Therapy practice in Bryn Mawr

Peace on earth begins with peace at home

The following article was published in the summer 2017 issue of The Beacon. In my therapy practice in Bryn Mawr, I try to bring this perspective in all my work with clients.

The effort to establish right human relations is helpful, indeed essential, in integrating the personality with the soul. The lack of “right relations” comes most often from a selfish attitude and an emotional body that is not held steady in the light. It is disharmony in personal relations that very often causes a person to decide that he or she must get hold of him- or herself and make some changes. Our relationships are indeed our greatest teachers.

The desire and the need for harmonious relationships is quite often the thing that puts us on our Path. The pain we feel as a result of disharmony is a real pain; brain imaging studies show that physical and emotional pain “light up” the same regions of our brains. What’s worse, the pain we feel when we are the perpetrator of disharmony is like added salt in our painful wound; we feel embarrassed, ashamed, or guilty, in addition to our angers and fears. This is a powerful combination that makes most eventually decide that Something Must Be Done.

The work, once committed to, involves a complete reorientation of thinking – away from oneself as victim, toward oneself as creator. When taking stock, we learn to reframe our point of view to include perspective-taking and empathy for the Other. We begin to practice “not taking it personally” and to recognize that when our emotions are getting riled up, it is not actually about the Other person, but about some wound in our own Self that is needing to be healed. We begin to have compassion for ourselves and to forgive ourselves ― that is an essential piece of personality integration. No longer can the mind spend oodles of energy denigrating the emotional body; instead the ego learns to befriend the inner child and to work with it, to heal it and create peace rather than continuing disharmony.

As we practice detachment, not taking things personally and not assuming that we know what the Other is thinking or feeling, we begin to task ourselves with cultivating Right Speech. We begin to be careful with our words, which slows down our emotional reactivity. Our relationships increase in harmony. With more harmony, we are able to create a spaciousness that allows us to strive for utter harmlessness and self-forgetfulness. The body relaxes; health ensues. The seven points of light begin to radiate and we become a fit vehicle of expression for the Soul.

When we have committed ourselves to a spiritual path, our lives change in incredible ways. The old emotional reactions and underlying assumptions give way to a light and peaceful experience. The very intention to bring more “spirituality” into our lives does indeed invite light, and love, and goodwill. These are the cause and effect of establishing right human relations.

A constant reorientation to spiritual values changes a person. At the moment we decide that there Must Be Something More, and determine to find it, our lives change course. A meditation practice may be the single most important tool for self improvement, and such a practice can be hung on the scaffolding of just about any religious or non-religious tradition. Whether we are searching for Peace through mindfulness or are devoted to the Buddha-nature, the Christ, Ishvara, the Divine, or the Beloved doesn’t matter. We begin to ascend the mountain and as we climb, we find that all of our paths converge.

With this awakening of inclusiveness, there can be no denigration of another spiritual tradition, no room for thinking “my way is the Right Way, and yours is, say, a ‘political ideology’”. From our place of inclusiveness we gain empathy and search for the reasons why people behave, often badly, the way they do. Rather than condemning and judging, we seek to understand and to aid, even as perhaps we wish that the reins of power were held by more-evolved hands.  Yet we find solace in knowing that we all learn through pain – individuals and groups alike,

As we work to invoke the Soul, not only do our worldly views become larger and more inclusive, our close personal relations become more peaceful as well. We cannot but feel hypocritical if we make a fuss about a spiritual practice and then yell at our kids and criticize our spouses. Any momentary experience of mystical union rings hollow if followed by a fight at home.  The Love of the Soul has made its healing felt in every level of our personality-being and we begin to love and forgive ourselves, and from that peaceful place it is impossible to not-love or non-forgive others. And incredibly, when others criticize us we are far from defensive but rather seek to understand and find common ground. Exuding peace and love, others want to know how did we do that? Having sought the Light, the Light of the Soul has made its presence known and we are changed, and we are agents for change. Our seven centers begin to blaze and light our way, and light the Way for others.


therapy in bryn mawr

EFT for PTSD

A treatment for PTSD (posttraumatic stress disorder) that uses no drugs, has no side effects, and really works―does that sound too good to be true? Research shows that such a treatment does indeed exist. EFT, the emotional freedom techniques, can resolve PTSD symptoms in as little as five sessions. Kaiser Permanente, one of the largest hospital systems in the US, just published clinical guidelines for using EFT to treat PTSD. The guidelines were created by Dawson Church and colleagues, after reviewing the literature and surveying 448 practitioners to see how clinicians are getting results. Their recommendation: five to ten sessions of EFT for people with PTSD. EFT works for PTSD. I use it in my therapy practice in Bryn Mawr.

PTSD: military, accidents, and beyond

We often think of war veterans when we think of PTSD, as well we should: the VA estimates, conservatively, that between 11% and 20% of veterans who served in Iraq and Afghanistan have PTSD (other sources put the rate at closer to 30%). The rates are even higher among Vietnam War veterans, with nearly a third suffering from PTSD. But PTSD is not just a problem for the military. Indeed, it can affect people who have been in any traumatic situation: those who have been in serious accidents, victims of violent crimes, or diagnosed with life-threatening diseases can develop PTSD; the death of a loved one can cause PTSD-like symptoms.

PTSD prevalence

Nearly 8 of every 100 Americans are likely to experience PTSD during their lifetimes. Most people will go back to normal after a traumatic event, but some will develop symptoms that last more than a month (subclinical PTSD) or three months (clinical PTSD) and that interfere with their lives. The symptoms involve avoiding or "numbing out"; re-experiencing, often with nightmares or flashbacks; and some type of hyper-arousal, like being easily startled, on edge, having trouble sleeping, even having angry outbursts.

