activity or a global increase in spectral power (including within the alpha and theta bands) during exercise [140, 141]. Fascinatingly, there is even evidence of a higher degree of both alpha and theta activity during eyes-closed restful wakefulness in proficient

These converging lines of thought together with Dietrich [143, 144] support the connection between hypnosis, meditation, and acute exercise, which all result in prefrontal hypoactivation. Consequently, we now address the presence of increased theta activity following specifically structured bodily movement, focusing on several specific examples involving different degrees of diagonal

It has been suggested that rhythmical bilateral diagonal body movement improves motor and cognitive functions [145, 146], such as creativity and cognitive flexibility, similar to findings for hypnosis/mediation. However, no study that we are aware of has actually examined electrophysiological changes during diagonal body movements. The diagonal axis has the role of a metaphorical rule-breaker in relation to *the way of thinking*, as suggested by the definition of "diagonal thinking" as a mixture of logical (i.e., vertical) and creative (i.e., lateral) thinking [147]. Diagonal movements are widely used in disciplines based on whole-body movements such as tai chi, and recent paradigms such as Quadrato Motor Training,

Shapiro [148, 149], in her original description of EMDR, proposed that its directed eye movements mimic the saccades of rapid eye movement sleep (REM), known to be electrophysiologically related to synchronous theta waves [75, 150]. In addition, Stickgold [151, 152] proposed that the repetitive redirecting of attention during EMDR induces a neurobiological state similar to that of REM sleep. Additional study findings have supported the hypothesis that EMDR promotes the

**80**

<sup>4</sup> More specifically, as Pagani et al. [154] detail, delta activity is related to slow wave sleep, which in turn is related to transferring edited memories from the hippocampus to the neocortex, as well as to stimulating the integration of these into neocortical neuronal networks, while theta activity is related to REM sleep. Bilateral stimulation typical of EMDR causes immediate slowing of the depolarization rate of neurons from the dominant waking state frequency of around 7 Hz to about 1.5 Hz. Interestingly, as Pagani [154] further noted, animal research has demonstrated that low-frequency (5 Hz) stimulation can cause a depotentiation of amygdala AMPA receptors involved in the retention of traumatic memory and 900 stimuli at 1–5 Hz depotentiated synapses mediating memory, suggesting that memories aroused during therapy are reactivated, replayed, and encoded into existing memory networks. Interestingly, delta activity occurs as waves during bilateral stimulation in other frequency waves (such as beta) and is related to eye movements. Lastly, Pagani et al. [154] suggested that the consolidation of emotional memory in the neocortex during an EMDR session, which often results in a sudden symptoms disappearance, is associated with periods in which slow (1.5 Hz) and faster (theta-alpha) activity are elicited by the alternation of bilateral stimulation and improved cognition.

<sup>5</sup> Similarly to EMDR, also binaural beat, which requires bilateral stimulation, by presenting two slightly different wave forms to each ear via stereophonic headphones, thus generating a third "beat" frequency, was found to be related to hypnotic susceptibility and theta activity ([154–156], yet see [42]), suggesting in turn also complex dynamic interactions between the two hemispheres [157]. For example, beat frequencies in theta and alpha range both increased interhemispheric coherence selectively at alpha frequencies [158].

especially the visual system [159, 160]. Similar to Rimbert et al. [5], Marson et al. [161] further found post-movement beta rebound [162] between consecutive trials, namely, increased beta activity both in diagonal and vertical movements.

### **3.2 Quadrato Motor Training (QMT)**

Quadrato Motor Training is a mindful movement practice based on the Sphere Model of Consciousness. Participants are asked to move within a square (*quadrato,* in Italian), according to a specific sequence of instructions. QMT requires a high level of attention divided between the body and the spatial coordinates incorporated in the quadrato space, as well as silent waiting for the next instruction. Previous studies showed that QMT enhances theta activity and improves cognition (for a recent review, see [163, 164]). At the behavioral level, these changes have been associated with improvements in cognitive and psycho-emotional functioning [162, 165–167], considered important aspects of health and well-being.

What appears to make QMT different from other forms of physical activity is its impact on interhemispheric functional connectivity in the theta and alpha bands. In contrast to studies of other types of physical activity that focused on local changes in activity and have usually not reported changes in long-range connectivity, studies of healthy populations engaging in QMT have demonstrated both increased EEG power [168, 169] and coherence [170–173], especially in the theta and alpha bands. Indeed, both single sessions and protracted periods of QMT were found to result in increased intra- and interhemispheric functional connectivity in the theta and alpha bands [170–173]. Increased theta and alpha functional connectivity is thought to reflect improved cognitive functions and higher states of consciousness, due to better integration of information and communication across brain regions [174–176]. As such, these findings provide additional evidence relating to QMT's capacity to promote cognitive and psycho-emotional well-being.

