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NHS should offer hypnosis as standard says new report

Hypnosis should become a standard technique on the NHS to treat a range of conditions according to a new report.

The hypnosis and psychosomatic medicine section of the Royal Society of Medicine says the technique can be used to relieve pain and treat stress related conditions such as irritable bowel syndrome.

by Graham Satchell

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EMDR and Flying Phobias

An Example of The Use of EMDR for Treatment of Fears of Flying

by Ronald M. Doctor, Ph.D.

Typologies for the Fear of Flying: Implications for Flight Personnel and Therapists (Doctor & Seif, 2007) in which we describe the various types of fearful fliers we have encountered in clinical practice.  This  supplements and enriches the information contained in this paper.  I would also prefer that my deep appreciation and enthusiasm for EMDR not be seen as a “sales pitch.”  Reader scepticism is healthy as much as experience is essential.

EMDR is not a therapy by itself, not a panacea, not a different form of systematic desensitization nor a variation of the exposure or cognitive therapies.  It is also not hypnosis nor placebo effects.  All of these possibilities have been eliminated by empirical research.  At least in the beginning, EMDR is probably best viewed as a procedure that can be used within almost any form of relationship-based therapy (by this, I would include dentistry, hypnosis, physical therapies, etc. ).  As a procedure, it has parameters that guide  its application in terms of (1) the therapeutic goal, (2) the state of the client, and (3) the therapist’s ability to integrate the EMDR methodology into their approach and into a broad conceptual framework that includes psycho-neurophysiology.  Let’s look at each of these briefly.

Therapeutic goals in any therapy are to relieve symptoms, reduce dysfunctional behavior or aversive affect and to nurture well-being in the client.  At its theoretical base, EMDR sees many disorders as arising ultimately from traumatic experience (big “T” and/or little “t”) which, as we know it, tends to disrupt and create imbalance in the naturally adaptive resources that serve to resolve these traumas, restrict maturational and developmental progress and lock-in negative belief patterns about self and the surrounding world.  Symptoms can be the direct result of trauma but most often trauma creates dysfunctional internal conditions as a result of which disorders eventually develop.  The therapeutic use of EMDR is, therefore, based on a trauma treatment model.  I do want to mention that not all EMDR applications are directed at trauma.  For example, there is considerable work in applying it to enhance human performance in sports and social situations, applications with children, addiction control, ADHD, learning facilitation, belief modification, grief work, chronic pain reduction and so on. But most readers will want to use EMDR in their offices to resolve the effects of trauma and to facilitate development of more adaptive behaviour and positive self-beliefs.

The traumatic origins of much of psychopathology forces us to re-conceptualize assessment procedures and interviews and to go beyond the mind/body duality we explicitly or implicitly live with in our own professions.  So, let’s say that I see a terrified client who is being forced to fly with his new boss to Asia.  He flew for many years but eventually quit flying some six years after a particularly turbulent flight and is now essentially forced into a 10 hour trip to Korea in two days.  Here is our question.  Is it most effective for us to conceptualize this person’s fear of flying as merely a conditioned response to turbulence (where  fears seem to have developed) or are there other associative pathways?  In general, our clients do not come to us with ready-made analyses and solutions.  But, when using EMDR, “understanding” emerges from within the process that is set in motion by the application of EMDR.  Both the therapist speculations and any and all theories they prefer, must be set aside to allow the accelerated adaptive process set in motion by the EMDR to emerge and to seek a resolution on its own.  In this sense, what we call EMDR can be viewed as a guided self-healing process that the therapist simply sets in motion. With this in mind, I might start (as I did with this fellow) by focusing on the most fearful event the client had encountered in flying  (panic while flying in turbulence) and set up all the elements for EMDR (such as being aware of body sensations aroused by the incident, negative self-statements when looking back on the incident, emotions, and representations or images of the incident). Once these elements were present  we started a process of “bilateral stimulation” -in this case- eye movement, back and forth across the body median.  For this client, processing began quickly.  Tears started to come, along with sharp sensations in the body and the deep pain and images of a mother left behind as he made his way into a new life in a distant land emerged spontaneously.  Neither the client nor I foresaw this early trauma in this first and only session.  Would we evidently have seen these connections?  Probably so, in time, but in-depth understanding often takes considerable time. Soon emotions diminished as a result of the EMDR processing- starting and stopping as new material emerged- and a resolution was reached.  This was not catharsis driven resolution but an actual shift that had occurred as a result of the EMDR intervention.  This deep emotionally traumatic event was processed to an adaptive resolution.  We could then begin to install positive self-belief statements to replace the negative ones that had persisted for so long.   The next day, a 10-hour flight that would have been sheer terror before turned into a journey filled with enjoyment and considerable sleep.  Months later, at a chance encounter in a shopping mall, we met again and he embraced me.  I learned that he had settled into this country, married his beloved girl- friend and was now flying to Korea twice a month and had been doing so for the past two years.  He was now Vice President of the large electronics company that originally brought him to Korea.