Treating the "un-treatable"

After World War II, people used the term "shell shocked" to describe the symptoms of PTSD. For decades, it was believed that veterans could not recover from PTSD. More recently, researchers have been looking for ways to resolve the previously "unresolvable". Pharmaceuticals have not been an effective solution. In a creative move, the US government invested millions of dollars in a virtual reality technology to help veterans with PTSD. But that program is only available to some veterans, and is very costly and hard to replicate. EFT is effective, safe, has no side effects, all for the price of a therapy session ― except for veterans, who can get services for free through The Veterans Stress Project.

To learn more about EFT and other kinds of energy psychology, see emofree.com, energypsych.org, and my website, transformative-therapy.com. EFT for PTSD can get your life back on track.


Energy Psychology, EFT

Energy Psychology, EFT: A Mind-Body Approach

Energy Psychology (EP) is a family of therapies that combine Western psychology methods with Eastern energy-based healing principles. This mind-body approach allows EP to facilitate rapid, positive change. The most common form of EP is EFT, the emotional freedom techniques. More than 100 studies published in peer-reviewed journals document the effectiveness of these simple energy-based techniques.

The Meridians and Related Emotions

Understanding EP begins with an acceptance that we are more than meets the eye. Everything is energy, as the saying goes! For instance, acupuncturists have worked with meridians for thousands of years. In a nutshell, meridians can be though of as little energy highways that run through our bodies, carrying energy through our system. According to Traditional Chinese Medicine, each meridian is associated with a specific emotion or set of emotions. Because of this, you can release an emotional block (or a problem) when you stimulate its associated treatment point by tapping or rubbing it.

Here is a rundown of the meridian points and related emotions.

  Treatment Point Location Meridian Related Emotions
GV Above the mouth The Governing Vessel Associated with self esteem; moving forward
CF Below the mouth the Central Vessel Associated with shame; launching new projects
BL Inside eyebrow corner Bladder Trauma; aggravation, irritation
GB Outside corner of the eye Gallbladder Visceral anger: rage, fury, wrath
ST Under the eye Stomach Fear, anxiety
KI Just below the collarbone notches Kidney Anxiety
SP Under the armpits Spleen Worry
LV Bottom rib, under nipple Liver Anger
LU Thumb: outside corner of the nail Lung Grief
LI Index finger: outside corner of the nail Large intestine Guilt
PC Middle Finger: outside corner of the nail Pericardium Life-flow; sexual issues
HT Pinky Finger: outside corner of the nail Heart Anger about a specific issue
SI Outside edge of the hand Small intestine Vulnerability, sadness
3W Back of the hand, between the 4th and 5th metacarpals (leading to pinky and ring fingers) Triple warmer

(thyroid)

Pain, depression

 

The Meridian Treatment Points

Face/Head Points

TH: Many meridians run here

EB: Bladder meridian point

SE: Gallbladder meridian point

E: Stomach meridian point

UN: Governing Vessel point

Ch: Central Vessel point

 

Torso Points

CB: Kidney meridian point

UA: Spleen meridian point

LV: Liver meridian point

Hand Points

PC: Pericardium meridian point

LI: Large intestine meridian point

HT: Heart meridian point

LU: Lung meridian point

3W: Triple Warmer

SI: Small intestine

The Research

Peer-reviewed professional journals have published more than 100 research studies demonstrating the effectiveness of EP therapies. Importantly, this includes not just one-offs and case studies, but more than 50 randomized controlled trials, 40+ outcome studies, and four meta-analyses. (A meta-analysis depends on a pretty large group of studies, which are combined in order to draw conclusions with greater confidence.)

One striking study of veterans with PTSD showed that PTSD symptoms dropped after EFT treatment; after 10 sessions all the veterans were free from clinically diagnosable PTSD. This is so important, because we used to think PTSD was not treatable. More recently, the US government invested millions in a virtual-reality PTSD treatment center, which is cool -- but not very practical. The center is outside of DC, and did I mention expensive? Yet there are so many people who need treatment all over the country. EFT is a low-cost intervention which is simple, effective, and has virtually no negative side effects. In addition, clinicians and researchers have used EP to treat addictions, anxiety, depression, food cravings, phobias, sports performance, and stress.

EFT: The Emotional Freedom Techniques

One of the most common techniques in Energy Psychology is EFT. To use EFT, begin by bringing your problem to mind and allowing yourself to feel the emotions related to the problem. Then try to identify which emotion you feel most strongly. Rate that emotion on a 0-10 scale, with 0 meaning the problem does not exist, and 10 is the worst you've experienced.

Next, start tapping on the side of the hand, using all fingers from the other hand, while you repeat the setup statement (the problem, and an affirmation):

"Even though I (have this problem), I deeply and completely accept myself."

Note:

It doesn't matter which hand you use to tap, or which side you tap on. You can switch sides, tap on both sides, or just stick with one side…

Then tap the points while repeating the problem, using related statements such as "It feels terrible, it feels awful, I can't believe it, I feel so bad…"

Tapping sequence:

  1. TH Top of head
  2. EB Eyebrow corner
  3. SE Side of eye
  4. E Under eye
  5. UN Under nose
  6. Ch Chin, Under lip
  7. CB Collarbone
  8. UA Under arm

When you've finished tapping, take a deep breath, and reassess the problem on a 10-scale. If you have not achieved a "0", tap another round. Continue working until you have reached a 0.


The Gayatri: Most Ancient Mantram

The Gayatri is said to be the most ancient mantram known to humankind. It is a statement of aspiration and devotion, placing us on the sacred path of return.