Moreover, Ben-Soussan et al. [170] also found improved spatial cognition and reflectivity in groups who underwent a single session of QMT, in comparison to two control groups that underwent either simple motor or verbal training. The improvements were thought to stem from changes in functional connectivity, as evidenced by changes in intra- and interhemispheric coherence in theta and alpha bands [170].

Until recently, there has been a paucity of studies that investigated neural modulation during meditative movement. In a recent pilot study, De Fano et al. [163] examined five volunteers performing a single session of QMT characterized by three "blocks" which are rounds of the QMT routine. Since QMT requires executive control, which involves frontal theta activity, higher frontal theta power toward the last of the three QMT blocks, compared to the starting one, is expected. Indeed, a trend of increased theta activity was observed toward the last two blocks compared to the first one, which may reflect not only the cognitive control required by QMT performance but also the increase in cognitive effort that occurs overtime [163].

Going back to the theme of navigation and its connection to attention and salience dorsal and ventral streams discussed above, which are further related to the superior and inferior longitudinal fasciculi [177], 6 weeks of daily QMT was further found to increase white matter integrity as indicated by increased fractional anisotropy in the superior and inferior longitudinal fasciculi, as well as in additional tracts related to sensorimotor and cognitive functions [165].

#### **3.3 Tai chi and qigong**

Another meditative movement paradigm, tai chi, has been more heavily studied. Several electroencephalography EEG studies have reported that tai chi can produce

**83**

**Figure 1.**

*Inner Navigation and Theta Activity: From Movement to Cognition and Hypnosis…*

**4. The Sphere Model of Consciousness and the position** 

The Sphere Model of Consciousness [15] aims to symbolize the phenomenology of consciousness utilizing the geometrical properties of spatial coordinates within a

changes in mental state or electroencephalogram patterns associated with other alterations of cognitive or physical indices. An early study by Pan et al. [178] examined the difference in EEG theta between concentrative and non-concentrative qigong states, demonstrating that the frontal midline theta rhythm was related to the concentrative qigong state. As the theta rhythm has been suggested as one of the normal EEG patterns occurring in mental concentration, the authors concluded that the theta rhythm is an indicator of mental concentration during qigong. Notably, Field et al. [179] observed that performance on math computations significantly improved after a 20-min tai chi/ yoga training course and was associated with increased frontal theta activity. Field et al. [179] further found a trend of increased theta activity and decreased self-reported anxiety, and the authors attributed this to the relaxation effects of tai chi. This increased frontal theta activity was replicated in a study of skilled female tai chi practitioners, showing a pattern typically occurring during states of relaxation and attention [180]. Additional support for the importance of external movement, in parallel to inner movement and their possible connection, related to theta activity, comes from the fact that frequent movement is preferable to one's health over sedentary behavior, making movement therapies, when applied correctly, beneficial to chronic pain conditions, by ameliorating pain and related symptoms [181]. Moreover, the reported benefits are not only strictly related to musculoskeletal or vascular function but also with the mental dimension of well-being. For example, mindful movement practices, such as tai chi, have been found to significantly help in chronic pain management, for conditions such as osteoarthritis, low back pain, and fibromyalgia

*DOI: http://dx.doi.org/10.5772/intechopen.92755*

(for review, see [182]).

**within the sphere**

spherical framework (see **Figure 1**).

*The Sphere Model of Consciousness (adapted from [11, 13, 15]).*

## *Inner Navigation and Theta Activity: From Movement to Cognition and Hypnosis… DOI: http://dx.doi.org/10.5772/intechopen.92755*

changes in mental state or electroencephalogram patterns associated with other alterations of cognitive or physical indices. An early study by Pan et al. [178] examined the difference in EEG theta between concentrative and non-concentrative qigong states, demonstrating that the frontal midline theta rhythm was related to the concentrative qigong state. As the theta rhythm has been suggested as one of the normal EEG patterns occurring in mental concentration, the authors concluded that the theta rhythm is an indicator of mental concentration during qigong. Notably, Field et al. [179] observed that performance on math computations significantly improved after a 20-min tai chi/ yoga training course and was associated with increased frontal theta activity. Field et al. [179] further found a trend of increased theta activity and decreased self-reported anxiety, and the authors attributed this to the relaxation effects of tai chi. This increased frontal theta activity was replicated in a study of skilled female tai chi practitioners, showing a pattern typically occurring during states of relaxation and attention [180].

Additional support for the importance of external movement, in parallel to inner movement and their possible connection, related to theta activity, comes from the fact that frequent movement is preferable to one's health over sedentary behavior, making movement therapies, when applied correctly, beneficial to chronic pain conditions, by ameliorating pain and related symptoms [181]. Moreover, the reported benefits are not only strictly related to musculoskeletal or vascular function but also with the mental dimension of well-being. For example, mindful movement practices, such as tai chi, have been found to significantly help in chronic pain management, for conditions such as osteoarthritis, low back pain, and fibromyalgia (for review, see [182]).
