• Think Thin Weight Reduction
• How to reduce and control pain
• Stress Management
• Stop Smoking
• Relax into Healing (living with chronic illness, pain, preparation for surgery and treatments and getting well again)

I am an Advanced Hypnotherapist registered with the General Hypnotherapy Register and Smoking Cessation register. My membership of these professional organisations is up to date and I fully abide by their strict codes of conduct. I offer honest, professional, caring and confidential help with a wide range of challenges.

• Post Traumatic Stress Disorder (PTSD)
• Eating disorders and Weight Reduction
  
• Depression
• IBS
• Cancer
  
• Anxiety Disorders
• Breathing issues including Asthma and COPD
• Panic
• Phobias
• Pregnancy and Childbirth
  
• Dental Fear and Phobias
• Unwanted Habits
• Smoking cessation
• Addictions
• Insomnia and sleep disorders
  
• Pain and Symptom Management
• Preparation for Surgery and getting well again
  

Fed up with yo yo dieting? Ready for something that really works? The Lighten Up Weight Reduction programmes uses a blend of Hypnotherapy, NLP, Motivation and on some programmes, exercise, to help you feel happy with your body. The Mindful Method does not include diets, calorie counting or jumping onto your scales every day, which lets face it doesnt work, if they did everyone would be the size they wanted to be and the diet industry would not exist!  So if dieting isnt the answer what is?

• The Myth of diets and how much do you healthily need to reduce by?
• How to Change YOUR mind to Change YOUR Life using:-
• Hypnotherapy and NLP to re-programme your sub-conscious mind
• Smart Goal setting and rewards
• Checking your motivation and your motives
• Using visualisations to see into your future!
• Body awareness to find out what your body is trying to tell you
• How to breath healthily
• Affirmations - much more than positive thinking!
• Learning to love yourself
• How to overcome emotional eating
• Self-care and making time for relaxation
• Help in finding out your unconscious habits, the holes in your journey to a slimmer, healthier you, and learning how to take action to make lasting changes
• How to take control of cravings
• What´s the best exercise for you? A ballon filled with a kilo of fat is bigger than a ballon filled with a kilo of muscle, you can reduce weight without exercise, but why would you can get that lovely trim figure by burning fat and building muscle? Ironically you might not see such a big reduction on the scales, but you will see it in the mirror and your outline will be bump free!
• Why you need to Lighten Up!

RESEARCH FINDINGS USING GUIDED IMAGERY FOR WEIGHT LOSS AUGUST, 2006

What is overweight and obesity?

Today’s standard for measuring healthy weight is the use of the Body Mass Index, or BMI (weight in kilograms divided by height in meters, squared). People are defined as overweight if their BMI is 25 or more; obesity is defined as having a BMI of 30 or above.

Carrying too much weight is a known risk factor for diabetes, heart disease, stroke, hypertension, gall bladder disease, arthritis, respiratory problems including sleep apnea, and some cancers. Obesity can affect menstruation, stress incontinence, pregnancy, cholesterol levels, and often contributes to psychological conditions such as depression.

Obesity is caused by many factors. Certainly, genetics plays a role, but other major contributors are lifestyle, diet, and psychological factors (depression, anxiety, etc. leading to emotional eating). Additionally, weight gain can be caused by diseases such as hypothyroidism, Cushing’s Syndrome, depression, and neurological problems. Steroids can result in weight gain. In an ironic Catch-22, the antidepressants prescribed for emotional eating can, in themselves, cause weight gain.

Medical treatment of Weight Problems

Pharmacologic treatment of weight problems includes appetite suppressants (Orlistat and Sibutramine) and, often, anti-depressants. Morbid obesity, defined as weighing at least twice ideal weight and when weight interferes with normal physiological functioning, can be treated with gastrointestinal surgery (Bariatric surgery).

Non-pharmacologic treatment including imagery

Behavior modification has traditionally been the first recommendation in weight control: diet, exercise, nutritional education, and other behavior modification techniques. Individual and/or group psychology is often recommended, especially for obesity. Weight loss is often attained; sustained weight loss is usually not.

Mind/body approaches are also being used, often as part of a comprehensive program. Hypnosis has often proven effective in sustained weight loss in a number of studies (Anderson, 1985; Barabasz & Spiegel, 1989; Cochrane & Friesen, 1986; Johnson, 1997), while authors of another study report small, sustained losses only when the hypnosis included stress reduction (Stradling, Roberts, et al, 1998).

Behavior therapy has also been effective, especially when combined with hypnosis (Bolocosky, Spinler & Coulthard-Morris, 1985). Sustained weight loss has been achieved with Cognitive Behavioral Therapy (CBT) (Braet, Tanghe, et al, 2004; Braet, Van Winckel & Van Leeuwen, 1997; Dalle Grave, Todesco, et al, 2004; Dornelas, Wylie-Rosett & Swencionis, 1998; Mellin, Slinkard, & Irwin, 1987; Rapoport, Clark & Wardle, 2000), and its effectiveness has been increased with the addition of hypnosis (Kirsch, 1996).

In one study, adding guided imagery to a general behavior/education weight loss program increased weight loss by a factor of two (Rossman, undated). One group of clinically obese people who used a multi-component program CBT with relaxation, along with nutrition and exercise, achieved long-term weight loss (Golay, Buclin, et al, 2004).

Overweight adolescents often respond to peer pressure as motivation for losing weight. One program, which combined CBT with "peer-enhanced adventure therapy," was four times as successful as a program that combined CBT with exercise alone (Jelalian, Mehlenbeck, et al, 2006).

Guided imagery reduced binge eating by 74% and reduced vomiting by 73% in one group of patients with bulimia nervosa (Esplen, Garfinkle, et al, 1998). CBT has also proven successful in cases of binge eating (Devlin, Goldfein, et al, 2005; Fossati, Amati, et al, 2004; Gluck, Geliebter, et al, 2004; Grilo, Masheb, et al, 2005).

Conclusion

A low-cost imagery intervention may improve not only overweight patients’ weight and lower their anxiety about food, but may mitigate or prevent ancillary diseases, improve patients’ general health, and reduce patients’ utilization of medical services.

REFERENCES
Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB. Annual deaths attributable to obesity in the United States. JAMA. 1999;282(16):1530-1538.
Anderson MS. Hypnotizability as a factor in the hypnotic treatment of obesity. Int J of Clin and Exp Hyp. 1985;33:150-59.
Barabasz M, Spiegel D. Hypnotizability and weight loss in obese subjects. Int J of Eating Disorders. 1989;8(3):335-41.
Bolocosky DN, Spinler D, Coulthard-Morris L. Effectiveness of hypnosis as an adjunct to behavioral weight management. J Clin Psychol. 1985;Jan;41(1):35-41.
Braet C, Tanghe A, Decaluwe V, Moens E, Rosseel Y. Inpatient treatment for children with obesity: weight loss, psychological well-being, and eating behavior. J Pediatr Psychol. 2000;Oct;29(7):519-29.
Braet C, Van Winckel M, Van Leeuwen K. Follow-up results of different treatment programs for obese children. Acta Paediatr. 1997;Apr;86(4):397-402.
Cochrane G, Friesen J. Hypnotherapy in weight loss treatment. J Consult Clin Psycho. 1986;54:489-92.
Curtin C, Bandini LG, Perrin EC, Tybor DJ, Must A. Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review. MBC Pediatr. 2005;Dec 21;5(1):48 [Epub ahead of print].
Curtis, Leslie. Weight-loss Providers Agree to Help Consumers Make Better Choices . NIDDK Summer, 1999.
http://win.niddk.nih.gov/notes/summer99/PG4.html
Accessed August, 2006.
Dalle Grave R, Todesco T, Banderali A, Guardini S. Cognitive-behavioural guided self-help for obesity: a preliminary research. Eat Weight Disord. 2004; Mar;9(1):69-76.
Devlin MJ, Goldfein JA, Petkova E, Jiang H, Raizman PS, Wolk S, Mayer L, Carino J, Bellace D, Kamenetz C, Dobrow I, Walsh BT. Cognitive behavioral therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder. Obes Res. 2005;Jun;13(6):1077-88.
Dornelas EA, Wylie-Rosett J, Swencionis C. The DIET study: long-term outcomes of a cognitive-behavioral weight-control intervention in independent-living elders. Dietary Intervention: Evaluation Technology. J Am Diet Assoc. 1998;Nov;98(11):1276-1281.
Esplen MJ, Garfinkel PE, Olmsted M, Gallop RM, Kennedy S. A randomized controlled trial of guided imagery in bulimia nervosa. Psychol Med 1998 Nov;28(6):1347-57.
Finkelstein EA, Fiebelkorn IC, Wang G. State-level estimates of annual medical expenditures attributable to obesity. Obes Res. 2004;Jan;12(1):18-24.
Fossati M, Amati F, Painot D, Reiner M, Haenni C, Golay A. Cognitive-behavioral therapy with simultaneous nutritional and physical activity education in obese patients with binge eating disorder. Eat Weight Disord. 2004;Jun;9(2):134-8.
Gluck ME, Geliebter A, Lorence M. Cortisol stress response is positively correlated with central obesity in obese women with binge eating disorder (BED) before and after cognitive-behavioral treatment. Ann N Y Acad Sci. 2004; Dec;1032:202-7.
Golay A, Buclin S, Ybarra J, Toti F, Pichard C, Picco N, de Tonnac N, Allaz AF. New interdisciplinary cognitive-behavioural-nutritional approach to obesity treatment: a 5-year follow-up study. Eat Weight Disord. 2004; Mar;9(1):29-34.
Grilo CM, Masheb RM. A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder. Behav Res Ther. 2005; Nov;43(11):1509-25.
Jelalian E, Mehlenbeck R, Lloyd-Richardson EE, Birmaher V, Wing RR. 'Adventure therapy' combined with cognitive-behavioral treatment for overweight adolescents. Int J Obes (Lond). 2006 Jan;30(1):31-9.
Johnson DL. Weight loss for women: studies of smokers and nonsmokers using hypnosis and multicomponent treatments with and without overt aversion. Psychol Rep. 1997; Jun;80(3 Pt 1):931-3.
Kirsch I. Hypnotic enhancement of cognitive-behavioral weight loss treatment – another meta-re-analysis. J Consult Clin Psychol. 1996; June;64(3):517-9.
Mellin LM, Slinkard LA, Irwin CE Jr. Adolescent obesity intervention: validatin of the SHAPEDOWN program. J Am Diet Assoc. 1987; Mar;87(3):333-338.
Rapoport L, Clark M, Wardle J. Evaluation of a modified cognitive-behavioural programme for weight management. Int J Obes Relat Metab Disord. 2000; Dec;24(12):1726-1737.
Rossman, J. Director of Behavioral Medicine at Canyon Ranch. Unpublished study.
Stradling J, Roberts D, Wilson A, Lovelock F. Controlled trial of hypnotherapy for weight loss in patients with obstructive sleep apnoea. International Journal of Obesity and Related Metabolic Disorders. 1998 Mar; 22(3):278-81.
Third National Health & Nutrition Examination Survey (NHANES III) 1999. Centers for Disease Control. National Center for Health Statistics. Hyattsville, MD.
Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes Res. 1998; Mar;6(2):97-106.

We are all unique individuals and it is your Smoking history that will determine the best options for Smoking Cessation, for example if you are a light smoker and want to stop smoking for the first time, a single session of Hypnotherapy may be all you need. If on the other hand, you are a heavy smoker or someone who has tried to stop before, a  more supportive programme will be more appropriate.

The Mindful Coach combination package consist’s of a longer initial consultation and includes:-

• Preparation for your Smoking Cessation D Day 
• An easy to use Brainwave Entrainment Motivation track with affirmations, Cravings buster track and Relaxation session CD
• 2 x Hypnotherapy & NLP sessions, one week apart.
• Email support between appointments 
• The optional of a reduced price Breath Therapy session for those with breathing issues
• Cost 120 euros or 140 euros with the Breath Therapy session.
  

Journal of Experimental Psychology: General, 1977, Vol 106; 1:5-12 as reported in Nutrition News Issue 3 - March 2008 published by Higher Nature.

"Forget all those expensive nicotine replacement gums, patches, inhalators and nasal sprays. The answer to beating that cigarette addiction may be as simple as restoring your body's acid-alkaline balance. Way back in the 1970's the social Psychologist Dr Stanley Schachter, from New York's Columbia University of Psychology, found that people with a more acidic urine smoked considerably more cigarettes than those with a more alkaline urine. He believed that an acidic body flushed nicotine from the body much faster than a body in a normal, healthy alkaline state and that to restore blood and brain levels of nicotine back to their comfort levels smokers will reach for another cigarette to replace the lost nicotine. Too much acidity creates urges, cravings, withdrawal symptoms and negative emotions and Schachter's research, using a few grams of an alkaline mineral to alkalise his subject's urine, revealed that the more alkaline a test subject was, the less that subject felt the urge to smoke. Reducing stress and anxiety, and taking alkalising mineral salts can help restore the body's natural acid-alkaline balance and help fight those cravings"

RESEARCH FINDINGS USING GUIDED IMAGERY FOR STOPPING SMOKING July, 2006

SCOPE AND DIMENSIONS OF THE PROBLEM

According to the Centers for Disease Control, cigarette smoking is the largest preventable cause of illness, death, and medical expenditures in the U.S.A. In 1993, direct medical costs associated with smoking totaled an estimated $50 billion, and smoking was responsible for approximately 7 percent of total U.S. health care costs (CDC, 1994).

This $50 billion figure is highly conservative. Many factors were not included in the total medical costs: smoking-related burns from fires; perinatal care for low birth weight infants whose mothers smoked; and the costs of treating diseases in others caused by secondhand smoke.

Also not included were the indirect costs of lost productivity and early death (CDC, 1994). A more recent study found that annual smoking-related medical expenditures for California alone reached $72.7 billion in 1997, about 11% of total health care costs (Miller, Zhang et al, 1998).

The CDC estimates that 44.5 million adults in the United States smoke cigarettes, resulting in death or disability for half of all regular users. Cigarette smoking is responsible for more than 440,000 deaths each year, or one in every five deaths; counting direct and indirect costs, smoking related illness costs the nation more than $167 billion each year (NCCDPHP, 2006).