Several English translations exist. I learned the following one years ago. It was given by the Tibetan master, Djwhal Khul.

Oh Thou Who givest sustenance to the Universe

From Whom all things proceed

To Whom all things return

Unveil to us the true Spiritual Sun

Hidden by a disk of golden light

That we may know the truth

And do our whole duty

As we journey to Thy sacred feet.

The dual emphasis on knowing the truth and doing our duty are significant. It seems to me that to have knowledge without applying it is useless; and work without knowledge is fruitless. I think that the spiritual path encompasses both.

Yoga students and kirtan enthusiasts may be familiar with the Gayatri, which has been beautifully recorded by Wah! and Deva Premal. Next time you hear one of their beautiful recordings, you will have some meaning to attach to it!

 


therapy in bryn mawr

Past Life Regression Story

Past-life regression therapy with healing can be very powerful tools, helping to accelerate our personal growth and spiritual expansion.  We are able to re-pattern old habits of thinking and feeling that have their root in the distant past, becoming free and effective people in the present. I am passionate about the benefits of this healing technique and have often used regression with healing with clients in my therapy practice in Bryn Mawr. It has been an important part of my own journey as well.

A personal tale

One of my most interesting past-life regression and healing experiences happened about a decade ago. During the session, I retrieved a lifetime in which I was a young sailor, a boy not more than 15 years of age. I was climbing the mast of a tall ship and my foot got caught in the rigging; I lost my footing and fell. I was badly injured with a broken hip.

As the regression proceeded, I saw that I went on to live as a disabled person. In those days, that meant that I became a "beggar". I was left with deep self-esteem issues that continued to plague me in this lifetime. And, interestingly, I have a huge bruise-like birthmark on my hip.

Healing

Since the regression and healing session, I have changed in important ways. The birthmark is still on my hip; I still get dizzy when I look up at tall buildings. But my self-confidence began to improve almost immediately. I remember having two important and conflicting thoughts after the session: One, I was very skeptical that this had really happened! And secondly, I felt more comfortable in my own skin. Years later, I find myself looking back on this session as one of the most significant experiences of my journey.


energy psychology research

Energy Psychology Research

Transformative Therapy is a private therapy practice in Bryn Mawr, PA. We specialize in working with clients who have cancer and other serious illnesses. We offer a holistic approach to therapy including hypnosis and energy psychology. This article summarizes energy psychology research. This is a set of mind-body techniques that combine Western psychology with Eastern energy-based principles.

Energy Psychology

Energy psychology (EP) is a collection of methods that improve emotional and psychological functioning by combining cognitive techniques, such as imagery-based therapy and mindfulness, with physical methods derived from acupuncture and other Eastern systems (Feinstein, 2012; energypsych.org, 12/27/2012).

Research has shown that EP techniques are effective for treating psychological issues such as depression, anxiety, phobia, and posttraumatic stress disorder (PTSD). It is also effective for some physical problems such as chronic pain.

Research on EP has been conducted around the world and supporting evidence has been published in more than 20 independent, peer-reviewed scholarly journals.

Types of energy psychology techniques

There are various forms of energy psychology. The most well known forms focus on tapping or otherwise stimulating acupuncture meridian points (acupoints) while focusing on emotion-evoking stimuli. These meridian-based EP techniques include Emotional Freedom Techniques (EFT), Thought Field Therapy (TFT), Energy Diagnostic and Treatment Methods (EDxTM) and Tapas Acupressure Technique (TAT).

Energy psychology and the broader system of energy medicine have become increasingly popular with consumers and providers of mental health services (Lumadue, Munk and Woodten, 2005). This follows the broader trend of complementary therapies’ popularity among health care consumers (Eisenberg, 1998). The 2007 National Health Interview Survey found that 38% of American adults use some form of complementary/alternative medicine. Global rates are sometimes higher, with the World Health Organization reporting rates as high as 48% in Australia, 70% in Canada, and 75% in France.

Over a million people have downloaded The EFT Manual and The EFT Mini-Manual (Feinstein, 2009). In the U.S., many accredited continuing education programs for counselors include EP and other complementary and alternative practices (Lumadue, Munk and Wooten, 2005). In late 2012, the American Psychological Association approved the Association for Comprehensive Energy Psychology (ACEP) as a provider of continuing education credits for psychologists.

Consumers of mental health services should be aware that, because energy psychology is a relatively new field within psychology, we do not yet fully understand how it works. Critics claim that any treatment effects from EP modalities may result from placebo or other nonspecific therapeutic factors. However, current research suggests that well understood mechanisms of action are responsible for the observed effects (see below).

History

During the 1960s in the U.S., chiropractor George Goodheart developed applied kinesiology, an alternative field that involves the manual testing of muscles (Rosner and Cuthbert, 2012). He began teaching it to other chiropractors in the mid-1970s. John Diamond used applied kinesiology techniques for psychological purposes. Roger Callahan became interested in Goodheart’s techniques, which inspired the creation of Callahan Techniques ® Thought Field Therapy, the original meridian tapping therapy. Several of Callahan’s students went on to develop other forms of meridian-based EP techniques. Gary Craig created the Emotional Freedom Techniques after training with Callahan in the early 1990s, and various other clinicians added to the field with the creation of a dozen techniques that have in common the tapping on acupressure points (Gallo 2002). Meridian-based EP draws on traditional Chinese medicine, which identifies acupuncture meridians and acupoints. Traditional Chinese medicine  has been practiced for thousands of years, and has become increasingly popular in the West within the last few decades. A growing body of research points to the efficacy of acupressure and acupuncture, and the World Health Organization lists it as an effective and often proven treatment for a variety of physical and mental health concerns (WHO, 2013).

