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Monday 21 February 2011

Hypnosis and Food Intolerance

Originally written for FoodsMatter.com


In recent years the field of mind body medicine (known as psycho-neuro-immunology or PNI) has been gaining wider recognition. Clinicians are now realising that the Cartesian dualist viewpoint with regard to medicine and healing (that the mind and body are separate entities that do not communicate) is no longer applicable, and that a holistic approach to the treatment of a patient is desirable.

Increasingly the patient’s emotional state, beliefs, etc. are being addressed as part and parcel of their treatment package. This not withstanding, it has been known for a long time that emotional factors play an important role in the course of disorders of the intestinal tract and that to treat conditions such as irritable bowl syndrome, food intolerance and food allergy, psychological stability and well-being needs to be attained.

From this position the realisation that other gastrointestinal disorders (as well as organic disorders in general) will benefit from the alleviation of psychological upset has become widely acknowledged, and that both positive and negative emotional factors can and do influence the functioning of our immune system (the part of our body responsible for maintaining our health). Many clinicians are now recommending that some form of psychological intervention accompany standard treatment approaches and much has been written in the scientific press detailing the efficacy of such interventions. These studies have also shown that the hypnotherapeutic approach is particularly effective in alleviating symptoms, improving quality of life, and reducing absenteeism from work.

What is hypnosis?
The use of hypnosis as a therapeutic tool has a very long history. The earliest recorded examples are found in the sleep temples of ancient Egypt where archaic hieroglyphs detail procedures that in this day and age would be considered hypnotic. (The word ‘hypnosis’ was only invented in the 1800s.) Interest in its use has fluctuated throughout the years and is currently in resurgence perhaps due to the ever expanding scientific literature detailing its efficacy, combined with the general public’s search for a viable alternative/accompaniment to so called conventional medicine.

Hypnosis is, in essence, a very pleasant and natural state of deep mental and physical relaxation that is often referred to as trance into which almost anyone can enter if they so wish. In this state a person is open to accepting beneficial suggestions delivered by a therapist (a process known as hypnotherapy) that can help alleviate a wide range of presenting symptoms.

However, for some the very word hypnosis is steeped in mysticism and many erroneous myths have arisen surrounding the subject. For example, the belief that it is akin to brain washing is far from the truth, and it is important to realise that hypnosis is not mind control. A patient in trance is not ‘under the power’ of the therapist. On the contrary, full control is maintained throughout with the unconscious mind protecting the subject, rejecting unwanted suggestions or any that are alien to a person’s ethical or moral beliefs. Essentially, hypnotherapy is a therapeutic method that allows a person to regain control over an area of their life where they feel control has been lost, thus helping to alleviate both psychological and physical symptoms. 

By Peter Mabbutt

www.lcch.co.uk

Friday 18 February 2011

Thousands are Dodging the Dentist

Hard-up people are putting their health at risk by avoiding trips to the dentist, a new survey shows.

Sixty eight per cent of dentists said their patients were deferring treatment and 59 per cent reported cancelled appointments.

The poll of 251 dentists in England, for the British Dental Association (BDA), found the knock-on effect was a clear rise in the numbers needing emergency treatment.

More than a third (34 per cent) of practitioners questioned in October and November said they had seen increased demand for emergency treatment over the previous 12 months.

Dental check-ups often reveal more serious underlying health problems than simple gum disease.

Some dental diseases are closely linked to many serious health conditions including heart disease, arthritis and diabetes.

‘It’s understandable that, at a time when there is widespread concern about household finances, some patients’ financial anxieties are leading them to defer dental appointments and treatment,’ said Susie Sanderson, of the BDA.

‘Achieving short-term money savings at the expense of longer-term health problems isn’t wise, though.

‘Neglecting your oral health can increase both the complexity of the problems you face and the cost of the treatment you must eventually have.’

Monday 14 February 2011

Hypnosis and Surgery

From a talk given to the James Braid Society in July 2002:


Hypnosis and Pre and Postoperative Surgery
Peter Mabbutt FBSCH
CEO/Director of Studies


Despite the fact that we live in a health-conscious society cardiovascular disease is still one of the major causes of premature death.

These days we drink too much; we eat too much (of both the wrong and right kinds of food); and smoking is still endemic. Compounding this we are encouraged to lead increasingly sedentary and stressful lifestyles. All this represents bad news for the heart as these activities place it under increasing strain and could result in the development of cardiovascular disease.

If recognised early enough, drugs and a change of lifestyle are all that’s needed to provide an effective route to management and recovery from cardiovascular disease. However, for some the only route to better health will be through surgical intervention.

For anyone facing the prospect of surgical intervention this will be a major event in their life. Despite the fact that the techniques of cardiovascular surgery have advanced immeasurably over recent years, as with all surgical interventions there is a risk of death. It is therefore not surprising that patients faced with surgical intervention go through a whole range of feelings and emotional responses. Research has shown that 60% of patients hospitalised for heart disease experience elevated levels of stress, anxiety and depression. Unfortunately the heart responds unfavourably to these emotional states thus placing extra demands on an already damaged cardiovascular system.

Psychology of surgery

For anyone being told that they need to undergo a surgical procedure this will undoubtedly provoke a stressful response, that may increase when the surgery is considered to be major or life saving. For many this can bring on a bereavement reaction as they will experience a whole range of losses: a loss of health; a perceived loss of control over their life; and a possible loss of independence. Also, they are likely to experience guilt over the harm their life-style may have caused their body. Compounding this may be an increased awareness of their own mortality as they are going into hospital for an operation that will save their life. Fear is another factor that features as many patients may be worried that they will not survive the surgery or, alternatively, that they may be damaged mentally or physically in some way by the surgical procedure.