It is estimated that Medicare will spend $800 billion over the next 20 years caring for people with smoking-related illnesses (Rodgers, 1997).

Effectiveness and Cost-effectiveness of Smoking Cessation Programs

Smoking-related illness consumes so many health resources that smoking cessation has been called the “gold standard” of medical cost-effectiveness (Warner, 1997). His report from the University of Michigan School of Public Health found that: “A considered review of the evidence recommends support of all of the major forms of smoking-cessation intervention; even the most expensive are highly cost effective compared with all medical treatments studied.”

For example, a simple instruction from a physician to stop smoking resulted in a 2% quit rate one year later, an effect study authors called “modest but highly cost effective. It cost $1500 to save one life (Law, Tang, 1995).” As interventions become more intensive, costs go up. However, even modestly effective programs will save far more than they cost (Westmaas, Nath & Brandon, 2000).

Issues in Smoking Cessation

While it is typical for stop-smoking programs to achieve short-term success rates of 50-60%, the rate of relapse is often 60-80% in the year following the program (Wynd, 1992a). Most widely-used programs have long-term success rates under 35% (Colletti, Supnick & Rizzo, 1982; Hensel, Cavanagh et al, 1995).

Non-drug programs include psychotherapy, behavioral therapy, providing information, support groups, hypnosis, telephone monitoring, and rapid-smoking. The most commonly used medication is nicotine, given as a patch or in chewing gum. The prescription drugs bupropion and fluoxetine are also used. All these treatments have similar long-term success rates, varying from 15-32% in different studies (Sykes & Marks , 2001; West, McNeill & Raw, 2000).

Combining nicotine replacement and/or bupropion with behavioral therapy and psychological support has consistently shown itself more effective than a single treatment alone, with 35% or more of patients remaining smoke-free for a year (McGhan & Smith, 1996).

A recent study combined CBT with community reinforcement and naltrexone to achieve an abstinence rate of 43% at three-month follow-up (Roosen, Van Beers et al, 2006). In two other studies, 58.5% of those using behavior therapy and nicotine patches were abstinent at five years (Garcia Vera, 2004), while 80% of those in a multicomponent CBT program that also incorporated relaxation training and imagery rehearsal changed their behavior (30% has reduced their cigarette consumption; 50% were abstinent) (Huang, 2005).

Imagery and self-hypnosis in smoking cessation

In two studies, groups who used guided imagery to relax and gain a sense of personal power had much higher 3-month abstinence rates than a control group which received only counseling (Wynd, 1992a; Wynd, 1992b. Smokers who practiced imagery at home and continued practicing after the training program ended had abstinence rates over 52% at three months (Wynd, a). In a 2005 study of guided imagery, smokers using an audio-taped imagery program had twice the abstinence rates as the control group (25% versus 12%) at 24-month follow-up (Wynd, 1995).

Using self-hypnosis even once resulted in 22% of 226 patients remaining smoke-free after two years. Similar success rates also occurred in a group single-session hypnosis program (Ahijevych, Yerardi, et al, 2000). While the results are modest, it is better than trying to quit without any help (Spiegel, Frischholtz et al, 1993). However, hypnosis, which incorporates relaxation, imagery and positive suggestion, has been reported to have a success rate as high at 90% (Klager, 2004).

A clinical hypnosis study at the College of Medicine at Texas A&M University had an 81% success rate in the three-session hypnosis group, with a 48% success rate at 12 months post-treatment (Elkins & Rajab, 2004). Thus, imagery and self-hypnosis have been as effective as other behavioral and psychological approaches. The techniques were even more effective in patients who found them pleasant.

Conclusion

A low-cost, guided imagery based, self-care program is likely to be at least as effective as other behavioral or psychological treatments. It should help at least 20-32% of users stop smoking in the long term. The results may be even better if nicotine replacement is used at the same time. The benefits of smoking cessation in terms of patient outcomes and lower need of medical services make this program highly cost-effective.

References

Ahijevych K, Yerardi R, Nedilsky N. Descriptive outcomes of the American Lung Association of Ohio hypnotherapy smoking cessation program. International Journal of Clinical and Experimental Hypnosis. 2000 Oct; 48 (4):374-87.
Centers for Disease Control and Prevention (CDC). Medical-Care Expenditures Attributable to Cigarette Smoking -- United States, 1993. MMWR Morb Mortal Wkly Rep. 1994 43(26);469-472 July 08.
Colletti G, Supnick JA, Rizzo AA. Long-term follow-up (3-4 years) of treatment for smoking reduction. Addict Behav. 1982;7(4):429-33.
Elkins GR, Rajab MH. Clinical hypnosis for smoking cessation: preliminary results of a three-session intervention. Int J Clin Exp Hypn. 2004 Jan;52(1):73-81.
Garcia Vera MP. Clinical utility of the combination of cognitive-behavioral techniques with nicotine patches as a smoking-cessation treatment: five-year results of the "Ex-Moker" program. J Subst Abuse Treat. 2004 Dec;27(4):325-33.
Hensel MR, Cavanagh T, Lanier AP, Gleason T, Bouwens B, Tanttila H, Reimer A, Dinwiddie RL, Hayes JC. Quit rates at one year follow-up of Alaska Native Medical Center Tobacco Cessation Program. Alaska Med. 1995 Apr-Jun;37(2):43-7.
Huang CL. Evaluating the program of a smoking cessation support group for adult smokers: a longitudinal pilot study. J Nurs Res. 2005 Sep;13(3):197-205.
Klager R. [Smoking cessation. With hypnosis success in over 90%] [Article in German] MMW Fortschr Med. 2004 May 13;146(20):16.
Law M, Tang JL. An analysis of the effectiveness of interventions intended to help people stop smoking. Arch Intern Med. 1995 Oct 9;155(18):1933-41.
McGhan, W.F, Smith MD. Pharmacoeconomic analysis of smoking-cessation interventions. Am J Health Syst Pharm. 1996 Jan 1;53(1):45-52.
Miller L, Zhang X, Rice D, Max W.  State Estimates of Total Expenditures Attributable to Cigarette Smoking, 1993. Public Health Reports 1998 113: 447-458. Quoted on:
www.berkeley.edu/news/berkeleyan/1998/0916/smoking.html.
Accessed June, 2006.
Rodgers K. The hazards of secondhand smoke. Business & Health Special Report. Vol. 15, No. 8, summer, 1997, p. 6.
Roozen HG, Van Beers SE, Weevers HJ, Breteler MH, Willemsen MC, Postmus PE, Kerkhof AJ. Effects on smoking cessation: naltrexone combined with a cognitive behavioral treatment based on the community reinforcement approach. Subst Use Misuse. 2006;41(1):45-60.
Sykes CM, Marks DF. Effectiveness of a cognitive behaviour therapy self-help programme for smokers in London, UK. Health Promot Int. 2001 Sep;16(3):255-60.
Spiegel D, Frischholz EJ, Fleiss JL, Spiegel H. Predictors of smoking abstinence following a single-session restructuring intervention with self-hypnosis. Am J Psychiatry. 1993 Jul;150(7):1090-7.
Targeting Tobacco Use: The Nation's Leading Cause of Death. At a Glance 2006. National Center for Chronic Disease Prevention and Health Promotion. http://www.cdc.gov/nccdphp/aag/aag_osh.htm
Accessed June, 2006.
Warner KE. Cost effectiveness of smoking-cessation therapies. Interpretation of the evidence-and implications for coverage. Pharmacoeconomics. 1997 Jun;11(6):538-49.
West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax. 2000 Dec;55(12):987-99.
Westmaas JL, Nath V, Brandon TH. Contemporary smoking cessation. Cancer Control. 2000 Jan-Feb;7(1):56-62.
Wynd, CA. Relaxation imagery used for stress reduction in the prevention of smoking relapse. J Adv Nurs. 1992a Mar;17(3):294-302.
Wynd CA. Personal power imagery and relaxation techniques used in smoking cessation programs. Am J Health Promot. 1992b Jan-Feb;6(3):184-9.
Wynd CA. Guided health imagery for smoking cessation and long-term abstinence. J Nurs Scholarsh. 2005;37(3):245-50.

I have also included some recent research on the use of Guided Imagery for Medical and Dental therapy which I hope may be of interest to you.

Please also note that I do not offer any type of diagnosis, rather the techniques and therapies on offer should be seen as complimentary (not alternative) to the services offered by your Doctor or Medical Practitioner.

Dental fears and phobias come in all shapes and sizes, from fear of needles, the sound of the drill and gagging to name just a few. In extreme cases these problems lead to not being able to go to the Dentist for treatment when you need it. Help is at hand and during your initial consultation we will explore your problems and your session will be tailored to meet your needs. Sound Therapy Relaxation CD´s will be available shortly, to help you prepare for, and relax during treatments. Please ask for details.

Can Imagery and Brainwave Entrainment Help Me?

Guided Imagery and Brainwave Entrainment have powerful physiological consequences and also conveys important and otherwise inaccessible information from the sub-conscious mind. There are virtually no limits to the number of situations where it can be used to enhance Health and Well-being.

There are 3 main areas: -

• Relaxation and stress reduction, which is easy to learn
• Active Visualisation, or Guided Imagery, where you follow the spoken word of the Therapist either during your Therapy session or on a CD. During this type of session you are encouraged to imagine desired therapeutic outcomes while in a relaxed, open state of mind. This technique cannot be under estimated in allowing you to become an active part of your own healing,  which is of significant value by itself.
  
• Brainwave Entrainment with or without Affirmations can be used to alleviate symptoms, stimulate healing responses in the body, enhance learning, modify health endangering behaviors, and provide effective motivation for making positive life changes.

The Clinical applications of Guided Imagery and Brainwave Entrainment are tremendously broad, and include, but are not limited to: 

• Acute and chronic pain relief
• Addictions
• Anxiety, phobias, and panic disorders
  
• Cravings
• Cancer treatment and life-threatening illness 
• Depression 
• Fertility, birthing, and delivery 
• Grief therapy
• IBS
  
• Immune enhancement
• Managing chronic illness 
• Mind/body issues
• Motivation
  
• Post-traumatic stress disorders
• Pregnancy, Childbirth and beyond
  
• Preparation for surgery and medical procedures
• Relaxation training including activating your Relaxation Response
  
• Sleep disorders
• Smoking cessation
• Sports Performance enhancement
• Stress reduction and management
• Terminal illness and end of life care
• Weight Reduction

What is Imagery?

A mental image can be defined as a thought with sensory qualities. It is something we mentally see, hear, taste, smell, touch, or feel. Brainnwave Entrainment enhances our ability to work with our thoughts both in our conscious and those that are deep within our sub-conscious minds.

The term “Guided Imagery” refers to a wide variety of techniques, including simple visualisation and direct suggestion using imagery, metaphor and story-telling, fantasy exploration and active imagination where elements of the sub-conscious are invited to appear as images that can communicate with the conscious mind.

Once considered an “alternative” “or complementary” approach, Guided Imagery is now finding widespread scientific and public acceptance, and it is being used to teach relaxation, alleviate anxiety and depression, relieve physical and psychological symptoms, overcome health-endangering habits, resolve conflicts, and help patients prepare for surgery and tolerate procedures more comfortably. They allow you to tap into the natural healing capacities of your mind and body. Specifically they will help you: -

• Improve your overall health, well-being and vitality.
• Develope new positive attitudes and behaviours
• Be an active participant in your own healing
• Break old, harmful habits
• Get motivated and more importantly, stay motivated!
  

Mental images, formed long before we learn to understand and use words, lie at the core of who we think we are, what we believe the world is like, what we feel we deserve, what we think will happen to us, and how motivated we are to take care of ourselves. These images strongly influence our beliefs and attitudes about how we fall ill, and what will help us to get better.

Guided Imagery can be considered one of the oldest and most ubiquitous forms of medicine and while we may attribute these therapeutic benefits to ‘placebo effects’, they have real and measurable effects with important implications for our understanding of the healing process.

In the early 1970s, inspired by the pioneering work of Irving Oyle, Carl and Stephanie Simonton, Robert Assagioli and others, Drs. David Bresler and Martin Rossman began to develop and research contemporary imagery approaches for patients coping with chronic pain, immune dysfunction, cancer, heart disease, and other catastrophic and life-threatening illnesses. Their work continues today, and there is now over 35 years of scientific research and clinical practice, that has proven the effectiveness of the techniques. T

Although no one really knows what “consciousness” is, you could think of it as being related to the process of attention, for what we attend to and focus on is what we experience. There is an old saying that “whatever you give your attention to grows,” whether it’s your garden, your children, or your worries and fears. You are only really and truely alive in the present moment, the past is only alive in your memories and the future is the future, something that does not yet exist.

Over the years, most of us learn to give our major attention to the conscious mind and the chatter of its little voice that never ceases to call for our attention. We quickly become lost in our thoughts, forgetting that any other parts of us exist.

However, we are much more than are conscious mind and what it thinks. We are also characterized by the richness of our sub-conscious mind and its intuitions, emotions, feelings, memories, drives, motives, goals, appetites, aspirations, ambitions, values, beliefs, attitudes, and perceptions, all of which are expressed more fully by our imagery experiences than by conscious verbal awareness. Yet, in our Western culture, we tend to pay much less attention to these images and the feelings they convey than we do to the “little voice” of our conscious mind. Eckhart Tolle in his book Realizing the Power of Now, tell us "Be at least as interested in what goes on inside you as what happens outside. If you get the inside right, the outside will fall into place"

What happens during a Guided Imagery or Brainwave Entrainment session

Imagery has profound physiological consequences, and the body tends to respond to imagery as it would to a genuine external experience. You may not know it, but the mind cannot tell the difference between what is real, and what is imagined! For example, if you vividly imagine slowly sucking on the sour, tart slice of a fresh, juicy lemon, you will soon begin to salivate. Another example is sexual fantasy or reading a racy paragraph in a book, your body will respond accordingly! 