Research

Research on EP has followed American Psychological Association (APA) Division 12 Criteria (Feinstein, 2012). These criteria stipulate that for a treatment to be considered empirically effective it must be demonstrated to be superior to an established treatment in two randomized controlled trials. If a treatment is found to be superior to a control group, it is considered “probably efficacious”. The difference must reach the level of statistical significance, or p <.05. This means that there is less than a 5% chance that the results are due to chance. In his comprehensive review of the literature on energy psychology, Feinstein (2012) describes 18 randomized controlled studies. All of them reported statistically significant changes from pre- to post-treatment. All of these studies used self-report inventories, and half also included objective measures such as structured clinical interviews, physiological markers such as salivary cortisol levels, and observable measures such as body weight.

By treatment condition

Emotional Distress

Energy psychology techniques have been found to be effective in treating emotional distress. A study of workshop participants who received EFT showed very significant improvement on all scales of distress, and the changes held at six-week follow-up (Rowe, 2005). Church and Brooks (2010) tested healthcare workers attending EFT workshops, and found significant improvement on all scales; the gains held at three-month follow-up. Palmer and Hoffman (2011) also found significant improvement on a range of emotional symptoms after EFT workshops, and the results held on follow-up.

Anxiety

Energy psychology has shown efficacy in several studies of anxiety. In the largest study of EP, Andrade (Andrade & Feinstein, 2004) studied approximately 5,000 patients with anxiety disorder and found that EFT yielded significant decreases in anxiety; 90% of EFT patients had a reduction in symptoms and 76% were symptom-free, and the results held at follow-up. A randomized control trial by Irgens et al (2012) found significant relief of anxiety symptoms following TFT treatment. Other studies found significant results with public- speaking anxiety (Schoninger & Hartung, 2010; Jones et al, 2010). Rubino (2012) and Benor et al (2009) found significant improvement using EP techniques to treat test-taking anxiety.

Depression

Randomized control trials that measure depression before and after treatment find that EP methods yield significant drops in depressive symptoms. Church, DeAsis & Brooks (2012) studied moderately to severely depressed college students and found mood in the normal range after four EFT sessions. Other studies have found significant improvements in depression among healthcare workers (Church & Brooks, 2010), veterans (Church, 2013), and fibromyalgia sufferers (Brattberg, 2008).

Phobia

EP has found statistical significance in treating phobias. Three randomized control trials using EFT (Salas et al, 2011; Baker & Segal, 2010; Wells et al, 2003) and one using TFT (Darby & Hartung, 2012) found that a single session can resolve a phobia, and that the results last.

PTSD

Several studies, including three randomized control trials, have found that energy psychology methods produce significant relief for people with PTSD. Church et al (2013) studied 59 veterans with PTSD. After treatment, 90% of the EFT group no longer met diagnostic criteria for PTSD, compared to just 4% in the wait list group. Several studies have found EP (TFT) leads to highly significant reduction in trauma among survivors of the Rwandan genocide (Sakai et al, 2010; Stpme et a;. 2009; Stone et al, 2010). A study conducted in Britain compared EFT to Eye Movement Desensitization and Reprocessing (EMDR), and found both treatments to produce significant therapeutic gains at post-treatment and follow-up (Karatzias et al, 2011).

Theory

All energy psychology methods include three core components: exposure to the psychological or emotional issue, generally achieved by calling it to mind; cognitive interventions, such as affirmations; and some type of energy intervention, whether meridian-based, energy-center-based, or biofield-based.

Meridians

The exact mechanisms for the effectiveness of EP are not well understood. One underpinning of the meridian-based EP techniques is the theory of the energy meridian system of traditional Chinese medicine. According to this theory, energy known as qi or chi flows through the body in pathways called meridians. A block in the flow causes distress or disease, and a release of the blockage brings relief (Baker, 2009). This theory, however, is yet unproven.

There have been studies supporting the existence of acupoints and meridians through electrical conductance in the skin (Prokhorov et al, 2006); however, there are no known studies demonstrating the correlation between alterations in the acupoints or meridians and changes in disease conditions (Baker, 2009). While the concept of acupoints and meridians is somewhat foreign to many Westerners, and has not been proven by Western scientific method, it is a cornerstone of traditional Chinese medicine, and has been widely practiced for thousands of years and researched over the past several decades.

The World Health Organization recognized acupuncture as “proved - through clinical trials - to be effective” in treating more than two dozen medical and mental health issues including depression, and shown to be effective but needing further proof for more than five dozen medical and mental health issues.

Acupressure

Much research has focused on acupuncture, and acupressure, its non-needle counterpart, is said to work in much the same way. A comparison of acupuncture to non-needle stimulation of acupoints found non-needle stimulation to be as effective as standard acupuncture (Cherkin et al, 2009). Acupressure has been shown to reduce stress hormone levels (Cabyoglu, Ergene, and Tan, 2006; Eshkevari, 2003).

Memory

Another key to understanding the efficacy of energy psychology may lie in memory reconsolidation, the process in which the retrieval of a memory returns the memory to a labile state, which is then subject to restabilization (Forcato et al, 2009). When recalled, memories become temporarily unstable and changeable (Besnard, Caboche, Laroche, 2012). Memory retrieval therefore provides an opportunity for memory plasticity, or changeability; reconsolidation after recall provides an opportunity to update memories.

Ecker et al (2012) identify three steps for memory reconsolidation: vividly access emotional memory, juxtapose that memory with a contradictory experience, and verify that change has occurred. Most EP interventions incorporate activating a psychologically arousing thought or memory while juxtaposing the arousal with the calming effect that comes from stimulating acupressure points.