Not all clients are ready to process.  We estimate that between 10 and 30% of clients are not initially responsive to these procedures.  Often preparations (safe place, relaxation, affect modulation skills, etc.) are needed before starting EMDR.  Dissociation and personality disorders must also be assessed as part of preparation and will require considerable containment training to help the client modulate and tolerate emotional arousal.  EMDR is far from being aspirin or Tylenol for the psyche. Clearly it is a substantive process that taps into the fundamental aspects of neuro-psychological base to our lives.  As such it carries great respect for its power from those who use it.  Brain scans confirm that actual structural and functional improvements occur in the brain as a result of EMDR treatment (Van der Kolk, l998) so we know that emotional, psychological and neuro-physiological changes occur in this process.

Finally,  therapists must somehow integrate this new theoretical and procedural resource into their practice before appreciating the full range of applications that will become available to them.  Fortunately, both Pavlov and Freud advocated trauma models of psychopathology so behaviourists and psycho-analytically based therapists and all those in- between can feel comfortable with its inclusion in their work.

It terms of the fear of flying, trauma and traumatic experience looms up as a potential source both in the development of fear of flying and for the maintenance of these reactions over time.  Flying involves potential trauma in the form of turbulence, crowds, forced social confinement, claustrophobia, heights, germs, darkness, deep water, changes in body sensations and many other stimuli encountered in even ordinary flights. There is also the personal history of trauma many fliers bring to the air plane   Experiences such as family losses, abuse, fears of being away from a “safe place,” addictions, fears about destination events, and so on, can be factors  that can create arousal and emotions that quickly become attached to air travel and form a trauma base for air travel.  Likewise, horrific images often seen on the news or in movies of death, terrorist attacks, crashes and so on, can serve as implicit conditioned stimuli that elicit fear in air travel.

Let me address some of the research effectiveness questions briefly.  APA Division 12 has placed EMDR and two other methods on a list of effective treatments for civilian PTSD populations.  Even though the EMDR studies utilized only three sessions and the other methods many more, these three methods are on the list because they meet the criteria for empirically proven effectiveness (Chamblis et al., 1998).  Meta-analyses (Van Etten & Taylor, l998; Davidson,  & Parker, 2001; Maxfield & Hyer, 2002), comparing empirical results of treatments for PTSD, have concluded that EMDR is the most effective psychological and chemical treatment for PTSD.  Likewise, contemporary reviews (Allen, Keller & Console, l999; Feske, l998) present a positive picture of the EMDR research results.  These are articles worth reading for the therapist interested in EMDR.  I would also recommend Francine Shapiro’s book  (2001) as a thorough explanation of theory and procedures but caution readers to obtain adequate and extensive supervision in EMDR while working with clients.

Most contemporary psychologists sense and believe that we are on the verge of a new era in psychotherapy that will take us away from the mainly verbal, conceptual therapies we have practised for generations and into applications that directly access and affect neuro-psychological processes.  Recent brain studies have identified cortical and sub-cortical areas responsible for triggering arousal reactions to sensory perceptions and for storing traumatic memory-experience; so we must look for new interventions- such as EMDR-  to access and repair these imbalances.  It is an exciting time and EMDR has brought psychology and psychotherapy to the doorway of this new era.