Guided Imagery and Brainwave Entrainment has been shown to affect almost all major physiologic systems of the body, including respiration, heart rate, blood pressure, metabolic rates in cells, gastrointestinal mobility and secretion, sexual function, cortisol levels, blood lipids, and even immune responsiveness. For example, if you suffer from depression, a Brainwave Entrainment session can help re-balance your brain chemicals and enhance the production of Seratonin to help lift your depression.

Many people think reading a book or watching an action film on the TV is relaxing, but now you know that your brain doesnt know the difference between the real and imagined perhaps you should rethink your relaxtion activities! On the other hand, if you are currently unable to get out of bed and go out into the fresh air, listening to a Relaxation CD with Guided Imagery of a walk by the sea or in the mountains will leave you relaxed and refreshed.

With respect to producing specific physiological changes that can promote healing, Guided Imagery and Brainwave Entrainment represents important enhancement to traditional Medical care, working alongside your Doctor or Specialist to improve and enhance your overall health, well-being and vitality.

For further information, and to see how the Mindful Coach can help your situation, please call to arrange your FREE initial consultation.

Getting a cancer diagnosis can be a very frightening experience, especially when  you are living abroad, away from many of your friends and family. However, there is much you can do to become an active part in your own healing and improve your quality of life.

Positive Mental Guided Imagery, Brainwave Entrainment, Binaural Beats, Affirmations and Visualisation techniques help prepare for and enhance treatment, achieve relaxation and boost your immune system which in turn aid the fight against cancer and help the healing process. Many of these techniques can also help the people that support you, so should you wish, your partner/carer is welcome to join you at your private sessions at no extra charge.

Professional, friendly and caring help and support is only a phone call away, please ring to arrange your FREE initial consultation to discuss how I can best support you. If you are unable to travel to Altea la Vieja, some therapies can be carried out via the Telephone or VoIP or depending on where you live, I may be able to travel to you.

Hypnotherapy and Self Hypnosis can reduce the negative impact that living with chronic pain can have on a persons life. It alleviates feelings of anxiety, sadness, anger, frustration and fear by targeting negative thoughts and feelings related to the pain. Self Hypnosis is also used widely to help both with the preparation for birth, the birth itself, recovery and breast feeding.

RESEARCH FINDINGS USING GUIDED IMAGERY FOR CANCER PAIN July, 2006

Definition and Scope of the Problem of Cancer Pain

Pain is among the most common and most feared symptoms of cancer. According to the Cancer Information Network, between 30%-50% of cancer patients experience pain, and approximately 70% experience severe pain at some point during the course of their disease (2006).

National costs of cancer pain management are difficult to estimate. However, in 1990, a single hospital, City of Hope, estimated their costs for hospitalizations for uncontrolled cancer pain at over $5 million. This cost would have risen to $9 million if their patients receiving home parenteral infusions of morphine had been in-patients (Ferrell & Griffith, 1994).

Medical Treatment of Cancer Pain

Various types of drugs are used to control cancer pain: non-steroidal anti-inflammatories (NSAIDS), COX-2 inhibitors, and opioids (such as morphine or Demerol). Non-pain medications can also help: drugs to relieve cramps, stabilize the heart rhythm, seizure medications, sleep aids, and drugs to relieve depression and anxiety. Used correctly, these medications can completely control pain in over 50% of cases, according to cancer specialist Daniel Brookoff, MD (2001a).

For pain that doesn’t respond to oral medications, opiates can be given intravenously (I.V.s) or directly into the spinal canal. In even more severe cases, surgery and radiation are sometimes used effectively. Use of a TENS (Transcutaneous Electrical Nerve Stimulation) device sometimes helps.

Pain specialists estimate that pain could be effectively controlled in nearly all cancers (Brookoff, 2001a). Failure to adequately treat cancer pain can lower quality of life and lead to unnecessary hospital stays. The indirect costs in lost productivity and missed work for patients and caregivers are unknown but must be substantial, as is the burden of unrelieved suffering.

Problems in Cancer Pain Treatment

Some physicians are not adequately informed about the value of non-narcotic medications, particularly anti-depressants (Brookoff, 2001a). Likewise, many patients do not request or use available medications. They may avoid anti-depressants and take less of their narcotics because they are afraid of addiction (Brookoff, 2001b). Depression, insomnia and stress can greatly increase the perception of pain and suffering (Cicala, 2001).

Non-medical Treatments Including Guided Imagery

Various complementary therapies have been found successful to varying degrees in cancer pain. These include acupuncture (Johnstone, Polston et al, 2002), hypnosis (Levitan, 1992; Vickers & Vassileth, 2001), and guided imagery (Syrjala, Cummings & Donaldson, 1992; Syrjala, Donaldson et al, 1995).

Two studies at the Fred Hutchinson Cancer Center demonstrated significant relief of cancer pain with relaxation and self-hypnosis consisting of relaxation and guided imagery (Syrjala, Cummings & Donaldson, 1992; Syrjala, Donaldson et al, 1995).

Researchers at Sloan-Kettering Memorial Cancer Center reported that “randomized trials support the value of hypnosis for cancer pain and nausea; relaxation therapy, music therapy, and massage for anxiety. Such complementary therapies are increasingly provided at mainstream cancer centres” (Vickers & Cassileth, 2001). A University of Minnesota researcher reported significant pain relief from a hypnosis technique called glove anesthesia (Levitan, 1992).

Self-hypnosis, relaxation, and meditation have been significantly effective in many types of pain, including cancer (Sloman, Brown et al, 1994; Sellick & Zaza, 1998). Kabat-Zinn and others reported dramatic improvement in the chronic pain in a group of 90 patients who participated in a 10-week meditation program (Kabat-Zinn, Lipworth & Burney, 1985). These patients had increased comfort and less psychological distress. In some cases, they were able to use less medication. Other researchers’ patients achieved profound relief of arthritis pain with self-hypnosis (guided imagery) (Carni & Gilbert, 1982).

Despite studies that confirm that mind-body approaches such as guided imagery, hypnosis, and relaxation have direct physiological effects in stress levels, the immune system, and pain management (Bakke, Purtzer & Newton, 2002; Gruzelier, 2002), many times, doctors aren’t the first ones to suggest alternative pain approaches. One doctor at the Eastern Virginia School of Medicine found that many cancer patients come to that clinic familiar with hypnosis and request it for their pain (Lynch, 1999).

In a 2003 review of the literature, the authors reviewed complementary and alternative medicine (CAM) use in end-of-life issues such as pain. They found that self-hypnosis was one of the techniques that may provide relief in cancer pain, and that relaxation and imagery specifically could help with the pain of mouth sores (oral musositis) (Pan, Morrison et al, 2000).

Authors of a 2004 review reported evidence of efficacy for hypnosis in cancer pain (Shukla & Pal, 2004). The authors of two dissertations on the effects of guided imagery reported that patients had less anxiety and depression (Caruso, 1999; Henge, 1999). A 2005 review confirmed the efficacy of mind-body techniques for in treating cancer pain, as well as for other anxiety and mood disturbances that are common in oncology patients (Deng & Cassileth, 2005)

Conclusion

When used along with prescribed medications, guided imagery can contribute to controlling pain and anxiety in cancer patients. In some cases, guided imagery can allow reduction of medication usage.

References
Bakke AC, Purtzer MZ, Newton P. The effect of hypnotic-guided imagery on psychological well-being and immune function in patients with prior breast cancer. J Psychosom Res. 2002 Dec;53(6):1131-7.
Brookoff D. (2001a). “Other Medications Used to Treat Cancer Pain,” in The Cancer Pain Sourcebook, R. Cicala, ed. Contemporary Books: Lincolnwood, IL. p.103-125.
Brookoff D. (2001b) “Opioid (Narcotic) Pain Medications,” in The Cancer Pain Sourcebook, R. Cicala, ed. Contemporary Books: Lincolnwood, IL. p. 77-78.
Cancer Information Network.
http://www.cancerlinksusa.com/therapy/cancerpain.asp
Accessed July, 2006.
Caruso P. A comparison of guided imagery techniques with chemotherapy patients. Doctoral Dissertation, California School of Professional Psychology, Alameda, California. 1999.
Cicala R. (2001). “Introduction to Cancer Pain” in The Cancer Pain Sourcebook. R. Cicala, ed. Contemporary Books: Lincolnwood, IL p. 51-74.
Deng G, Cassileth BR. Integrative Oncology: Complementary Therapies for Pain, Anxiety, and Mood Disturbance. CA Cancer J Clin. 2005; 55:109-116.
Devine EC. Meta-analysis of the effect of psychoeducational interventions on pain in adults with cancer. Oncol Nurs Forum. 2003 Jan-Feb;30(1):75-89.
Ferrell BR, Griffith H. Cost issues related to pain management: report from the cancer pain panel of the agency for health care policy and research. J Pain Symptom Manage. 1994 9:221-234.
Gruzelier JH. A review of the impact of hypnosis, relaxation, guided imagery and individual differences on aspects of immunity and health. Stress. 2002 Jun;5(2):147-63.
Helge TD. A comparison of three audio guided imagery tapes on the self efficacy of cancer chemotherapy patients. Doctoral Dissertation, California School of Professional Psychology, Alameda, California. 1999.
Johnstone PA, Polston GR, Niemtzow RC, Martin PJ. Integration of acupuncture into the oncology clinic. Palliat Med. 2002 May;16(3):235-9.
Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine. 1985 June; 8(2):163-90.
Levitan AA. The use of hypnosis with cancer patients. Psychiatr Medicine.1992 10(1):119-31.
Lynch DF Jr. Empowering the patient: hypnosis in the management of cancer, surgical disease and chronic pain. Am J Clin Hypn. 1999 Oct;42(2):122-30.
Pan CX, Morrison RS, Ness J, Fugh-Berman A, Leipzig RM. Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life. A systematic review. J Pain Symptom Manage. 2000 Nov;20(5):374-87.
Sellick SM, Zaza C. Critical review of 5 nonpharmacologic strategies for managing cancer pain. Cancer Prev Control. 1998; 2: 7-14.
Shulka Y, Pal SK. Complementary and alternative cancer therapies: past, present and the future scenario. Asian Pac J Cancer Prev. 2004 Jan-Mar;5(1):3-14.

Sloman R, Brown P, Aldana E, Chee E. The use of relaxation for the promotion of comfort and pain relief in persons with advanced cancer. Contemp Nurse. 1991; 3: 6-12.
Syrjala KL, Cummings C, Donaldson GW. Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: a controlled clinical trial. Pain. 1992 Feb;48(2):137-46. Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain. 1995 Nov; 63 (2):189-98.
Varni JW, Gilbert A. Self-regulation of chronic arthritic pain and long-term analgesic dependence in a haemophiliac. Rheumatol Rehabil 1982 Aug;21(3):171-4.
Vickers AJ, Cassileth BR. Unconventional therapies for cancer and cancer-related symptoms. Lancet Onco. 2001 Apr;2(4):226-32.

RESEARCH FINDINGS USING GUIDED IMAGERY FOR CHILDBIRTH July, 2006

The value of childbirth preparation

Many of the mothers involved are looking for ways to participate more actively in preparation for delivery and in the process of labor, and to avoid “medicalized” births.

A search for books on “natural childbirth” on Amazon.com, conducted on June 29, 2006, yielded 431 titles, up from 309 titles just three years earlier. Another indicator of this trend is the rise in the use of midwives, which rose from 0.9% in 1975 to nearly 8% of vaginal deliveries in 2001 (Martin and Hamilton, 2005). A recent survey of nurse midwives revealed that 48.8% of CNM’S recommend mind-body techniques for the birthing process (Gentz, 2001).

Although the programs of Lamaze and Dick-Read are the most widely used forms of childbirth preparation in this country, psychological and educational preparation with self-hypnosis and guided imagery have proven effective in several studies (Harmon, Hynan & Tyre, 1990; Martin, Schauble, et al, 2001; Oster 1994; Schauble, Werner, et al, 1998).

Self-hypnosis and guided imagery – the terms are used interchangeably in the literature – combinee deep relaxation with positive suggestion for a normal, comfortable birth. Relaxation and breathing techniques can also reduce anxiety in laboring women (Almeida and de Sousa, 2005).

In one study, a group of 22 women who learned self-hypnosis in a four-session program had shorter hospital stays and fewer surgical interventions than a matched control group who received psychosocial counseling sessions (Martin, Schuable, et al, 2001). Harmon, Hynan, and Tyre (1990) studied 60 pregnant women, half of whom received hypnotic suggestions for an enjoyable childbirth, deep relaxation, and glove anesthesia. The treatment group had quicker progress through Stage 1 of labor, less reported pain, less use of medication, and their babies had higher Apgar scores at 1 and 5 minutes.

Imagery and self-hypnosis have also demonstrated effectiveness in reducing complications of pregnancy (Mehl, 1994; Torem, 1994). For example, Mehl used guided imagery with 100 women whose babies were in breech positions at 37 to 40 weeks' gestation. He compared them with a matched comparison group. In the hypnosis group, 81% of the babies spontaneously "turned" to the proper position, compared with 48% of the comparison group.

Mind-body techniques can also be used for reducing women’s anxiety and stress during pregnancy; these techniques are effective across cultural lines, as well, as illustrated by a 2006 study, where Iranian women using relaxation techniques had significantly reduced low-weight births, cesarean sections, and/or instrumental extractions (Bastani F, Hidarnia, et al, 2006).

Gentz, in her 2001 review of the literature, concluded that hypnosis is “a helpful adjunct” for women during the birthing process.

Authors of a 2003 review found that women using hypnosis were more satisfied with the management of their labor pain when compared with women using other forms of alternative and complementary methods of pain management (Smith, Collins, et al, 2003). More recently, authors of a 2004 review reported that women using hypnosis needed less analgesia and rated their pain as less severe than those in the non-hypnosis groups (Cyna, McAuliffe & Andrew, 2004).

Guided imagery with relaxation has also been used effectively in improving post-partum anxiety, depression, and self-esteem (Rees, 1995). 

Conclusion

Guided imagery can increase women’s feelings of control and confidence in the labor process, significantly reduce their perception of pain, help them handle complications that might arise, and reduce costs by shortening hospital stays and lowering the frequency of surgical interventions.