It must be remembered that psychological disturbance also occurs during the post-surgical period. Even when surgery has been successful many patients will enter a period of post-surgical depression. Many factors may be responsible including a continued perception of lost health due to post-anaesthetic nausea, pain, and worry about the healing process. Patients may also experience a profound loss of control over their life. During the early stages of recovery they may be bed-bound and therefore reliant on others for cleaning, feeding and drinking. Compounding this they will experience a loss of privacy with regard to bodily functions, as urine and faecal output need to be monitored immediately after surgery.

Many patients will experience concerns over what they will and won’t be able to do in the future as a result of their heart condition and surgery. Unfounded concerns that they will be unable to engage in the sexual act can lead to psychogenic sexual dysfunction. The belief that they may damage the heart during coitus can lead to performance anxiety with all its consequences.

Often patients will exhibit concerns that they will be unable to give up activities proscribed by their medical-care team such as excessive alcohol consumption, smoking and eating certain foods.

If left untreated all these psychological factors could provoke a negative mind-set. Many studies have shown that a patient’s outlook toward upcoming surgery as well as to the post-surgical period can greatly affect recovery outcome. Essentially, patients with a poor outlook may have a poor prognosis (it has also been shown that those patients who are socially isolated and come from the lower-income bracket are also at greater risk post-surgically). However, those patients showing an optimistic outlook recover more rapidly and show an increased survival rate.

Studies have shown that those patients undergoing hypnosis as an integral part of the pre- and post-operative procedure demonstrate an increased rate of recovery and decreased levels of post-surgical infection.

Hypnosis and Surgery

As the patient should be set up for success from the beginning, pseudo orientation in time needs to be included on each session, taking the patient to a time in the future when they have successfully recovered from the operation. It goes without saying that the therapist must ensure that the pseudo-orientated future is realistic and achievable. As well as this, ego boosting should also be included on each session to help the patient create a positive mind-set and to enhance inner resources.

Reframing approaches should not be ignored. It is an undeniable fact that the patient’s life-style may have led to the reason they are in hospital at this time. Reframing the situation so that the patient perceives that they are taking control of their future thus ensuring a speedy recovery as well as living a long, healthy and productive life will be of obvious benefit to the therapeutic process.

Induction of Hypnosis

A word needs to be said about the induction process used with cardiovascular patients. Any induction will suffice. However, as part of the therapeutic process it is important to teach the patient how to relax, so progressive relaxation approaches should be the therapist’s primary consideration as this will indirectly provide a format for the patient’s own approach to relaxation.

Dealing with Fear

Many patients will understandably have a fear of the process of surgery and of their stay in hospital. Imagination techniques (a preferable term to visualisation as asking someone to visualise implies that they have to ‘see’ and therefore does not take into account the other modalities of representation) should be used to take them through their hospital experience and beyond: being admitted to hospital; the pre-surgical stay; going to the operating theatre and receiving their pre-medication; undergoing the operation; their time in the recovery room; being taken back to the ward and their post-operative stay; leaving hospital; and making a full recovery. Presented scenarios should show the patient coping calmly, confidently and with appropriate self-control. Again the therapist needs to be realistic with regard to the outcome. Self-hypnosis should be taught and the patient encouraged to practice these imagination techniques.

If the patient has specific fears with regard to their stay in hospital, for example needle phobia, these need to be dealt with as a separate issue.

Life-style Issues

Many patients presenting for cardiovascular surgery will be advised to make life-style changes. These may include reducing their alcohol intake, stopping smoking or reducing their weight. Here hypnosis takes an obvious role and standard approaches are used. For the patient there is the added incentive of the increased health risk should they not change which will provide a strong motivator that can be used during therapy. Care should be taken as some may view these life-style changes as a short-term adaptation and may subsequently revert to old behaviours once they have recovered (a possible indication that they are experiencing denial with regard to the seriousness of their heart condition).

Stress management should be taught, as stress responses will place an added burden on an already damaged heart. The use of self-hypnosis should be included and encouraged, as the trance state will reduce any stress-induced increase in cardiac activity. It is also known that the trance state will reduce blood pressure (high blood pressure, or hypertension, is a major risk-factor in coronary disease).

Post-surgery

In many cases pre-surgical hypnotic intervention will help to prevent post-surgical depression. However, biochemical changes occurring after the use of anaesthetics may result in the patient developing an endogenous depression. This state should be dealt with appropriately.

A positive mental attitude towards the healing process needs to be encouraged. Various approaches can be taken with an emphasis placed on healing the body: asking the patient to imagine the heart healing and becoming more healthy; imagining the wound healing, the tissue and bone knitting together with the minimum of scarification; imagining the body protecting the wound, the immune system guarding the incision and preventing infection.

Pain may be an issue and the full range of pain control techniques should be employed: glove anaesthesia; imagination approaches; control room of the mind; dissociation.

The therapist should also help the patient to maintain recommended life-style changes.

Cardiophobia

Some patients develop cardiophobia: an abnormal awareness of their heart beating. This can provide a focus for neuroticism after any heart event or surgical intervention, as the patient may believe that naturally occurring changes in the beating of the heart herald a catastrophic heart event. Consequently they become over-protective towards their cardiovascular system and this may lead to a sedentary life-style (that in its own right will be damaging to the heart). Desensitisation approaches and reframing should be used.

Regression

A word of warning with regard to the use of regression with patients who have experienced a heart event needs to be given. Do not take them back to the event as they may re-experience it with inevitable consequences. If carrying out a diagnostic approach, regressing the patient year by year, avoid the year in which the event occurred for same reason. If possible regression should be avoided.

Conclusion

Hypnosis can play an important role in cardiovascular surgery by helping to create a positive mental outlook for the surgical patient. This, combined with helping the patient undertake and maintain lifestyle recommendations, can significantly increase the prospects of a full and healthy recovery.