According to Lane (2009), the stimulation of acupressure points activates the parasympathetic nervous system by regulating stress hormones and activating the parasympathetic nervous system. The mechanism for meridian-based EP techniques may be conceptualized as counterconditioning of a traumatizing thought or emotional trigger with a feeling of calm, activated by acupressure point stimulation.

Learn more

If you are interested in learning more about energy psychology research, visit the Association for Comprehensive Energy Psychology research section.


References

Andrade, J., & Feinstein, D. (2004). Energy psychology: theory, indications, evidence. In D. Feinstein, Energy psychology interactive (Appendix, pp. 199-214). Ashland, OR: Innersource.

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Baker, H., Carrington, P., Putilin, D. (2009). Theoretical and methodological problems in research on Emotional Freedom Techniques (EFT) and other meridian-based therapies. Psychology Journal, 6 (2), 34-46

Besnard, A., Caboche, J., and Laroche, S. (2012). Reconsolidation of memory: a decade of debate. Progress in Neurobiology, 99 (1), 61-80.

Brattberg, G. (2008). Self-administered EFT (Emotional Freedom Techniques) in individuals with fibromyalgia: A randomized trial. Integrative Medicine: A Clinician's Journal,Aug/Sep, 30-35.

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NIH NCCAM http://nccam.nih.gov/health/whatiscam

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Rowe, J. (2005). The Effects of EFT on Long-Term Psychological Symptoms. Counseling and Clinical Psychology Journal, 2 (3), 104-111.

Rubino, A. (2012). The effectiveness of Emotional Freedom Techniques (EFT) for optimal test performance: A randomized, controlled trial. Energy Psychology: Theory, Research, & Treatment, 4(2), 13-24. doi:10.9769.EPJ.2012.4.2.SJ

Salas, M., Brooks, A., & Rowe, J. (2011). The immediate effect of a brief energy psychology intervention (Emotional Freedom Techniques) on specific phobias: A pilot study. Explore: The Journal of Science and Healing, 7, (3), 155–161. doi:10.1016/j.explore.2011.02.005

Schoninger, B; Hartung, J. (2010). Changes on self-report measures of public speaking anxiety following treatment with thought field therapy.  Energy Psychology Journal. doi: 10.9769.EPJ.2010.2.1.BS

Swingle, P., Pulos, L., & Swingle, M. K. (2005). Neurophysiological Indicators of EFT

Treatment Of Post-Traumatic Stress. Journal of Subtle Energies & Energy Medicine. 15, 75-86.

Waite, L., Holder, M. (2003). Assessment of the emotional freedom technique: an alternative treatment for fear. The Scientific Review of Mental Health Practice, 2(1), 20-26.

Wells, S., Polglase, K., Andrews, H., Carrington, P., Baker, A. (2003) Evaluation of a meridian-based intervention, Emotional Freedom Techniques (EFT) for reducing specific phobias of small animals. Journal of Clinical Psychology, 59 (9), 943-966

World Health Organization (2013), retrieved from http://apps.who.int/medicinedocs/en/d/Js4926e/5.html, 3/13/13


hypnotherapy for cancer patients

Hypnotherapy for Cancer Patients

Transformative Therapy is a private therapy practice in Bryn Mawr, PA. We specialize in working with clients who have cancer and other serious illnesses. We offer a holistic approach to therapy including hypnosis and energy psychology. This article summarizes research demonstrating the benefit of hypnotherapy for cancer patients.

The benefits of hypnotherapy for cancer patients

There is a growing interest in the mind-body-spirit approach to health. According to the NIH, 38% of American adults used some form of complementary or alternative therapy in 2007, the most recent year for which statistics are available.

Hypnosis is an evidence-based form of complementary therapy that is growing in popularity. Researchers have documented the effectiveness of hypnosis for people with cancer across all phases of treatment, from detection/diagnosis, through various types of treatment, and into survivorship.

Hypnosis is a relatively low-cost and certainly low-risk intervention that has been shown to improve quality of life, decrease pain and other symptoms and treatment side-effects, decrease depression and anxiety, and improve well-being. Two studies have shown that hypnosis may even have an impact on longevity.

What is hypnosis?

Hypnosis is a relaxed state of mind. When we are hypnotized our brains are using alpha and theta brainwaves, just as we do in meditation and some stages of sleep. These relaxed brainwave patterns allow us to more open to suggestion, or "suggestible": we are more likely to believe what we are told, and we are able to change how we think and feel about things. We can use this suggestibility to our great benefit in many areas of life, from emotional wellbeing to health. Indeed, there is a growing body of clinical data supporting the use of hypnosis for health in general, and for supporting cancer care in particular. Here are some highlights from the literature:

Cancer Detection/Diagnosis:

Hypnosis has been shown to decrease anxiety, distress, and pain for people undergoing biopsy. The studies published have focused on breast cancer screening.

  • Lange et al (2006) studied 236 women undergoing core image-guided breast biopsy. Women who had hypnosis experienced significantly less anxiety (p<0.001) and pain (p=0.024)
  • Montgomery et al (2002) studied 20 excisional breast biopsy patients and found that women who had hypnosis before the procedure had less pre- and post-biopsy distress and less post-biopsy pain (p's<0.001).
  • Schnur et al (2008) compared the effect of hypnosis versus attention control for 90 women undergoing breast biopsy. They found less pre-biopsy upset (p<0.0001), depression (p0.02), and anxiety (p<0.0001), and the hypnosis group were more relaxed (p<0.001).