REFERENCES

Almeida NA, de Sousa JT, Bachion MM, Silveira Nde A. [The use of respiration and relaxation techniques for pain and anxiety relief in the parturition process] [Article in Portuguese] Rev Lat Am Enfermagem. 2005 Jan-Feb;13(1):52-8. Epub 2005 Mar 3.
Bastani F, Hidarnia A, Montgomery KS, Aguilar-Vafaei ME, Kazemnejad A. Does relaxation education in anxious primigravid Iranian women influence adverse pregnancy outcomes?: a randomized controlled trial. J Perinat Neonatal Nurs. 2006 Apr-Jun;20(2):138-46.
Cyna AM, McAuliffe GI, Andrew MI. Hypnosis for pain relief in labour and childbirth: a systematic review. Br J Anaesth. 2004. Oct;93(4):505-11. Epub 2004 Jul 26.
Gentz BA. Alternative therapies for the management of pain in labor and delivery. Clin Obstet Gynecol. 2001 Dec;44(4):704-32.
Goldstein J. C-sections: Why are so many South Florida babies born this way. Miami Herald, 2005 Nov. 29. Pg. 10E.
Hamilton BE, Ventura SJ, Martin JA, Sutton PD. Preliminary Births for 2004: Infant and Maternal Health. Health E-Stats. National Center for Health Statistics. 2005.
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelim_births/prelim_births04.htm
Accessed June, 2006.
Harmon TM, Hynan MT, Tyre TE. Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education. J Consult Clin Psychol. 1990 58:525-30.
Martin JA, Hamilton BE, Sutton PD, et al. Births: Final data for 2003. National vital statistics reports; vol 54 no 2. Hyattsville, MD: National Center for Health Statistics. 2005. http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_02.pdf
Accessed June, 2006
Martin, AA, Schauble PG, Rai SH, Curry RW Jr. The Effects of Hypnosis on the Labor Processes and Birth Outcomes of Pregnant Adolescents. The Journal of Family Practice. 2001 May Vol. 50, No. 5.
Mehl LE. Hypnosis and conversion of the breech to the vertex presentation. Arch Fam Med. 1994 3:881-87.
Oster MI. Psychological preparation for labor and delivery using hypnosis. Am J Clin Hypnosi. 1994 37:12-21.
Rees BL. Effect of relaxation with guided imagery on anxiety, depression, and self-esteem in primiparas. J Holist Nurs. 1995 Sep;13(3):255-67.
Schauble PG, Werner WEF, Rai SH, Martin A. Childbirth preparation through hypnosis: the hypnoreflexogenous protocol. Am J Clin Hypnosis. 1998 40:273-83.
Sachs BP, Kobelin C, Castro M A, Frigoletto F. The Risks of Lowering the Cesarean-Delivery Rate. N Engl J Med. 1999 Jan. 7; 340:54-57.
Smith CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev. 2003;(2):CD003521.
Torem MS. Hypnotherapeutic techniques in the treatment of hyperemesis gravidarum. Am J Clin Hypnosis. 1994 37:1-11.
World Health Organization. Joint Interregional Conference on Appropriate Technology for Birth. Apr,1985. Qtd on Choices in Childbirth. http://www.choicesinchildbirth.org/who.htm
Accessed June, 2006.

RESEARCH FINDINGS USING GUIDED IMAGERY FOR DENTAL PROCEDURES July, 2006

RESEARCH FINDINGS USING GUIDED IMAGERY FOR CORONARY HEART DISEASE July, 2006

Definition of the Problem

Coronary heart disease (CHD) results when deposits called plaques build up in arteries. This leads to atherosclerosis, a condition that reduces blood flow and oxygen. CHD, also called coronary artery disease (CAD), develops over time, and leads to partial or complete blockage of the arteries involved. One major cause of atherosclerosis is having high lipids (fats) such as cholesterol and triglycerides in the blood. Other major causes are hypertension, and smoking. Stress, obesity, and a sedentary lifestyle also contribute to the development of CHD. Other risk factors are heredity, race, age, diabetes, depression, low socioeconomic status, social isolation, and male gender.

CHD can be “silent,” producing no symptoms, or patients can experience shortness of breath, dizziness, chest pain (angina), or a heart attack.

Medical Treatment

Treatment for CHD depends on many factors, including the severity of the disease and any comorbid conditions. Frequent treatments include aspirin, beta-blockers, nitrates, lipid-lowering medications, and ACE inhibitors. Surgical procedures include coronary artery bypass, and angioplasty. Recommended lifestyle changes include quitting smoking, maintaining correct weight, regular exercise, and following a diet low in fat and cholesterol (Bass, 2001).5

Lifestyle Changes, Emotions, and Well-Being

A landmark 1998 study by Dean Ornish and associates demonstrated that lifestyle changes (diet, exercise, relaxation, and social support) can dramatically reverse CHD (Ornish, Scherwitz, et al, 1998).6 Other studies have shown that emotions play a major role in CHD. Fear, grief, and anxiety can trigger cardiac events (Ornish, 1998; Verrier and Mittleman, 1997; Williams, Kiecolt-Glaser, et al, 1999).7-9 Anger can be a trigger (Boltwood, Taylor, et al, 1993; Ironson, Taylor, et al, 1993; Verrier, Hagestad and Lown, 1987; Verrier, Mittelman, et al, 1995)7,10-13, and depression can affect the outcome of long-term survival (Barefoot, Brummett, et al, 2000).14 The role of stress in the development and progression of CHD both in men and women is also well documented (Allison, Williams, et al, 1995; Bairey, Krantz and Rozanski, 1990; Nordstrom, Kwyer, et al, 2001; Orth-Gomer, Wamala, et al, 2000; Sheps, McMahn, et al, 2002).15-19

Mind-Body Approaches Including Guided Imagery

Relaxation, and guided imagery, and other mind-body intervensions can reduce the impact of CHD both psychologically and physiologicallyin several ways.

Anger and other possibly harmful emotional states are reduced by the inner-focused, relaxed state induced by guided imagery and other mind-body modalities. Additionally, a sense of emotional well-being can be improved by the use of these therapies. Guided imagery and relaxation can reduce stress, and lower heart rate and blood pressure Hermann, 2002; .20-23 (Crowther, 1983; Hermann, 2002; Pender, 1985; Sharpley, 1994; Taylor, Farquhar, et al, 1977). Meditation produces similar physiological results Barnes, Treiber, et al, 2004; Castillo-Richmond, Schneider, et al, 2000; Zamarra, Schneider, et al, 1996; Lin, Nahin, et al, 2001), as does biofeedback, with or without imagery (Nakao, Yano, et al, 2003).24-25 Yoga that combined both postures and yogic breathing produced significant positive levels of blood lipids in those patients who participated in the program (Bijlani,Vempati, et al, 2005). Raja yoga improved respiratory functions, cardiovascular parameters and lipid profile (Vyas & Dikshit, 2002).

According to a review of 23 major heart disease studies, when psychosocial approaches were added to standard medical treatments, survival and further cardiac event rates improved significantly (Linden, Stossel and Maurice, 1996).26 A more recent review also confirmed that relaxation training can help patient recover from a cardiac events, reduce future angina and arrhythmias, and speed the time it takes to return to work (van Dixhoorn and White, 2005). Complementary approaches like relaxation training and imagery are so effective that they are routinely done at prestigious facilities such as Columbia Presbyterian Hospital’s Department of Surgery (Oz, Lemole et al, 1996).27 Relaxation, imagery, and education are important parts of Stanford’s Chronic Disease Self-Management Program (Lorig, Sobel et al, 1999). Use of guided imagery in cardiac patients 28 has led to shorter hospital stays, lower pharmacy costs, and lower use of pain medication (Halpin, Speir, et al, 2002).

The results of a lifestyle study showed that 80% of people who used complementary approaches were able to avoid cardiac surgery – a savings of almost $30,000 per patient (Ornish, 1998).29 Quality of life can also improve (Chang, Hendricks, 2005). Self-management of chronic conditions including CHD improves symptom management and reduces medical costs (Lorig, Sobel et al, 1999).28 In assessing the its importance, researchers van Dixhoorn and White deemed relaxation training “an important ingredient of cardiac rehabilitation” (2005).

Conclusion
A low-cost guided imagery-based program can help to lower stress and blood pressure, enhance an overall sense of emotional well-being, and improve compliance with lifestyle changes. Each of these factors, in turn, can aid in slowing, halting or reversing the progression of CHD and in reducing the number of further coronary events, re-hospitalizations, and surgeries.