Bibliography

Allen, J.G., Keller, M.W. & Console, D.A. (1999)  EMDR: A closer look             [Video manual].  New York: Guildford Press.

Chamblis, D.L., Baker, M.J., Baucom, D.H., Beutler, L.E., Calhoun, K.S., Crits-Christoph, P., Daiuto, A., DeRubeis, R., Detweiler, J., Haaga, D.A.F., Bennett Johnson, S., McCurry, S., Mueser, K.T., Pope, K.S., Sanderson, W.C., Shoham, V., Stickle, T., Williams, D.A.& Woody, S.R. (1998)  Update on empirically validated therapies, II, The Clinical Psychologist, 51, 3-16.

Davidson, P.R. & Parker, K.C.H. (2201)  Eye movement desensitization and reprocessing (EMDR): A meta-analysis.  Journal of Consulting and Clinical Psychology, 69, 305-316.

Doctor, R.M. & Seif, M.N. (2007) Typologies for the fear of flying: Implications for flight personnel and therapists.  Paper presented at the Third World Conference on the Fear of Flying, Montreal, Canada.

Feske, U. (1998)  Eye movement desensitization and reprocessing treatment for posttraumatic stress disorder.  Clinical Psychology: Science and Practice, 5, 171-181.

Maxfield, L. and Hyer, L.A. (2002)  The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD.  Journal of Clinical Psychology, 58, 23-41.

Shapiro, F. (2001)  Eye movement desensitization and reprocessing: Basic          principles, protocols and procedures. (2nd ed.) New York: Guildford Press.

van Etten, M. & Taylor, S. (1998)  Comparative efficacy of treatments for posttraumatic stress disorder: a meta-analysis.  Clinical Psychology & Psychotherapy, 5, 126-144.

van der Kolk, B. (1998)  The neurophysiology of EMDR treatment.  Paper presented at the EMDRIA International Conference, Baltimore, Maryland.

This paper is dedicated to the Navy pilot who, during WWII, stayed with his crippled plane in order to guide it past the school yard where I and many other children were playing at recess, and lost his life in trying to eject far too late.

by Ronald M. Doctor, Ph.D.

Director, Freedom to Fly, Los Angeles

 EMDR: Third World Conference on Fear of Flying (WCFF/3).

Source of Article:

http://www.rondoctor.com/2011/10/the-use-of-emdr-for-treatment-of-fears-of-flying/

happy ii

Thoughts & Ideas

Thoughts and ideas: People can suffer from thoughts of low self-esteem, or obsessive thoughts about someone or something. They may not be able, for example, to get out of their minds the idea that they are suffering from an illness, despite medical reassurance, or that a partner is unfaithful. HYPNOTHERAPY can help the client to change such ideas.

…More to follow

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NRT ‘not effective’ for smoking cessation, research finds

By Elizabeth Smythe

A new study has discovered that Nicotine Replacement Therapies (NRT) are not effective long-term smoking cessation methods, The Telegraph reports.

The products, which include patches, inhalers, nasal sprays and gum, were investigated by researchers from the Harvard School of Public Health and the University of Massachusetts, who followed the progress of nearly 800 recent quitters over three time periods.

They found that there was no significant difference in relapse rates among those who had used NRT and those who had not. Similarly, there was no difference in success rates.

However, according to Metro, heavy smokers who used NRT without professional therapy were “twice as likely to relapse”.

Lead author, Hillel Alpert said: “This study shows that using NRT is no more effective in helping people stop smoking cigarettes in the long-term than trying to quit on one’s own.”

Giving up smoking is by no means an easy undertaking. In most cases it is a habitual behaviour that is hard to change, something NRT cannot tackle.

Fortunately, stop smoking hypnosis can be extremely effective, employing cognitive behavioural therapy to reprogramme the unconscious mind and change those ingrained habits. An additional benefit is that this method is nicotine free.