Cancer treatment

Hypnosis can support every mainstream form of cancer treatment. It has been helpful for surgical patients, has reduced side-effects of chemotherapy, and has helped with the effects of radiation. Here are some ways that researchers have found hypnosis for cancer patients to be helpful:

Surgery

Surgical patients who received hypnosis pre-operatively had less anxiety, pain, pain medication, emotional upset, and fatigue, and had shorter treatment time:

  • A meta-analysis conducted by Montgomery, David, Winkel and Silverstein (2002) investigated the use of hypnosis for surgical patients. Results revealed a large and significant effect size (d=1.20) for hypnosis. Patients in hypnosis treatment groups had better outcomes than 89% of patients in control groups (effect size, D=1.20). Hypnosis affected a wide range of clinical outcomes including pain, pain medication, negative affect, blood pressure, nausea, fatigue, and treatment time.
  • Montgomery et al (2007) conducted a randomized, controlled trial of 200 breast cancer patients undergoing excisional biopsy or lumpectomy found that those who were given 15 minutes of hypnosis before the procedures required pain medication, reported less pain intensity, pain unpleasantness, nausea, fatigue, discomfort, and emotional upset.
  • Lang et al (2008) Studied 201 patients receiving tumor embolization or radiofrequency ablation were randomized to standard care, attention, or hypnosis groups. Patients in the hypnosis group had significantly less pain and anxiety and received significantly less medication (midazolam or fentanyl) than patients in the standard care (33% less medication) or empathic attention (43% less medication) groups.

Chemotherapy

Anti-nausea medications have improved quality of life for patients receiving chemotherapy. However, some patients still experience chemotherapy-related nausea and vomiting.  Hypnosis has been shown to help alleviate these treatment effects:

  • Richardson et alconducted a meta-analysis of randomized controlled trials (RCTs) (n=6) of hypnosis for controlling nausea and vomiting associated with cancer chemotherapy. All studies reported positive results including statistically significant reductions in nausea and vomiting with a moderate effect size for hypnosis compared to attention control and a large effect size of hypnotic treatment compared to treatment as usual.
  • A second review of the literature by Redd, Montgomery, and DuHamel (2001) also supports the use of hypnosis to treat chemotherapy-related nausea and vomiting. This review included both randomized and non-randomized studies.

Radiology

Patients undergoing radiation treatment are often affected by fatigue and emotional distress. Hypnosis helps:

  • Montgomery et al (2009) studied 42 breast cancer radiation patients to test whether CBT with hypnosis could affect fatigue. They found that hypnosis had a significant impact on fatigue: fatigue increased in the control group, whereas fatigue in the CBT-hypnosis group did not increase (p<0.05).
  • Schnur et al (2009) studied 40 women undergoing radiation for breast cancer to see if CBT with hypnosis could impact positive and negative affect. They found that CBTH significantly reduced negative affect and increased positive affect.

Survivorship

According to the American Cancer Society, in January 2014 there were 14.5 million cancer survivors in the United States. Many experience impaired quality of life after treatment, including neuropathy and pain, cognitive problems, fatigue, fear of cancer recurrence, hot flashes and sexual dysfunction (American Cancer Society). Hypnosis may help with the after-effects of cancer treatment:

  • Elkins et al (2008) studied 60 women who had been treated for breast cancer to investigate the efficacy of hypnosis to treat hot flashes and other treatment after-effects. They found hypnosis significantly improved hot flashes, anxiety, sleep, and depression, compared to the non-treatment control group.

Advanced/metastatic disease

Metastatic and recurrent diagnoses can be very distressing for cancer patients. Metastatic patients often experience pain and suffering, as well as emotional distress. Hypnosis has had a measurable impact on quality and even quantity of life for these patients:

  • Two studies ― one by Spiegel and Bloom in 1983, and a more recent replication by Butler et al in 2009 ― found that women with metastatic breast cancer who had been randomly assigned to weekly group therapy with hypnosis experienced significantly less pain and suffering and improved mood than no-treatment controls.
  • In 1989, Spiegel et al studied 86 metastatic breast-cancer patients and found hat survival time was significantly longer in the women who were randomly assigned to supportive group therapy with hypnosis (mean of 36.6 months) compared to no-treatment controls (mean of 18.9 months).
  • A replication by Spiegel et al in 2007 found that survival time for metastatic breast cancer patients with ER-positive cancers was not significantly affected by the hypnosis intervention (mean of 32.8 months). However, for ER negative patients, the hypnosis group had a significant longer survival time (mean of 29.8 months) than the non-treatment controls (mean of 9.3 months).

Hypnosis by any other name….

Many people hear the word "hypnosis" and think of people at comedy shows walking like a chicken. There is also often a general unease, as many believe that hypnosis will somehow make them do things they otherwise would not do. Because of this, many practitioners are inclined to use words like "guided imagery" or "relaxation". However, there is some benefit to using the word "hypnosis".

  • Gandhi and Oakley compared the hypnotic suggestibility of patients in two groups receiving the same intervention, but with one group calling it "hypnosis" and the other "relaxation". They found that those in the "hypnosis" group were significantly more suggestible than those in the "relaxation" group. In their meta-analysis of hypnosis to treat distress related to medical procedures, Schnur et al similarly found greater effect sizes for interventions labeled "hypnosis" compared to "relaxation".

Hypnosis delivery: live or recorded?

There is a plethora of guided meditations, guided imagery, and hypnosis on the market, for free or offered at a low cost. While these recordings can be helpful, live hypnosis is better:

  • According to results of a meta-analysis by Montgomery et al (2002), live hypnosis had a large effect size (d=1.40) whereas recorded hypnosis had a moderate effect size (d=.55).
  • In their meta-analysis of hypnosis for distress related to medical procedures, Schnur et al (2008) found that live hypnosis had a large effect size (g=1.22), while recorded hypnosis had a moderate effect size (g=0.19).