References:
1. American Heart Association. (2002). 2003 Heart and Stroke Statistical Update. Dallas, Texas. Pg. 4.
www.americanheart.org/downloadable/heart/10590179711482003HDSStatsBookREV7-03.pdf Accessed: September, 2003.
2. American Heart Association. (2002). 2003 Heart and Stroke Statistical Update. Dallas, Texas. Pg. 11.
www.americanheart.org/downloadable/heart/10590179711482003HDSStatsBookREV7-03.pdf Accessed: September, 2003.
3. American Heart Associatin. (2001). 2002 Heart and Stroke Statistical Update. Dallas, Texas: American Heart Association. www.americanheart.org/downloadable/heart/10148328094661013190990123HS_State_02.pdf. Pg. 12.
Accessed: September, 2003.
4. www.nhlbi.nih.gov/health/public/heart/other/chdfacts.htm)
5. Baas, A. MD (2001). Chronic Ischemic Heart Disease in Best Practice of Medicine. Accessed at Merck Praxis MD http://merck.praxis.md/bpm/bpm.asp?page=BPM01CA05
6. Ornish, D., Scherwitz, L.W., Billings, J.H., Brown, S.E., Gould, K.L., Merritt, T.A., Sparler, S., Armstrong, W.T., Ports, T.A., Kirkeeide, R.L., Hogeboom, C, Brand, R.J. (1998). Intensive lifestyle changes for reversal of coronary heart disease. JAMA, Dec 16;280(23):2001-7.
7. Verrier, R.L., Mittelman, M.A. (1997). Cardiovascular consequences of anger and other stress states. Baillieres Clin Neurol, Jul;6(2):245-59.
8. Williams, R., Kiecolt-Glaser, J., Legato, M.J., Ornish, D., Powell, L.H., Syme, S.L., Williams, V. (1999). The impact of emotions on cardiovascular health. The Journal of Gender-Specific Medicine, 2[5]:52-58.
9. Ornish, D. (1998). Love & Survival: The Scientific Basis for the Healing Power of Intimacy. New York, NY: HarperCollins.
10. Mittleman, M.A., Maclure, M., Sherwood, J.B., et al.(1995). Triggering of acute myocardial infarction onset by episodes of anger. Circulation, 92:1720-1725.
11. Ironson, G., Taylor, C.B., Boltwood, M., et al. (1993). Effects of anger on left ventricular ejection fraction in coronary artery disease. Am J Cardiol, 70:281-285.
12. Boltwood, M.D., Taylor, C.B., Boutte Burke, M., et al. (1993). Anger report predicts coronary artery vasomotor response to mental stress in atherosclerotic segments. Am J Cardiol, 72:1361-1365.
13. Verrier, R.L., Hagestad, E.L., Lown, B. (1987). Delayed myocardial ischemia induced by anger. Circulation, 5:249-254.
14. Barefoot, J.C, Brummett, B.H., Helms, M.J., Mark, D.B., Siegler, I.C., Williams, R.B. (2000). Depressive Symptoms and Survival of Patients with Coronary Artery Disease. Journal of Psychosomatic Medicine, Nov-Dec; 62(6): pp790-5.
15. Orth-Gomer, K., Wamala, S.P., Horsten, M., Schenck-Gustafsson, K., Schneiderman, N., Mittleman, M.A. (2000). Marital Stress worsens prognosis in women with coronary heart disease: The Stockholm Female Coronary Risk Study. JAMA, Dec 20; 284 (23): pp. 3008-3014.
16. Sheps, D.S, McMahon, R.P., Becker, L., Carney, RM., Freedland, K.E., Cohen, J.D., Sheffield, D., Goldberg, A.D., Ketterer, M.W., Pepine, C.J., Raczynski, J.M., Light, K., Krantz, D.S., Stone, P.H., Knatterud, G.L., Kaufmann, P.G. (2002). Mental stress-induced ischemia and all-cause mortality in patients with coronary artery disease: Results from the Psychophysiological Investigations of Myocardial Ischemia study. Circulation, Apr 16;105:1780–1784.
17. Bairey, C.N., Krantz, D.S., Rozanski, A. (1990). Mental stress as an acute trigger of ischemic left ventricular dysfunction and blood pressure elevation in coronary artery disease. Am J Cardiol, Nov 6;66(16):28G-31G.
18. Nordstrom, C.K., Dwyer, K.M., Merz, C.N., Shircore, A, Dwyer, J.H. (2001). Work-related stress and early atherosclerosis. Epidemiolog, Mar;12(2): 180-5.
19. Allison, T.G., Williams, D.E., Miller, T.D., Patten, C.A., Bailey, K.R., Squires, R.W., Gau, G.T. (1995). Medical and economic costs of psychologic distress in patients with coronary artery disease. Mayo Clin Proc, Aug;70(8):734-42.
20. Pender NJ. (1985). Effects of progressive muscle relaxation training on anxiety and health locus of control among hypertensive adults. Res Nurs Health, Mar;8(1) :67-72
21. Sharpley, C.F. (1994). Maintenance and generalizability of laboratory-based heart rate reactivity control training. Journal of Behavioral Medicine,17(3): 309-329).
22. Crowther, J.H. (1983). Stress management training and relaxation imagery in the treatment of essential hypertension. J Behav Med, Jun;6(2):169-87.
23. Taylor, C.B., Farquhar, J.W., Nelson, E. & Agras, S.(1977). Relaxation therapy and high blood pressure. Archives of General Psychiatry, 34: 339-42.
24. Zamarra, J.W., Schneider, R.H., Besseghini, I., Robinson, D.K., Salerno, J.W. (1996). Usefulness of the transcendental meditation program in the treatment of patients with coronary artery disease. Am J Cardiol, Apr 15;77(10):867-70.
25. Castillo-Richmond, A., Schneider, R.H., Alexander, C.N., Cook, R., Myers, H., Nidich, S., Haney, C., Rainforth, M., Salerno, J. (2000). Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke. Mar;31(3):568-73.
26. Linden, W., Stossel, C., Maurice, J. (1996). Psychosocial interventions for patients with coronary artery disease: a meta-analysis. Arch Intern Med, Apr 8;156(7):745-52.
27. Oz, M.C., Lemole, E.J., Oz, L.L., Whitworth, G.C., Lemole, G.M. (1996). Treating CHD with Cardiac Surgery Combined with Complementary Therapy. Medscape Womens Health, Oct;1(10):7.
28. Lorig, K.R., Sobel, D.S., Stewart, A.L., Brown, Jr B.W., Ritter, P.L., Gonzalez, V.M., Laurent, D.D., Holman, H.R. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization and costs: A randomized trial. Medical Care, 37(1): 5-14.
29. Ornish, D. (1998) Avoiding revascularization with lifestyle changes: The Multicenter Lifestyle Demonstration Project. Am J Cardiol, 82:72T-76T.
Allison TG, Williams DE, Miller TD, Patten CA, Bailey KR, Squires RW, Gau GT. Medical and economic costs of psychologic distress in patients with coronary artery disease. Mayo Clin Proc. 1995 Aug;70(8):734-42.
American Heart Association. (2002). 2003 Heart and Stroke Statistics -- 2003 Update. Dallas, TX. American Heart Associatin. 2002. Pg. 12, 40. www.americanheart.org/downloadable/heart/10590179711482003HDSStatsBookREV7-03.pdf Accessed: June, 2006.
Baas A. MD. Chronic Ischemic Heart Disease in Best Practice of Medicine. 2001. Modified March 25, 2003. Accessed at Merck Praxis MD. http://merck.micromedex.com/index.asp?page=bpm_brief&article_id=BPM01CA05.
Accessed June, 2006.
Bairey CN, Krantz DS, Rozanski A. Mental stress as an acute trigger of ischemic left ventricular dysfunction and blood pressure elevation in coronary artery disease. Am J Cardiol. 1990. Nov 6;66(16):28G-31G.
Barefoot JC, Brummett BH, Helms MJ, Mark DB, Siegler IC, Williams RB. Depressive Symptoms and Survival of Patients with Coronary Artery Disease. Journal of Psychosomatic Medicine. 2000 Nov-Dec; 62(6): pp790-5.
Barnes VA, Treiber FA, Johnson MH. Impact of transcendental meditation on ambulatory blood pressure in African-American adolescents. American Journal of Hypertension. 2004 Apr; 17(4): pages 366-9.
Bijlani RL, Vempati RP, Yadav RK, Ray RB, Gupta V, Sharma R, Mehta N, Mahapatra SC. A brief but comprehensive lifestyle education program based on yoga reduces risk factors for cardiovascular disease and diabetes mellitus. J Altern Complement Med. 2005 Apr;11(2):267-74.
Boltwood MD, Taylor CB, Burke MB, Grogin H, Giacomini J. Anger report predicts coronary artery vasomotor response to mental stress in atherosclerotic segments. Am J Cardiol. 1993 72:1361-1365.
Castillo-Richmond A, Schneider RH, Alexander CN, Cook R, Myers H, Nidich S, Haney C, Rainforth M, Salerno J. Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke. 2000 Mar;31(3):568-73.
Chang BH, Hendricks A, Zhao Y, Rothendler JA, LoCastro JS, Slawsky MT. A relaxation response randomized trial on patients with chronic heart failure. Journal of Cardiopulmonology and Rehabilitation. 2005 May-Jun; 25 (3): 149-57.
Crowther JH. Stress management training and relaxation imagery in the treatment of essential hypertension. J Behav Med. 1983 Jun;6(2):169-87.
Halpin LS, Speir AM, CapoBianco P, Barnett SD. Guided imagery in cardiac surgery. Outcomes in Management & Nursing Practice. 2002 Jul-Sep;6(3):132-7.
Herrmann JM. Essential hypertension and stress. When do yoga, psychotherapy and autogenic training help?] [Article in German] MMW Fortschr Med. 2002 May 9;144(19):38-41.
Ironson G, Taylor CB, Boltwood M. Bartzokis T, Dennis C, Chesney M, Spitzer S, Segall GM. Effects of anger on left ventricular ejection fraction in coronary artery disease. Am J Cardiol. 1993 70:281-285.
Lin MC, Nahin R, Gershwin ME, Longhurst JC, Wu KK. State of complementary and alternative medicine in cardiovascular, lung, and blood research: executive summary of a workshop. Circulation. 2001 Apr 24;103(16):2038-41.
Linden W, Stossel C, Maurice J. Psychosocial interventions for patients with coronary artery disease: a meta-analysis. Arch Intern Med. 1996 Apr 8;156(7):745-52.
Lorig KR, Sobel DS, Stewart AL, Brown Jr BW, Ritter PL, Gonzalez VM, Laurent DD, Holman HR. Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization and costs: A randomized trial. Medical Care. 1999 37(1): 5-14.
Mittleman MA, Maclure M, Sherwood JB, Mulry RP, Tofler GH, Jacobs SC, Friedman R, Benson H, Muller JE. Triggering of acute myocardial infarction onset by episodes of anger. Circulation. 1995 92:1720-1725.
Nakao M, Yano E, Nomura S, Kuboki T. Blood pressure-lowering effects of biofeedback treatment in hypertension: a meta-analysis of randomized controlled trials. Hypertension Research. 2003 Jan; 26(1): pages 37-46.
National Heart Blood and Lung Institute http://www.nhlbi.nih.gov/health/dci/Diseases/Cad/CAD_Summary.html. Accessed June, 2006.
Nordstrom CK, Dwyer KM, Merz CN, Shircore A, Dwyer JH. Work-related stress and early atherosclerosis. Epidemiolog. 2001 Mar;12(2): 180-5.
Ornish D, Scherwitz LW, Billings JH, Brown SE, Gould KL, Merritt TA, Sparler S, Armstrong WT, Ports TA, Kirkeeide RL, Hogeboom C, Brand RJ. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998 Dec 16;280(23):2001-7.
Ornish D. (1998). Love & Survival: The Scientific Basis for the Healing Power of Intimacy. New York, NY: HarperCollins.
Ornish D. Avoiding revascularization with lifestyle changes: The Multicenter Lifestyle Demonstration Project. Am J Cardiol. 1998c 82:72T-76T.
Orth-Gomer K, Wamala SP, Horsten M, Schenck-Gustafsson K, Shneiderman N, Mittleman MA. Marital stress worsens prognosis in women with coronary heart disease: The Stockholm Female Coronary Risk Study. JAMA. 2000 Dec 20; 284 (23): pp. 3008-3014.
Oz MC, Lemole EJ, Oz LL, Whitworth, GC, Lemole GM. Treating CHD with cardiac surgery combined with complementary therapy. Medscape Womens Health. 1996 Oct;1(10):7.
Pender NJ. Effects of progressive muscle relaxation training on anxiety and health locus of control among hypertensive adults. Res Nurs Health. 1985 Mar;8(1) :67-72.
Sharpley CF. Maintenance and generalizability of laboratory-based heart rate reactivity control training. Journal of Behavioral Medicine.1994 17(3): 309-329).
Sheps DS, McMahon RP, Becker L, Carney RM, Freedland KE, Cohen JD, Sheffield D, Goldberg AD, Ketterer MW, Pepine CJ, Raczynski JM, Light K, Krantz DS, Stone PH, Knatterud GL, Kaufmann PG. Mental stress-induced ischemia and all-cause mortality in patients with coronary artery disease: Results from the Psychophysiological Investigations of Myocardial Ischemia study. Circulation. 2002 Apr 16;105:1780–1784.
Taylor CB, Farquhar JW, Nelson E & Agras S. Relaxation therapy and high blood pressure. Archives of General Psychiatry. 1977 34: 339-42.
Van Dixhoorn J, White A. Relaxation therapy for rehabilitation and prevention in ischaemic heart disease: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 2005; June;12(3):193-202. Vyas R, Dikshit N. Effect of meditation on respiratory system, cardiovascular system and lipid profile. Indian J Physiol Pharmacol. 2002 Oct;46(4):487-91.
Verrier RL, Hagestad EL, Lown B. Delayed myocardial ischemia induced by anger. Circulation. 1987 5:249-254.
Verrier, RL, Mittelman MA. Cardiovascular consequences of anger and other stress states. Baillieres Clin Neurol. 1997 Jul;6(2):245-59.
Williams R, Kiecolt-Glaser J, Legato, MJ, Ornish D, Powell LH, Syme SL, Williams V. The impact of emotions on cardiovascular health. The Journal of Gender-Specific Medicine. 1999 2[5]:52-58.
Zamarra JW, Schneider RH, Besseghini I, Robinson DK, Salerno JW Usefulness of the transcendental meditation program in the treatment of patients with coronary artery disease. Am J Cardiol. 1996 Apr 15;77(10):867-70.

RESEARCH FINDINGS USING GUIDED IMAGERY FOR MRI August, 2006

RESEARCH FINDINGS USING GUIDED IMAGERY FOR PEOPLE UNDERGOING RADIATION September, 2006

RESEARCH FINDING USING GUIDED IMAGERY FOR PREPARING FOR SURGERY August, 2006

Mind-Body Approaches to Coping with Surgery

Patients are often given drugs (sedation) to reduce and calm them before surgery or other medical procedures. However, sedation often increases the risk of low blood pressure or getting too little oxygen. As a result, researchers have looked at other ways to reduce pre-surgical anxiety.

Some of the most effective techniques include relaxation with guided imagery, self-hypnosis, and providing reassuring information prior to the procedure (Ashton, Whitworth, et al, 2000; Dreher, 1998; Faymonville, Fissette, et al, 1995; Lang and Hamilton, 1994; Lang, Joyce, et al, 1996; Ludwick-Rosenthal, Neufeld, 1993).

Used before surgery, non-pharmacologigic, mind-body techniques can reduce anxiety in adults (Bennett, 1996; Bugbee, Wellisch, et al, 2005; Good, 2004; McCaffrey, Taylor, 2005; Pellino, Gordon, et al, 2005), and children (Calipel, Lucas-Polomeni, et al, 2005).

Relaxation with guided imagery or self-hypnosis before and during surgery can shorten procedures (Butler, Symons, et al, 2005; Halpin, Speir, et al, 2002; Lang, Benotsch, et al, 2000; Tusek, Church, et al, 1997). These techniques can also significantly reduce procedural and post-surgical pain and the need for pain medication (Antall & Kresevec, 2004; Ashton, Whitworth, et al, 2000; Faymonville, Fissette, et al, 1995; Good, Anderson, et al, 2005; Halpin, Speir, et al.; Huth, Broome & Good, 2004; Lambert, 1996; Lang, Benotsch, et al, 2000; Lang & Hamilton, 1994; Lang, Joyce, et al, 1996; Laurion & Fetzer, 2003; Manyande, Berg, et al, 1995; Meurisse, Hamoir, et al, 1999; Montgomery, Weltz, et al, 2002; Patterson, Wiechman, et al, 2006; Rensi, Peticca & Pescatore, 2000; Syrjala, Donaldson, et al, 1995; Tusek, Church, et al, 1997; Weinstein & Au, 1991), even when only used post-surgically (Nilsson, Rawal, et al, 2003).

These techniques can shorten the time it takes for patients’ intestinal motility to return to normal (Disbrow, Bennett & Owings, 1993; Tusek, Church, et al, 1997), and shorten their hospital stay (Bennett, 1996; Cowan, Buffington, et al, 2001; Disbrow, Bennett & Owings, 1993; Lambert, 1996; Meurisse, Faymonville, et al, 1996; Rapkin, Straubing & Holroyd, 1991; Tusek, Church, et al). There is also some evidence that these techniques can reduce blood loss (Bennett; Enqvist, von Konow & Bystedt, 1995; Lucas, 1975; Meurisse, Faymonville, et al), and speed wound healing (Holden-Lund, 1988; Ginandes, Brooks, et al, 2003; Jones, 1977).

Improvements have been shown in sleep (Gross,Kreitzer, et al, 2005), and other psychological parameters such anxiety (Ashton, Whitworth, et al, 2000; Gross, Kreitzer, et al; Kanji, White & Ernst, 2004), and post-surgical anger and depression (de Klerc, de Plessis, et al, 2004).

Several sources, including Blue Shield of California and Cedars Sinai Medical Center (Los Angeles), have reported that patients who used guided imagery tapes to prepare for surgery were very satisfied with them – plus, it reduced their bills (Fontana, 2000; Holden-Lund, 1988; Naiditch, 2000). In addition, guided imagery audio tapes are routinely used and recommended by many well respected physicians, including Mehmet Oz, M.D., heart surgeon and Director of the Complementary Care Center at New York’s Columbia Presbyterian Medical Center (Oz, 2000).

Conclusion

Research available to date supports the conclusion that a low-cost guided imagery-based program to prepare patients for surgery can help to lower pre-surgical anxiety, reduce pain and the need for post-operative medication, shorten procedure time and hospital stay, and possibly reduce surgical bleeding, and speed recovery.