Mr Alpert continued: “Some heavily-dependent smokers perceive nicotine replacement therapy as a sort of “magic pill”. Upon realising it is not, they find themselves without support in their quitting efforts, doomed to failure.”

As a result of the study findings, the researchers are calling for greater regulation of over-the-counter NRT products and for more empirical research. Mr Alpert also suggested that using public money to fund the provision of NRT was now “of questionable value.”

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Hypnotherapy effective for smoking cessation, expert says

Hypnotherapy has been highlighted as a great way for habitual smokers to quit, so says The Daily Mirror.

At this time of year, hundreds of people vow to give up smoking as one of their New Year resolutions. Sadly, large numbers fail to stick to their plan and reach their goal.

However, “latest research” cited by the newspaper recommends a great starting point for hopeful quitters – understanding what sort of smoker they are and following a cessation method which is appropriate.

For those whose smoking habit has become ingrained into the routine of their day, it is suggested that retraining the brain could be an effective solution – done via stop-smoking hypnosis.

Cognitive behavioural therapy could help nicotine addicts break the associations they have with cigarette and replace them with “new, healthier habits.”

Working with the unconscious mind could be key, writes expert Kirsty Hanley for Huffington Post UK, especially as it controls approximately 90 per cent of what we do.

‘Post-hypnotic’ messages absorbed during childhood can affect behaviour into adulthood, she says: “The good news is that these patterns can be changed and, with the right help, often quicker than you might imagine.”

Over ten million British people smoke. Some 80,000 die each year from smoking-related diseases, hence why giving up smoking is one of the best health decisions an individual can ever make.

By Elizabeth Smythe

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Fibromyalgia – A Pain You Must Live With?

Fibromyalgia symptoms

Are you looking for information about the symptoms of fibromyalgia? Here is an overview of the symptoms and signs of fibromyalgia that you can use to help you talk with your doctor.

The main fibromyalgia symptoms include deep muscle pain, painful trigger points or tender points, and morning stiffness. Other major symptoms of fibromyalgia include sleep disorders, fatigue and anxiety. In order to make an accurate diagnosis, your doctor will need to review the signs and symptoms you are experiencing. Fibromyalgia affects far more women than men.

What are the common symptoms of fibromyalgia?
  • Common symptoms of fibromyalgia, also known as fibromyalgia syndrome or FMS, may include:
  • Anxiety
  • Concentration and memory problems – known as “fibro fog”
  • Depression
  • Digestive disorders
  • Discolouration of hands and feet (Raynaud’s phenomenon)
  • Dryness in mouth, nose and eyes
  • Fatigue
  • Headaches
  • Irritable bowel syndrome
  • Morning stiffness
  • Pain
  • Painful menstrual cramps
  • Restless legs syndrome
  • Sleep problems
  • Swelling, numbness, and tingling in hands, arms, feet and legs
  • Trigger points
  • Urinary symptoms
Is pain the most common symptom of fibromyalgia?

Yes. Widespread pain is characteristic of more than 97% of patients with fibromyalgia. In fact, pain is usually what forces a person with fibromyalgia to see his or her doctor.

Unlike the joint pain of osteoarthritis, fibromyalgia pain is felt over the entire body. It is a deep, sharp, dull, throbbing or aching pain that is felt in the muscles, tendons and ligaments around the joints. NHS Choices describes the muscle and tissue pain as tender, aching, burning or stabbing. A sufferer may also experience increased sensitivity and prolonged pain.

For some people with fibromyalgia, the pain comes and goes. The pain also seems to travel throughout the body.

Do painful trigger points accompany FMS pain?

Along with the deep muscle soreness and body aches, people with fibromyalgia have painful trigger points or localised areas of tenderness around their joints that hurt when pressed with a finger. It is the tissue around the joints rather than the joints themselves that are painful. These trigger points or tender points are often not areas of deep pain. Instead, they are superficial, located under the surface of the skin.

The location of trigger points is not random. They are in predictable places on the body. If you apply pressure to trigger points on a person without fibromyalgia, he or she would just feel pressure. For a person with fibromyalgia, pressing the trigger points is extremely painful.