Conclusions

Did you make it this far? Congratulations! Treat yourself to a guided meditation. :-) For those who are living with cancer and undergoing cancer treatment, hypnosis can be tremendously helpful to address a wide range of symptoms, from emotional distress to physical pain. Relaxing and opening ourselves up to the mind-body-spirit connection improves quality of life and overall wellbeing. If you want to explore hypnotherapy for cancer patients, contact me.


 

References

Butler LD, Koopman C, Neri E, Giese-Davis J, Palesh O, Thorne-Yocam KA, Dimiceli S, Chen XH, Fobair P, Kraemer HC, Spiegel D (2009). Effects of supportive-expressive group therapy on pain in women with metastatic breast cancer. Health Psychologl.28(5):579-87.

Elkins G, Marcus J, Stearns V, Perfect M, Rajab MH, Ruud C, Palamara L, Keith T (2008). Randomized trial of a hypnosis intervention for treatment of hot flashes among breast cancer survivors. Journal of Clinical Oncoogyl. 26(31):5022-6.

Gandhi B, Oakley DA (2005). Does 'hypnosis' by any other name smell as sweet? The efficacy of 'hypnotic' inductions depends on the label 'hypnosis'. Consciousness and Cognition. 14(2):304-15.

Lang EV, Berbaum KS, Faintuch S, Hatsiopoulou O, Halsey N, Li X, Berbaum ML, Laser E, Baum J (2006). Adjunctive self-hypnotic relaxation for outpatient medical procedures: a prospective randomized trial with women undergoing large core breast biopsy. Pain. 126(1-3):155-64.

Lang EV, Berbaum KS, Pauker SG, Faintuch S, Salazar GM, Lutgendorf S, Laser E, Logan H, Spiegel D. (2008) Beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment: when being nice does not suffice. Journal of Vascular Interventional Radiology. 19(6):897-905.

Montgomery GH, David D, Winkel G, Silverstein JH, Bovbjerg DH (2002). The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis. Anesthesia and Analgesia. 94(6):1639-45

Montgomery GH, Weltz CR, Seltz M, Bovbjerg DH, (2002). Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. International Journal of Clinical Exp Hypnosis. 50(1):17-32.

 Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH (2007). A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. Journal of the National Cancer Institute. 99(17):1304-12.

Montgomery GH, Kangas M, David D, Hallquist MN, Green S, Bovbjerg DH, Schnur JB (2009) Fatigue during breast cancer radiotherapy: an initial randomized study of cognitive-behavioral therapy plus hypnosis.Health Psychology. 28(3):317-22.

Reid WH, Montgomery GH, DuHamel KN (2001) Behavioral intervention for cancer treatment side effects. Journal of the National Cancer Institute. 93(11):810-23.

Richardson J, Smith JE, McCall G, Richardson A, Pilkington K, Kirsch I. (2007). Hypnosis for nausea and vomiting in cancer chemotherapy: a systematic review of the research evidence. European Journal of Cancer Care (Engl). 16(5):402-12.

Schnur JB, Bovbjerg DH, David D, Tatrow K, Goldfarb AB, Silverstein JH, Weltz CR, Montgomery GH, (2008). Hypnosis decreases presurgical distress in excisional breast biopsy patients. Anesthsia and Analgesoa; 106(2):440-4

Schnur JB, Kafer I, Marcus C, Montgomery GH (2008). Hypnosis to manage distress related to medical procedures: a meta-analysis. Contemporary Hypnotherapy. 25(3-4):114-128.

Schnur JB, David D, Kangas M, Green S, Bovbjerg DH, Montgomery GH (2009) A randomized trial of a cognitive-behavioral therapy and hypnosis intervention on positive and negative affect during breast cancer radiotherapy. Journal of Clinical Psychology. 65(4):443-55.

Spiegel D, Bloom JR (1983) Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosomatic Medicine. 45(4):333-9.

Spiegel D, Bloom JR, Kraemer HC, Gottheil E (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 2(8668):888-91.

 


Dealing with Death

Poetry from the Other Side, Dealing with Death.

In the summer of 2015, a client of mine―I'll call her Beth―made her transition out of the body. I had worked with her for a year and a half as she battled a particularly aggressive form of cancer. She and I became close as regular clients and their therapists do. I was sad, but even more so, I was honored to help. It is powerful, coming to terms with and dealing with death. It was an experience I will never forget.

Blocked

A few weeks before she died, I visited Beth in the hospital to do some Reiki healing. (I am a Reiki Master in addition to a regular mental health counselor). A couple of days later, I went back to do another healing session, but this time there were endless interruptions and the healing never got done. When I left her that afternoon, I told her that I would check in and do some distant healing.

I went home with every intention to do distant Reiki, but when I tried to connect, I was "told" that I wasn't allowed to. When we do distant healing, we telepathically or mentally ask for permission. For the first time in my experience,  it was not granted.

Beth and I emailed each other later that week, and she wrote that she was in hospice. I offered to come and visit her and do some more Reiki. In a message on Tuesday, she suggested that maybe I could come on Friday. In the days that followed she was in and out of consciousness. Her husband took over answering her text messages. We never got the visit scheduled for that Friday, so I tried again to do some distant communication and healing. This time, permission granted.

The Healing

When I connected with Beth, the first thing that I saw was an image of her body lifted over itself. And then she and I began to have a conversation. I found myself reassuring her that it was OK for her to go. I was guided to say things that I'd never thought of before, and the words flowed through me.

Beth's biggest problem was her anguish at leaving her teenage daughter. However, I saw and shared that this early death had been known since before her daughter was born. In fact, though not consciously, all of the decisions that they had made as a family were leading to this point and preparing the daughter for success.