References:

Antall GF, Kresevic D. The use of guided imagery to manage pain in an elderly orthopaedic population. Orthop Nurs. 2004 Sep-Oct;23(5):335-40.
Ashton C. Jr, Whitworth GC, Seldomridge JA, Shapiro PA, Weinberg AD, Michler RE, Smith CR, Rose EA, Fisher S, Oz MC. Self-hypnosis reduces anxiety following coronary artery bypass surgery. A prospective, randomized trial. J Cardiovasc Surg. 2000 Apr;41(2):335-6.
Baglini R, Sesana M, Capuano C, Gnecchi-Ruscone T, Ugo L, Danzi GB. Effect of hypnotic sedation during percutaneous transluminal coronary antioplasty on myocardial ischemia and cardiac sympathetic drive. Am J Cardiol. 2004 Apr 15;93(8):1035-8.
Bennett HL. A comparison of audiotaped preparations for surgery: evaluation and outcomes. Paper presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, 1996. Tampa, FL.
Bugbee ME, Wellisch DK, Arnott IM, Maxwell JR, Kirsch DL, Sayre JW, Bassett LW. Breast core-needle biopsy: clinical trial of relaxation technique versus medication versus no intervention for anxiety reduction. Radiology. 2005 Jan;234(1):73-8. Epub 2004 Nov 24.
Calipel S, Lucas-Polomeni MM, Wodey E, Ecoffey C. Premedication in children: hypnosis versus midazolam. Paediatr Anaesth. 2005 Apr;15(4):275-81.
Cowan GS Jr, Buffington CK, Cowan GS 3rd, Hathaway D. Assessment of the effects of taped cognitive behavior message on postoperative complications (therapeutic suggestions under anesthesia. Obes Surg. 2001 Oct;11(5):589-93.
Crawford AH, Jones CW, Perisho JA, Herring JA. Hypnosis for monitoring intraoperative spinal cord function. Anesth Analg. 1976 Jan-Feb;55(1):42-4.
Disbrow EA, Bennett HL, Owings JT. Effect of preoperative suggestion on postoperative gastrointestinal modility. West J Med. 1993 May;158(5);488-92.
de Klerk JE, du Plessis WF, Steyn HS, Botha M. Hypnotherapeutic ego strengthening with male South African coronary artery bypass patients. Am J Clin Hypn. 2004 Oct;47(2):79-92.
Dreher H. Mind-body interventions for surgery: evidence and exigency. Advances in Mind-Body Medicine. 1998. 14:207-222.
Enqvist B, von Konow L, Bystedt H. Pre-and perioperative suggestion in maxillofacial surgery: effects on blood loss and recovery. Int J Clin Exp Hypn. 1995 Jul;43(3):284-94.
Faymonville ME, Fissette J, Mambourg PH, Roediger L, Joris J. Lamy M. Hypnosis as adjunct therapy in conscious sedation for plastic surgery. Reg. Anesth. 1995 Mar-Apr;20(2):145-51.
Fontana GP, M.D. Acupuncture, Massage, Guided Imagery Ease Pain After Bypass Surgery. (News release, Westport, Conn: Reuters Health Information, June 9. 2000) 1-2.
Ginandes C, Brooks P, Sando W, Jones C, Aker J. Can Medical Hypnosis Accelerate Post-Surgical Wound Healing? Results of a Clinical Trial. American Journal of Clinical Hypnosis. 2003 45:4, April, pp. 333-351.
Good M, Anderson GC, Ahn S, Cong X, Stanton-Hicks M. Relaxation and music reduce pain following intestinal surgery. Res Nurs Health. 2005 Jun;28(3):240-51.
Gross CR, Kreitzer MJ, Russas V, Treesak C, Frazier PA, Hertz MI. Mindfulness meditation to reduce symptoms after organ transplant: a pilot study. Adv Mind Body Med. 2004 Summer;20(2):20-9.
Hall MJ, Owings MF. 2000 National Hospital Discharge Survey. Advance data from vital and health statistics; no 329. Hyattsville, Maryland: National Center for Health Statistics. 2002. Table 8.
Hall MJ, Hall L. Ambulatory surgery in the United States, 1996. Advance data from vital and health statistics; no. 300. Hyattsville, Maryland: National Center for Health Statistics. 1998. Table 4.
Halpin LS, Speir AM, CapoBianco P, Barnett SD. Guided imagery in cardiac surgery. Outcomes Manag. 2002 Jul-Sep; 6(3):132-7.
Holden-Lund C. Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing and Health. 1988 11 Aug. 235-244.
Huth MM, Broome ME, Good M. Imagery reduces children's post-operative pain. Pain. 2004 Jul;110(1-2):439-48.
Jones CW. Hypnosis and spinal fusion by Harrington instrumentation. Am. Journal of Clinical Hypnosis. 1977 Jan;19(3):155-7.
Lambert S. The Effects of Hypnosis/Guided Imagery on the Postoperative Course of Children. Developmental and Behavioral Pediatrics. 1996 17 (5) 307-310.
Lang EV, Benotsch, EG, Fick, LJ, Lutgendorf S, Berbaum ML, Berbaum, KS, Logan H, Spiegel D. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet. 2000 Apr 29;355(9214) :1486-90.
Lang EV, Hamilton D. Anodyne imagery: an alternative to i.v. sedation in interventional radiology. AJR Am J Roentgenol. 1994 May;162(5):1221-6.
Lang EV, Joyce JS, Spiegel D, Hamilton D, Lee KK. Self-hypnotic relaxation during interventional radiological procedures: effects on pain perception and intravenous drug use. Int J Clin Exp Hypn. 1996 Apr;44(2):106-19.

Laurion S, Fetzer SJ. The effect of two nursing interventions on the postoperative outcomes of gynecological laparoscopic patients. J of Perianesthesia Nursing. 2003 Aug;18(4)254-61.

Lucas ON. The use of hypnosis in hemophilia dental care. Ann N Y Acad Sci. 1975 Jan 20;240:263-6.
Ludwick-Rosenthal R, Neufeld RW. Preparation for undergoing an invasive medical procedure: interacting effects of information and coping style. J Consult Clin Psychol. 1993 Feb;61(1):156-64).
Manyande A, Berg S, Gettins D, Stanford SC, Mazhero S, Marks DF, Salmon P. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosom Med. 1995 Mar-Apr;57(2):177-82.
Meurisse , M, Faymonville ME, Joris J, Nguyen Dang D, Defechereux T, Hamoir E. Endocrine surgery by hypnosis. From fiction to daily clinical application. Service de Chirurgie des Glandes Endocrines et Transplantation, Centre Hospitalier Universitaire de Liege, Belgique. Ann Endocrinol (Paris). 1996 57(6):494-501.
Meurisse M, Hamoir E, Defecheueux T, Gollogly L, Derry O, Postal A, Joris J, Faymonville ME. Bilateral neck exploration under hypnosedation: a new standard of care in primary hyperparathyroidism? Ann Surg. 1999 Mar;229(3):401-8. Montgomery GH, Weltz CR, Seltz M, Bovbjerg DH. Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. Int J Clin Exp Hypn. 2002 Jan;50(1):17-32.
Naiditch M. Blue Shield Announces Guided Imagery Program to Help Members Have an Easier Surgery & Recovery. News release. Blue Shield, 2000 May 4.
https://www.blueshieldca.com/bsc/newsroom/pr/Guided_Imagery.jhtml;jsessionid=TWTS43ZYCWIJHJP3YYSSGLNF5XDCEITT
Accessed: September, 2006.
Nilsson U, Rawal N, Enqvist B, Unosson M. Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery; a randomized controlled trial. Acta Anaesthesiol Scand. 2003 Mar;47(3):278-83.
Oz M, M.D. Healing from the Heart: A Leading Heart Surgeon Explores the Power of Complementary Medicine. New York: EP Dutton, 1998.
Patterson DR, Wiechman SA, Jensen M, Sharar SR.Hypnosis delivered through immersive virtual reality for burn pain: A clinical case series. International Journal of Clinical and Experimental Hypnosis. 2006 Apr; 54 (2):130-42.
Pellino TA, Gordon DB, Engelke ZK, Busse KL, Collins MA, Silver CE, Norcross NJ. Use of nonpharmacologic interventions for pain and anxiety after total hip and total knee arthroplasty. Orthopedic Nursing. 2005 May-Jun; 24 (3):182-90.
Rapkin DA, Straubing M, Holroyd JC. Guided imagery, hypnosis and recovery from head and neck cancer surgery: an exploratory study. Int J Clin Exp Hypn, 1991 Oct;39(4) :215-26.
Rensi C, Peticca L, Pescatori M. The use of relaxation techniques in the periopperative management of proctological patients: preliminary results. Int J Colorectal Dis. 2000 Nov;15(5-6):313-6.
Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain. 1995 Nv;673 (2):189-98.
Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum. 1997 Feb;40(2):172-8.
Weinstein EJ, Au PK Use of hypnosis before and during angioplasty. Am J Clin Hypn. 1991 Jul;34(1):29-37.

Neuro-Linguistic-Programming or NLP for short is the practical application of human communication as first understood by Dr Richard Bandler. This was subsequently broken down by Dr Bandler and John Grinder based on the work of the Psychiatrist and Hypnotist Dr Milton Erikson and other successful therapists in the early 70's.  

• Neuro refers to: The Mind, the nervous system and the five senses (Sight, Hearing, Taste, Smell and Touch)
• Linguistic refers to:  Language and non-verbal ways in which people express their experiences of the world.
• Programming refers to:  The fact that people behave according to their personal programming with the ability to organise their comminication and neurological systems to achieve specific desired goals and results.

You could think of NLP is an educational tool where a technique or exercise is learnt by a person, allowing them to make positive changes to their lives. The techniques allow you to up-date your programming by removing old habits and behaviours that no longer work for you, and replaced with more effective habits and behaviours. Some people ask if its like brain washing, well I prefer to turn it around and say that we are washing your brain!

• If one person can do something, anyone can learn to do it
  
• The ability to change the process by which we experience reality is often more valuable than changing the content of our experience of reality
• The map is not the territory
• The meaning of the communication is the response you get
• The mind and body are part of the same system
• People already have inside them all the resources needed to affect change
• The positive worth of the individual is held constant, while the value and appropriateness of the internal and/or external behavious is questionned
• Feedback vs Failure. All results and behaviours are achievements, whether they are desired outcomes for a given task/context or not. If what you are doing doesnt work - do something else!
• Successful communicators accept and utilise all communication/behaviour presented to them

RESEARCH FINDINGS USING GUIDED IMAGERY FOR ANXIETY  July, 2006

What are Anxiety Disorders?

Anxiety disorders is an umbrella term used to describe a wide diversity of psychological conditions. The two major anxiety disorders are Generalized Anxiety Disorders (GAD) and Panic Disorders. Others include Post-Traumatic Stress Disorders (PTSD), phobias, separation anxiety, performance anxiety, and Obsessive-Compulsive Disorders (OCD).

All of these conditions are marked by feelings of apprehension, tension, or uneasiness which can range from mild to incapacitating. Physical symptoms can include stress, palpitations, and sweating. The severity of these symptoms can vary. No single cause seems to be responsible for anxiety disorders. Both psychological and physical causes are usually involved. Genetics can also play a role.

Medical Treatment of Anxiety

Treatment depends on the precise anxiety disorder. Serotonin-reuptake inhibitors (SSRIs) are the most frequent initial medications prescribed. Other medications include benzodiazepines, trycyclics (if depression is also involved), MAO inhibitors (for OCD), beta-blockers (for phobias), and clonidine (for PTSD).

Non-pharmacologic treatment including imagery

The most effective approach is cognitive-behavior therapy (CBT). It is usually combined with medication.

Mind-body approaches have proven effective in cases of situational anxiety, such as test-taking (Wachelka and Katz, 1999), fear of flying (Aitken and Benson, 1984), undergoing surgery (Saadat, Drummond-Lewis, et al, 2006; Simmons, Chabal, et al, 2004; Tusek, Church, et al, 1997; Tusek, Cwynar, 1999); and in dealing with illnesses or conditions such as heart trouble (van Dixhoorn & White, 2005; Vila, Benedicto, et al, 2005), cancer (Deng & Cassileth, 2005; Hidderley & Holt, 2004), infertility (Chan, Ng, et al, 2006), pregnancy (Bastani, Hidarnia, et al, 2005; Rees, 1995; Teixeira, Martin, et al, 2005), and childbirth (Almeida, de Sousa, et al, 2005).

Many medical studies confirm the effectiveness of CBT for anxiety disorders (Borkoved & Ruscio, 2001; Butler, Fennell, et al, 1991; Lenz & Demal, 2000; Silverman, Kurtines, et al, 1999; Toren, Wolmer, et al, 2000). CBT can sometimes be so effective that it can replace medication in treating the symptoms of OCD and PTSD (Basco, Glickman, et al, 2000).

Studies also confirm the effectiveness of the mind-body techniques of guided imagery (Rees, 1995; Tusek, Cwynar & Cosgrove, 1999), relaxation (Aitken & Benson, 1984; Eppley, Abrams & Shear, 1989; Mathew, Ho, et al, 1981; Pender, 1985; Wachelka & Katz, 1999; Weber, 1996), hypnosis (Ashton, Whitworth, et al, 1997; Bryant, Moulds, et al, 2005; Benson, Frankel, et al, 1978; Davidson, Farnbach & Richardson, 1978; Stetter, Walter, et al, 1994), meditation (Finucane & Mercer, 2006; Kabat-Zinn, Massion, et al, 1992; Reibel, Greeson, et al, 2001), autogenic training (Hidderley and Holt, 2004; Jorm, Christensen, et al, 2004) and biofeedback (Clark & Hirschman, 1990; Rice, Blanchard & Purcell, 1993).

CBT and/or mind-body therapies have been effective in all types of anxiety disorders and across all age ranges (Barrett, 1998; Barrett, Duffy, et al, 2001; Barrowclough, King, et al, 2001; Craske MG, Golinelli, et al, 2005; Kendall & Southam-Gerow, 1996; Klinger, Bouchard, et al., 2005; Otto & Smits, 2004; Rayburn & Otto, 2003; Stanley, Beck, et al, 2003), and patients reported feeling more in control of their lives (Pender, 1985; Weinman, Semuch, et al, 1983), even when delivery is computer-assisted (Kenardy, Dow, et al, 2003).

These positive benefits have been sustained in follow-ups as long as six years (Barrett; Barrowclough, King et al; Kenardy, Robinson, et al, 2005; Kendall and Southam-Gerrow). In a study of over 1000 patients, behavioral medicine (relaxation response, cognitive restructuring, exercise, and nutrition) was able to significantly reduce anxiety as well as its medical symptoms (Nakao, Fricchione, et al, 2001). A biofeedback study of 45 people with GAD showed “significant reduction” in one measure of anxiety and its physical and psychological symptoms (Rice, Blanchard and Purcell, 1993).