Is fatigue a fibromyalgia symptom?

Next to pain and the tender trigger points, fatigue is a major complaint. Fatigue in fibromyalgia refers to a lingering tiredness that is more constant and limiting than what we would usually expect. Some patients complain of being tired even when they should feel rested, such as when they have had enough sleep. Some patients report the fatigue of fibromyalgia as being similar to the symptoms of flu. Some compare it to how it feels after working long hours and missing a lot of sleep.

With fibromyalgia, you may feel:
  • Fatigue on getting up in the morning.
  • Fatigue after mild activity such as shopping or cooking dinner.
  • Too fatigued to start a task such as folding clothes or ironing.
  • Too fatigued to exercise.
  • More fatigued after exercise.
  • Too fatigued for sex.
  • Too fatigued to function adequately at work.
Are sleep disturbances a common symptom of fibromyalgia?

Sleep disturbances are common in most people with fibromyalgia. While people with fibromyalgia may not have difficulty falling asleep, their sleep is light and easily disturbed. Many sufferers wake up in the morning feeling exhausted and unrefreshed. These sleep disturbances may help create a constant state of fatigue.

During sleep, individuals with fibromyalgia are constantly interrupted by bursts of brain activity similar to the activity that occurs in the brain when they are awake. Some tests in sleep laboratories done on individuals with fibromyalgia have shown that people with fibromyalgia experience interruptions in deep sleep. These interruptions limit the amount of time they spend in deep sleep. As a result, their body is unable to rejuvenate itself.

Some people with fibromyalgia report that the morning stiffness may last only a few minutes, but in general, it is usually very noticeable for more than 15 to 20 minutes each day. In some cases, though, the stiffness lasts for hours, and in others it seems to be present all day.

While most people feel stiff when they first wake up, the stiffness associated with fibromyalgia is much more than simply a minor aching. In fact, people with fibromyalgia have the same feeling of stiffness in the morning that people feel with many types of arthritis, especially rheumatoid or inflammatory arthritis.

Is depression a fibromyalgia symptom?

Depression is a key symptom for most people with fibromyalgia. Approximately one out of every four patients with fibromyalgia has current major depression. And one out of every two people with fibromyalgia has a lifetime history of depression.

Stress from the constant pain and fatigue can cause anxiety. Also, chronic pain can result in a person being less active and becoming more withdrawn. This, in turn, can lead to depression.

It is also possible that anxiety and depression may actually be a part of fibromyalgia, just like the pain. Many patients with depression and fibromyalgia tell of having great difficulty concentrating on their work along with impaired short-term memory at times.

What causes swelling and tingling hands with fibromyalgia?

Neurological complaints – such as numbness, tingling and burning – are often present with fibromyalgia. While what causes these feelings is unclear, numbness or tingling sensations in the hands, arms, or legs are felt by more than half of the people with fibromyalgia. The feelings may be especially bothersome when they occur in the mornings along with morning stiffness on arising.

The medical term for these sensations is paraesthesia. The sensations usually happen at irregular times. When they do occur, they may last a few minutes or they may be constant. While the sensations can be bothersome, they are not severely limiting.

Are chronic headaches a symptom of fibromyalgia?

Chronic headaches, such as recurrent migraine or tension-type headaches, are common in about 70 per cent of people with fibromyalgia. They can diminish a person’s ability to cope with and self-manage FMS.

The headaches may be a result of pain in the neck and upper part of the back. They are often caused by tightness and contraction of the muscles of the neck, which results in a type of headache called tension-type headaches or muscle-contraction headaches. They may also be caused by tenderness from trigger points over the back of the head and neck. It is important to remember that other medical problems can cause headaches that should be properly diagnosed and treated by your doctor.

Is urinary frequency a symptom of FMS?

Feeling an urge to urinate, urinary frequency, painful urination, or incontinence can happen in about 25% or more of fibromyalgia cases. Since these problems can also be caused by other bladder and kidney diseases, such as an infection, check with your doctor to be sure no other problems are present.