When I finished talking I saw my client-friend standing before me, with a blazing sun behind her. She looked radiant and reassured, confident, happy, and powerful. Three days later, she died.

Dealing with Death

I attended her funeral, which was an amazing service filled with reverence and love. Many of the women in attendance were wearing head scarves, and some of them were printed with Beth's poetry. The day was beautiful. Her spirit was surely there, proud to witness the love and devotion of her community.

On the day following her death, another friend of mine was giving a talk on metaphysics and channeling. At the end of her talk, she led our group through a guided meditation in which we connected with a loved one on the other side.

In the exercise, we went up a flight of stairs and down a hallway into a room and sat on a bench. Next to us was a box. We were to open the box and see if it had any contents. Mine contained a scarf printed with Beth's poetry, but I couldn't read the words.

And then Beth was there. I started hurriedly talking to her but then decided to stop and pay attention! Immediately I saw an image of two women walking arm-in-arm down a ballroom floor, dressed in Victorian style clothing. After that I saw an image of a white horse's head with its mane blowing back in the wind. Both images gave me the impression that Beth and I have been friends before – that was the reason we had such an easy rapport and felt so close.

And then Beth read the poem that she had written for me.

True friendship transcends all bounds of time and place.
The seeds of friendship once planted blossom over many lifetimes.
Thank you for being my true friend.

Thank you, my friend. It is an honor to have crossed paths again.


therapy in Bryn Mawr

You Get What You (Think You) Deserve

In my therapy practice in Bryn Mawr, I often help clients resolve issues they have been dealing with for years. The issue may present in different forms, but at its core, it is the same thing, again and again. You get what you (think you) deserve.

Intractable issues?

Typically these intractable issues come in the areas of finance, relationship problems, or weight and other health issues. Even when we know, intellectually, that we should be able to keep our weight in check, or have healthy relationships, or freedom from financial struggle, we often let ourselves down, re-living the same problem again and again. We think we have it mastered, only to see it show up again.

Why? Why, after so much growth and effort, do we face the same stuff again and again? The problem lies deep in the subconscious mind, which is running programming from an earlier time in our lives (or lifetimes). On some level, the problem has become part of our identity; and on a deep level, we think that we deserve it. Consciously we know we deserve to be clear of it, but that doesn’t change the subconscious belief that we do not.

And it isn't simply that the problem is familiar. Usually, on a deep level, we believe that we deserve to have the problem. That's right: If you are struggling with some issue that seems to crop up again and again, chances are good that somewhere deep inside you believe you deserve it. On a deep level, you've bought the lie. The good news is that it is actually simple to find out what this reversal is and then to clear it. When we root out the mistruth we've been subconsciously repeating, the whole system collapses in on itself and we are free. I've seen clients laugh and cry when they release the lie. The world looks different and things fall into place.

And then, it shifts

Once an issue is cleared, it is cleared for good. However, sometimes there are layers upon layers that need to be addressed. Luckily, if a new facet of the issue is presented, it can be cleared in the same way the last one was. My approach combines energy psychology, hypnotherapy, and some neurolinguistic programming to efficiently resolve the issues, in a safe and peaceful way. It is always an honor to do this kind of work and so inspiring to see people make positive changes in their lives. Because they deserve  to!


EFT tapping points

Is tapping really necessary? Here's the deal with EFT tapping.

I have used EFT and other meridian tapping therapies both for myself and with many clients in my therapy practice in Bryn Mawr. I have seen issues―even really tough ones―clear up quickly, almost magically. These results intrigued me, and prompted me to do some research about the field of Energy Psychology; you can read some of it here. People sometimes wonder if tapping meridian points is really a necessary ingredient to EFT's success. One particularly bright and educated client of mine said that he believed it was exposure (the repeated statement of the problem) coupled with a self-soothing technique (tapping) that helped people get clear of their issues. He is a psychologist, so he thinks about these things. The topic has been widely debated, and he is not alone in his suspicions. And the research shows that―he's wrong. Here's the deal with EFT tapping.

EFT researchers have begun conducting "dismantling studies" to separate tapping from the cognitive and exposure portions of the protocol. The first study that attempted to parse out the components of EFT's success were (EFT skeptics) Waite and Holder. In 2003, they conducted a study comparing three tapping conditions (EFT, sham points, and a doll) to a non-tapping condition. However, they mistakenly used EFT points, because they asked participants to with their fingertips, which contain meridian points. Participants in all three tapping groups showed significant improvements; the non-tapping group did not. Waite and Holder concluded that EFT owed its success to distraction and desensitization. But they failed to take the fingertip meridian points into consideration when they reached this conclusion. Perhaps because of this, their study is an outlier when compared to other EFT studies.

In 2013, Louis Fox conducted a study to parse out the components of EFT's success.  He compared EFT to a control group that used the cognitive and exposure portions of EFT with mindful breathing instead of tapping. The group that used EFT tapping points did significantly better than the control group. In 2014, Rachel Rogers and Sharon Sears conducted a similar study but in this case the control group used sham tapping points. Again, the group that used the actual EFT tapping points had significantly better results. The most recent dismantling study was conducted in 2015 by Reynolds, who also compared EFT to a group using sham tapping. And again, the EFT group had better results than the control group. (See this study in the Energy Psychology Journal)

The research bears out again and again what EFT practitioners and enthusiasts have intuited for more than a decade. Tapping meridian points and focusing on the problem is the recipe for success. EFT has helped thousands of people overcome a variety of emotional issues. If you would like to learn more about it, I highly recommend EFT creator Gary Craig's website, along with the Association of Comprehensive Energy Psychology's.