Herbert Benson, a researcher famous for his studies on relaxation, and his colleagues, reported the effectiveness of meditation-based relaxation and self-hypnosis in the treatment of anxiety (Benson, Frankel, et al, 1978). A study of people with OCD showed that mental imagery could be used successfully to “freeze” the anxiety trigger in order to reduce fear and avoidance behavior in subjects (Riskind, Wheeler & Picerno, 1997). Self-help audiotapes and/or multimedia self-help programs have also been effective (Davidson, Farnbach & Richardson, 1978; Finch, Lambert & Brown, 2000).

Reviews of the literature confirm that all forms of CBT are “likely to provide some benefit for adults” (Rodebaugh, Holoway, and Heimberg, 2004), with relaxation techniques having the strongest evidence for generalized anxiety, panic disorders, dental phobia, and test anxiety, and autogenic training and meditation having some evidence to support their effectiness for generalized anxiety (Jorm, Christensen, et al, 2004).

Studies confirm physiological changes occur after using mind body techniques. After using relaxation training, one small study showed that subjects’ anxiety and platelet MAO levels were significantly lower (Mathew, Ho, et al, 1981), while in another study, subjects’ salivary cortisol levels were greatly reduced and salivary immunoglobulin A (sigA) levels significantly increased (Pawlow and Jones, 2005). Another 2005 study confirmed both physiological and psychological changes (Tafet, Feder, et al, 2005).

Conclusion

A program that includes imagery, relaxation, and behavioral changes can be a low cost, effective way for patients to actively participate in managing the symptoms of anxiety disorders.

REFERENCES

Aitken JR, Benson JW. The use of relaxation/desensitization in treating anxiety associated with flying. Aviat Space Environ Med. 1984 Mar;55(3) :196-9.
Almeida NA, de Sousa JT, Bachion MM, Silveira Nde A. [The use of respiration and relaxation techniques for pain and anxiety relief in the parturition process] [Article in Portuguese] Ret Lat Am Enfermagem. 2005 Jan-Feb;13(1):52-8. Epub 2005 Mar 3.
Ashton C Jr, Whitworth GC, Seldomridge JA, Shapiro PA, Weinberg AD, Michler RE, Smith CR, Rose EA, Fisher S, Oz MC. Self-hypnosis reduces anxiety following coronary artery bypass surgery. A prospective, randomized trial. J Cardiovasc Surg (Torino). 1997 Feb;38(1):69-75.
Barrett PM. Evaluation of cognitive-behavioral group treatments for childhood anxiety disorder. J Clin Child Psychol. 1998 Dec;27(4) :459-68.
Barrett PM, Duffy AL, Dadds MR, Rapee RM. Cognitive-behavioral treatment of anxiety disorders in children: long-term (6-year) follow-up. Journal of Consulting and Clinical Psychology. 2001 Feb; 69 (1): pp. 135-41.
Barrowclough C, King P, Colville J, Russell E, Burns A, Tarrier N. A randomized trial of the effectiveness of cognitive-behavioral therapy and supportive counseling for anxiety symptoms in older adults. J Concult Clin Psychol. 2001 Oct;69(5):756-62.
Basco MR, Glickman M, Weatherford P, Ryser N. Cognitive-behavioral therapy for anxiety disorders: why and how it works. Bull Menninger Clin. 2000 Summer;64(3 Suppl A) :A52-70.
Bastani F, Hidarnia A, Kazemnejad A, Vafaei M, Kashanian M. A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. J Midwifery Womens Health. 2005 Jul-Aug;50(4):e36-40.
Benson H, Frankel FH, Apfel R, Daniels MD, Schniewind HE, Nemiah JC, Sifneos PE, Crassweller KD, Greenwood MM, Kotch JB, Arns PA, Rosner B. Treatment of anxiety: a comparison of the usefulness of self-hypnosis and a meditational relaxation technique. An overview. Psychother Psychosom. 1978 30(3-4):229-42.
Borkoved TD, Ruscio AM. Psychotherapy for generalized anxiety disorder. J Clin Psychiatry. 2001 62 Suppl 11:37-42; discussion 43-5.
Bryant RA, Moulds ML, Guthrie RM, Nixon RD. The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder. J Consult Clin Psychol. 2005 Apr;73(2):334-40.
Butler G, Fennell M, Robson P, Gelder M. Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder. J Consult Clin Psycol. 1991 Feb;59(1) :167-75.
Centers for Disease Control and Prevention. National Center for Health Statistics, Vital and Health Statistics Series 13, No. 143. 1997.
Chan CH, Ng EH, Cha CL, Ho, Chan TH. Effectiveness of psychosocial group intervention for reducing anxiety in women undergoing in vitro fertilization: a randomized controlled study. Fertil Steril. 2006 Feb;85(2):339-46.
Clark ME, Hirschman R. Effects of paced respiration on anxiety reduction in a clinical population. Biofeedback Self Regul. 1990 Sep;15(3):273-84.
Craske MG, Golinelli D, Stein MB, Roy-Byrne P, Bystritsky A, Sherbourne C. Does the addition of cognitive behavioral therapy improve panic disorder treatment outcome relative to medication alone in the primary-care setting? Psychological Medicine. 2005 Nov;35 (11): pp. 1645-54.
Davidson GP, Farnbach RW, Richardson BA. Self-hypnosis training in anxiety reduction. Aust Fam Physician. 1978 Jul;7(7):905-10.
Deng G, Cassileth BR. Integrative oncology: complementary therapies for pain, anxiety, and mood disturbances. CA Cancer J Clin. 2005 Mar-Apr;55(2):109-16.
Eppley KR, Abrams AI, Shear J. Differential effects of relaxation techniques on trait anxiety: a meta-analysis. J Clin Psychol. 1989 Nov;45(6) :957-74.
Facts About Anxiety Disorders. National Institute of Mental Health. 2001, rev. 2006. http://www.nimh.nih.gov/publicat/adfacts.cfm
Accessed, July, 2006.
Finch AE, Lambert MJ Brown GJ. Attacking anxiety: a naturalistic study of a multimedia self-help program. J Clin Psychol. 2000 Jan;56(1) :11-21.
Finucane A, Mercer SW. An exploratory mixed methods study of the acceptability and effectiveness of Mindfulness-Based Cognitive Therapy for patients with active depression and anxiety in primary care. BMC Psychiatry. 2006 Apr 7;6:14.
Harman JS, Rollman BL, Hanusa BH, Lenze EJ, Shear MK. Physician Office Visits of Adults for Anxiety Disorders in the United States, 1985–1998. J of General Internal Medicine. Vol 17 Issue 3 March 2002. 165.
Hidderley M, Holt M. A pilot randomized trial assessing the effects of autogenic training in early stage cancer patients in relation to psychological status and immune system responses. Eur J Oncol Nurs. 2004 Mar;8(1):61-5.
Jorm AF, Christensen H. Griffiths KM, Parslow RA, Rodgers B, Blewitt KA. Effectiveness of complementary and self-help treatments for anxiety disorders. Med J Aust. 2004 Oct 4;181(7 Suppl):S29-46.
Kabat-Zinn J, Massion AO, Kristeller J, Peterson LG, Fletcher KE, Pbert L, Lenderking WR, Santorelli SF. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992 Jul;149(7) :936-43.
Kenardy JA, Dow MG, Johnston DW, Newman MG, Thomson A, Taylor CB.A comparison of delivery methods of cognitive-behavioral therapy for panic disorder: an international multicenter trial. Journal of Consulting Clinical Psycholy. 2003 Dec;71 (6): pp. 1068-75.
Kenardy J, Robinson S, Dob R. Cognitive behaviour therapy for panic disorder: long-term follow-up. Cognitive Behavioural Therapy. 2005; 34 (2): pages 75-8.
Kendall PC, Southam-Gerow MA. Long-term follow-up of a cognitive-behavioral therapy for anxiety-disordered youth. J Consult Clin Psychol. 1996 Aug;64(4):724-30.
Klinger E, Bouchard S, Legeron P, Roy S, Lauer F, Chemin I, Nugues P.Virtual reality therapy versus cognitive behavior therapy for social phobia: a preliminary controlled study. Cyberpsychol Behav. 2005 Feb;8(1):76-88.
Lenz G, Demal U. Quality of life in depression and anxiety disorders: an exploratory follow-up study after intensive inpatient cognitive behaviour therapy. Psychopathology. 2000 Nov-Dec;33(6):297-302.
Mathew RJ, Ho BT, Kralik P, Weinman M, Claghorn JL. Anxiety and platelet MAO levels after relaxation training. Am J Psychiatry. 1981 Mar;138(3):371-3.
Nakao M, Fricchione G, Myers P, Zuttermeister PC, Baim M, Mandle CL, Medich C, Wells-Federman CL, Martin Arcari P, Ennis M, Barsky AJ, Benson H. Anxiety is a good indicator for somatic symptom reduction through behavioral medicine intervention in a mind/body medicine clinic. Psychother Psychosom. 2001 Jan-Feb;70(1):50-7.
Otto MW, Smits JA, Reese HE. Cognitive-behavioral therapy for the treatment of anxiety disorders. Journal of Clinical Psychiatry. 2004;65 Suppl 5:34-41.
Pawlow LA, Jones GE. The impact of abbreviated progressive muscle relaxation on salivary cortisol and salivary immunoglobulin A (sigA). Appl Psychophsiol Biofeedback. 2005 Dec;30(4):375-87.
Pender NJ Effects of progressive muscle relaxation training on anxiety and health locus of control among hypertensive adults. Res Nurs Health.1985 Mar;8(1):67-72.
Rayburn NR, Otto MW. Cognitive-behavioral therapy for panic disorder: a review of treatment elements, strategies, and outcomes. CNS Spectrum. 2003 May;8 (5):pp. 356-62.
Rees BL. Effect of relaxation with guided imagery on anxiety, depression, and self-esteem in primiparas. J Holist Nurs. 1995 Sep;13(3):255-67.
Reibel DK, Greeson JM, Brainard GC, Rosenzweig J. Mindfulness-based stress reduction and health-related qualify of life in a heterogeneous patient population. Gen Hosp Psychiatry, 2001 Jul-Aug;23(4):183-92.
Rice KM, Blanchard EB, Purcell M. Biofeedback treatments of generalized anxiety disorder: preliminary results. Biofeedback Self Regul. 1993 Jun;18(2):93-105.
Riskind JH, Wheeler DJ, Picerno MR. Using mental imagery with subclinical OCD to ‘freeze’ contamination in its place: evidence for looming vulnerability theory. Behav Res Ther. 1997 Aug;35(8) :767-68.
Rodebaugh TL, Holaway RM, Heimberg RG. The treatment of social anxiety disorder. Clin Psychol Rev. 2004 Nov;24(7):883-908.
Saadat H, Drummong-Lewis J, Maranets, I, Kaplan D, Saadat A, Wang SM, Kain ZN. Hypnosis reduces preoperative anxiety in adult patients. Anesth Analg. 2006 May;102(5):1394-6.
Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Lumpkin PW, Carmichael DH. Treating anxiety disorders in children with group cognitive-behavioral therapy: a randomized clinical trial. J Consult Clin Psychol. 1999 Dec;67(6):995-1003.
Simmons D. Chabal C, Griffith J, Rausch M, Steele B. A clinical trial of distraction techniques for pain and anxiety during cataract surgery. Insight. 2004 Oct-Dec;29(4):13-6.
Stanley MA, Beck JG, Novy DM, Averill PM, Swann AC, Diefenbach GJ, Hopko DR. Cognitive-behavioral treatment of late-life generalized anxiety disorder. Journal of Consulting & Clinical Psychology. 2003 Apr; 71 (2): pp. 309-19.
Stetter F, Walter G, Zimmermann A, Zahres S, Straube ER. Ambulatory short-term therapy of anxiety patients with autogenic training and hypnosis. Results of treatment and 3 month follow-up. Psychother Psychosom Med Psychol.1994 Jul;44(7):226-34.
Tafet GE, Feder DJ, Abulafia DP, Roffman SS. Regulation of hypothalamic-pituitary-adrenal activity in response to cognitive therapy in patients with generalized anxiety disorder. Cognitive, affective & behavioral neuroscience. 2005 Mar; 5 (1): pages 37-40.
Teixeira J, Martin D, Prendiville O, Glover. The effects of acute relaxation on indices of anxiety during pregnancy. J Psychosom Obstet Gynaecol. 2005 Dec;26(4):271-6.
Toren P, Wolmer L, Rosenthal B, Eldar S, Koren S, Lask M, Weizman R, Laor N. Case series: brief parent-child group therapy for childhood anxiety disorders using a manual-based cognitive-behavioral technique. J Am Acad Child Adolesc Psychiatry. 2000 Oct;39(10) :1309-12.
Tusek DL, Cwynar R, Cosgrove DM. Effect of guided imagery on length of stay, pain and anxiety in cardiac surgery patients. J Cardiovasc Manag. 1999 Mar-Apr;10(2) :22-8.
Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum. 1997 Feb;40(2):172-8.
Van Dixhoorn J, White A. Relaxation therapy for rehabilitation and prevention in ischaemic heart disease: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 2005 Jun;12(3):193-202.
Vila R, Benedicto M, Pujadas C, Gomez M, Franzi A, Rodriguez L, Juncosa S. [Usefulness of relaxation techniques for patients with ischaemic cardiopathy: intervention in a health district] [Article in Spanish] Aten Primaria. 2005 Jun 30;36(2):78-84.
Wachelka D. Katz R. Reducing test anxiety and improving academic self-esteem in high school and college students with learning disabilities. J Behav Ther Exp Psychiatry. 1999 Sep;30(3):191-8.
Weber S. The effects of relaxation exercises on anxiety levels in psychiatric inpatients. J Holist Nurs. 1996 Sep;14(3):196-205.
Weinman ML, Semuch KM, Gaebe G, Mathew RJ. The effect of stressful live events on EMG biofeedback and relaxation training in the treatment of anxiety. Biofeedback Self Regul. 1983 Jun;8(2):191-20.

Breath Therapy can help with any problems you have with breathing (for example Asthma and Respiratory disease) but it can also help you tackle problems such as heart disease, high blood pressure, stress, anxiety and panic attacks. It can also help Divers learn how to breath correctly, stay relaxed under water and reduce air consumption. All in all, it is a therapy that can have a very profound effect on your health and well-being.