Do menstrual cramps affect women with fibromyalgia?

Unusually painful menstrual cramps occur in 30% to 40% or more of women with fibromyalgia. These cramps, along with other symptoms, are usually present for years.

How is Raynaud’s phenomenon related to fibromyalgia?

Raynaud’s phenomenon is present in 25% to 50% of people with fibromyalgia. With Raynaud’s, your fingers or toes may become quite pale, cold or blue when exposed to cold temperatures, for example when you are holding a cold glass. The pale or blue changes usually last a few minutes and may be accompanied by pain. When the hands or feet are warmed, they return to normal.

What is the relationship between restless legs syndrome and fibromyalgia?

Restless legs syndrome results in discomfort in the legs, especially the areas of the legs below the knees, and the feet. It is especially bothersome at night. The feeling can be painful, but most commonly it is described as the need to move the legs to try to make them comfortable.

Restless legs syndrome often interrupts sleep as the person tries to find a comfortable position for rest. As with other symptoms, restless legs syndrome can be found alone, with fibromyalgia, or along with other medical problems.

Is dryness in the mouth, nose or eyes a symptom of fibromyalgia?

Dryness in the mouth, nose or eyes can happen in otherwise normal people. But 25%or more of people with fibromyalgia have this feeling. Sometimes, this is caused by Sjögren’s syndrome. This occurs when the salivary glands and tear glands do not produce the normal amounts or quality of saliva to lubricate the mouth or tears to lubricate the eyes. There is no single known cause.

Although the dryness is mainly uncomfortable, the loss of normal lubrication for the eyes can increase the risk of infections. The loss of normal saliva and lubrication in the mouth increases the chances of tooth decay. Talk to your doctor or see an optician for the eye dryness and your dentist for good prevention advice and treatment.

Further Reading:

Fibromyalgia – Treating fibromyalgia

Fibromyalgia – What is fibromyalgia?

Fibromyalgia – What treatments work for fibromyalgia?

What is fibromyalgia?

Why am I so tired? Top 12 causes of fatigue

Fibromyalgia – Causes of fibromyalgia

Fibromyalgia – Diagnosing fibromyalgia

This article was taken from:

WebMD Medical Reference

View Article Sources

Medically Reviewed by Dr Rob Hicks on January 31, 2011

© 2009 WebMD, LLC. All rights reserved.

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Smoking Kills

There is no doubt that smoking kills.

The annual global death toll as a result of tobacco is currently six million people, 1 that is currently one person dying every six seconds as a result of tobacco, and contributes to most cancers including lip, mouth, throat, bladder, kidney, stomach, liver, and cervix. This statistic caused the U.S. Surgeon General to state that: “There is no risk free exposure to tobacco smoke, and therefore no safe tobacco product” 2

The cost to people’s lives is considerable and there is little surprise that people quitting smoking is on the increase. The seemingly unscalable wall a smoker encounters when trying to quit, however, is quite simply that they find themselves unable to do so; they have become an addict! 3 This addiction happens especially quickly with children, studies in the United States have found that addiction happens very quickly; that “…adolescent smokers displayed symptoms of nicotine withdrawal within the first few weeks of commencing smoking” 4, 5

It is therefore important that an aid to quitting smoking can be offered to those that want to quit. Even though hypnotherapy can provide this aid, it is the individual themselves that must do the quitting. Hypnotherapy does not create a magic spell that does all of the hard work.

1World No Tobacco Day 2011 celebrates WHO Framework Convention On Tobacco Control. WHO

press release 31 May 2011 http://www.who.int/tobacco/wntd/2011/en/

2U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology

and Behavioural Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA:

U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National

Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.

3Nicotine Addiction in Britain. A report of the Tobacco Advisory Group of the Royal College of Physicians. London, RCP, 2000

4DiFranza JR Hooked from the first cigarette. Scientific American 2008; 298: 82-87

doi:10.1038/scientificamerican0508-82

5Please see: http://www.ash.org.uk/files/documents/ASH_107.pdf for further research about smoking.