Lao Tzu said in 500B.C. “The perfect man breathes as if he is not breathing” its also interesting to note that if you look at breathing rates, the longest living mammals elephants and whales, breath on average 2 - 6 times per minute, dogs and rabbits breath approximately 30 - 40 times per minute and humans between 12 - 14. If you find you are breathing more than this, its a good indication that your health requires attention. 

 For anyone with breathing concerns, a combination of traditional and new mind-body techniques have the power to make real changes to your health and wellness, I have included details on some of the more common issues below, however please contact me to arrange your FREE initial consultation to discuss your own individual circumstances and find out if this type of therapy can help you.

There is a saying that goes "When the breath is steady so is the Mind" The way we breathe has far reaching effects on our well-being, infact the oxygen that we inhale is the major source of nutrients for the body, so breathing more effectively can improve your entire health. Through breathing exercises you will increase your lung capacity, learn how smooth, steady breathing helps reduce stress and activates your relaxation response, increases circulation, boosts your metabolic rate and gives you more energy - the list of benefits goes on and on!

During your initial FREE consultation we will discuss your medical history, any concerns you have and your goals. Sessions would include breathing and body awareness exercises, learning how to breathe to correct any problems and how to turn on your relaxation response (for more information please see the section on stress)

Asthma is classified as a chronic lung disease that cannot be cured, but it can be controlled, this is where the Mindful Coach can help you. 

 During an attack generally breathing becomes difficult, shallow and generally only in the upper part of the lungs. The lungs also tighten up and the air sacs do not expand leading to fear that they will not be able to continue to breath. Typically people with Asthma have problems with exhalation, however every person is different and the signs and symptoms can be different each time and can change over time and depend on the situation. Also it is important to be able to identify your particular triggers. Breath Therapy can help you find out how you breathe and help you make changes to a healthier breathing pattern, these techniques will also enable you to identify an attack at an early stage and take action. You might not be able to stop an attack, but you will be able to reduce its severity.

Nose Breathing

One way you can really improve your breathing, is to breathe only through your nose. This is because the nose has been designed specifically to clean and prepare the air we breathe, allowing only air of the right moisture and temperature level, free from dust, pollen and other small particles to enter into our delicate lungs. If you think of the air that you breathe as a type of fuel for your body, then I am sure you will agree that you want to deliver only the best possible air quality to ensure you body runs effectively. If on the other hand you breathe through your mouth (as many Asthmatics do) then you are losing out on all the benefits nose breathing can give you.

It is possible to change to nose breathing as this is the way nature intended us to breathe, its just a matter of changing an learned behaviour into the more healthy alternative. Blocked noses can be one of the challenges, try this easy exercise to see if it helps, there are more tips at the bottom of the page. 

Remember to breathe normally through out this exercise, and ONLY through your nose. Please read the instructions a couple of times before you begin.

1.      Starting movements –

Ø      Move your head backwards and forwards very slowly. Remember not to let your head fall back too far rather just look up towards the ceiling. 

Ø      Check that your shoulders are not moving and that your shoulder blades are sliding down your back towards your back pockets.

Ø      Now close your eyes and move slowly feeling the stretch as you breath in and take the chin towards your chest, and breathe out as you look up to the ceiling, its really nice to have a neck so dont let your head fall to far backwards

Ø      Concentrate on how heavy your head feels as it gently drops forward and enjoy the stretch

Ø      Repeat 6 times

2.      Now concentrate on your breathing, breath normally but slowly –

Ø      Close you eyes again and feel the cool air coming into your nostrils as you breathe in and lower your head and how warm the air is as it flows out as you look towards the ceiling

Ø      Repeat 6 times

3.      After a normal breath out, hold your nose –

Ø      Nod your head backwards and forwards three times, remember not to strain your neck and watch your shoulders do not creep up to your ears!

Ø      Let go of your nose and breathe in and out slowly

Ø      Repeat 3 times

4.      After a normal breath out, once again hold your nose –

Ø      Blow gently but don’t let any air escape, be careful not to strain

Ø      This is the same feeling as clearing your ears on the plane or when diving to the bottom of the swimming pool, some people find it easier to wiggle their jaws

Ø      Repeat 6 times

Practise this nose clearing exercise twice a day, if you have a badly blocked nose you can repeat up to 6 times daily.

TIPS

Ø      When you are trying to breathe through your nose, don’t strain to take the air into your nostrils, instead focus on opening your throat and forget about your nostrils. The trick to this is to imagine that you are actually breathing in through a hole in your throat, give it a try it really works!

Ø      Another effective method is to put your opposite hand up under the armpit on the blocked side and breath gently.

Ø      Using a mild saline solution to wash out your sinuses is also a great habit to develop. Net Pots are specifically designed for this and more information on how to use them is available in this section.

Caution – Please see medical advise before practising these exercises if you have an ear, nose or throat infection.

Chronic Obstructive Pulmonary Disease or COPD for short, is a term used to describe a number of breathing problems where there is damage to the breathing tubes and air sacs within the lung. It is a lung condition that encompasses chronic bronchitis (regular phlegm production) and emphysema (damage to the air sacs in the lung) COPD stands for Chronic Obstructive Pulmonary Disease, the symptoms are similar to Asthma but they are different diseases.

In COPD there is permanent damage to airways. The narrowed airways become fixed, so symptoms are chronic (persistent) In Asthma there is inflammation in the airways which causes the muscles in the airways to constrict. This again causes the airways to become narrow, but the symptoms come and go, and vary in severity from time to time. People with Asthma quickly learn what triggers an attack, it could be pet hair, dust or cold air for example.

There are approximately 30,000 deaths each year from COPD in the UK (NICE 2004). Smoking is the main cause, however evidence suggests that there would be around 4000 fewer of these deaths if occupational risks (dusts, smoke, fume) were removed. COPD is a major cause of disability and death and it is the 4th leading cause of death throughout the world.

Smoking is the cause of COPD in the vast majority of cases. Statistics tell us that about 3 in 20 one-pack-per-day smokers, and 1 in 4 two-pack-per-day smokers develop COPD if they continue to smoke because the lining of the airways becomes inflamed and damaged by the smoke. Air pollution and polluted work conditions may cause some cases, or make the disease worse. However, people who have never smoked rarely develop COPD.

Breath Therapy for patients with COPD (who hyperinflate their lungs druing attacks of bronchospasms, panic or exercise) includes a technique called Pursed Lip breathing. This technique includes small inhalations and long pursed-lipped exhalation. Once mastered, it helps control exhalation by preventing collapse of your airways, learned at rest, it can be applied during exercise and panic. It is also helpful to learn other breathing exercises that help to strengthen the muscles needed for breathing. Both of these techniques along with deep relaxation can be incorporated as needed into your sessions.

It must be stressed that Breath Therapy for COPD will not reverse the disease, but it will improve your quality of life and sense of well-being. It should be seen as a complimentary technique to your existing medical treatment.

RESEARCH FINDINGS USING GUIDED IMAGERY FOR ASTHMA July, 2006

Prevalence and costs

Asthma is a large, growing, and expensive health problem in all industrialized countries (American Lung Assn.). 

According to the Labor Occupational Safety & Health Administration, 15% of disabling asthma cases are work related. Occupational asthma is the most common type of occupational lung disease in the industrialized nations (Rabatin, 2001).

Workers with asthma are twice as likely to retire early; they have higher rates of absenteeism, and they rate their ability to work and their general health as poorer than non-asthmatic workers (Sauni, Oksa et al, 2001). Baking, electronics, chemical and metal manufacturing, paints and plastics, farming, and house cleaning are the highest risk occupations (Rabatin; Sauni, 2001).

What is asthma?

Asthma is thought to result from genetic sensitivity, environmental exposure to irritants and stress responses that lead to a cycle of “hyper-responsiveness” and inflammation in the bronchi. This inflammation, along with excess mucus production, can close airways and make breathing out difficult. Once established, this cycle is difficult to stop.

Medical treatment of asthma

Standard medical treatment includes daily use of an inhaled steroid medication, as-needed use of a bronchodilator (or “rescue medication”), and avoidance of environmental asthma “triggers.” (Oral medications are sometimes needed as well.) The biggest problem in asthma care is noncompliance, particularly with the steroid inhalers. Seventy percent of patients in some studies (Rand & Wise, 1994) either failed to take prescribed daily inhalers, or never filled the prescriptions (Piecoro, Potoski et al, 2001)

Non-pharmacologic treatment including imagery

According to researchers Bloomberg and Chen (2005) at St. Louis Children's Hospital, "The mind-body paradigm that links psychologic stress to disease is necessary when considering the global evaluation of childhood asthma." The mind-body connection is important in adult asthma, as well.

Behavioral and mind/body approaches are also used to control inflammation and spasm. Guided imagery was able to increase oxygenation in COPD patients (Louie, 2004). In two British studies, hypnosis reduced hyper-responsiveness, and increased forced expiratory volume through one year of follow up in adult patients who were easily hypnotized (Ewer & Stewart, 1986).

In a group of 250 patients who had not been tested for susceptibility, 59% of those receiving hypnotic suggestion were rated as “much better,” compared with 40% of a group who received relaxation training without hypnotic suggestions (Maher-Loughna, Macdonald et al, 1962).

Guided imagery uses deep relaxation and positive suggestion in ways nearly identical to hypnosis. The terms “self-hypnosis” or “auto-hypnosis” are used almost interchangeably with “guided imagery” in the literature (Olness, 1981).

A meta-analysis by Hackman, Stern, and Gershwin showed that, though larger, more randomized studies were needed, hypnosis has shown definite, long-term effectiveness in asthma, and that effectiveness is enhanced by the use of self-hypnosis. In one study, 303 pediatric asthmatics were offered hypnosis; some patient’s symptoms resolved after one session, and there was measurable improvement in 80% of those participating. No patients’ symptoms worsened (Anbar, 2002).

In another study of self-hypnosis with children, the researcher followed participants for a mean of nine months post-hypnosis. Positive results were recorded in 13 patients. Two of the children had no more symptoms and were able to discontinue their medication (Anbar, 2001). Hypnosis, combined with an education program, improved pediatric cooperation and compliance with taking peak flow measurements (Lehrer, Feldman et al, 2002).

In another study, adult asthmatics who listened to imagery tapes were less depressed an anxious, and were able to use less medication (Report, 1997). Asthma education programs that instruct patients about asthma, medications, and avoiding triggers, as this program does, help to reduce asthma morbidity.

According to a 2005 Mayo Clinic review of the hypnosis literature (Stewart, 2005), no fewer than five studies showed positive results for asthma patients using hypnosis; results included a large multicenter trial, with hypnosis patients reporting a "significant decrease" in failed treatments and an even larger number deemed "much improved" (Hypnosis for asthma, 1968).

In another study, 54% of hypnosis patients had "excellent" results, and 21% became asymptomatic and were able to discontinue medication (Collison, 1975).

In the Freeman and Welton 2005 study, the results were contrary to the researchers' hypothesis when it was shown that biologically targeted imagery was more efficacious than critical thinking asthma management.

Biofeedback was also effective in reducing some asthmatics’ dependence on steroid medication (Lehrer, Vaschillo, et al, 2004).

Team or combination approaches in asthma management can be beneficial, as with Stanford University School of Medicine's multicomponent program (Shames, Sharek et al, 2004).

Remarkable improvement occurred in the Anbar-Hummell (2005) multicomponent approach which incorporates hypnosis; 82% of their patients showed either improvement or resolution of their primary symptoms.

Conclusion

A low-cost imagery intervention may reduce asthmatic patients’ anxiety and use of medical services, and improve their pulmonary function.

REFERENCES

Anbar R D. Hypnosis in pediatrics: applications at a pediatric pulmonary center. BMC Pediatr. 2002 Dec 3;2(1):11
Anbar RD. Self-hypnosis for management of chronic dyspnea in pediatric patients. Pediatrics. 2001 Feb;107(2):E21.
Anbar RD, Hummell KE. Teamwork approach to clinical hypnosis at a pediatric pulmonary center. Am J Clin Hypn. 2005 Jul;48(1):45-9.
Bloomberg GR, Chen E. The relationship of psychologic stress with childhood asthma. Immunol Allergy Clin North Am. 2005 Feb;25(1):83-105.
Centers for Disease Control, National Center for Health Statistics. Asthma. http://www.cdc.gov/nchs/fastats/asthma.htm Accessed June, 2006.
Collison DR. Which asthmatic patients should be treated by hypnotherapy? Med J Aust. 1975;1:776-781.
Ewer TC, Stewart DE. Improvement in bronchial hyper-responsiveness in patients with moderate asthma after treatment with a hypnotic technique: a randomized controlled trial. British Medical Journal.1986 Nov 1; 293 (6555) 1129-32.
Family Guide to Asthma and Allergies. (1997). American Lung Association Asthma Advisory Group with Norman Edelman, MD. Little, Brown: New York.
Freeman LW, Welton D., Effects of imagery, critical thinking, and asthma education on symptoms and mood state in adult asthma patients: a pilot study. J Altern Complement Med. 2005 Feb;11(1):57-68.
Hackman RM, Stern JS, Gershwin ME. Hypnosis and asthma: a critical review. Journal of Asthma. 2000; Feb 37(1): 1–15.
[no authors listed] Hypnosis for asthma—a controlled trial: a report to the Research Committee of the British Tuberculosis Association. Br Med J. 1968;4:71-76.
Kohen DP. Applying hypnosis in a preschool family asthma education program: uses of storytelling, imagery and relaxation. American Journal of Clinical Hypnosis. 1997; 39 (3): 169-81.
Lehrer P, Feldman J, Giardino N, Song H, Schmaling K. Psychological aspects of asthma. Journal of Consulting and Psychology. 2002 70(3):691-711.
Lehrer PM, Vaschillo E, Vaschillo B, Lu SE, Scardella A, Siddique M, Habib RH. Biofeedback treatment for asthma. Chest. 2004 Aug; 126 (2): pages 352-61.
Lewith GT, Watkins AD. Unconventional therapies in asthma: an overview. Allergy.1996 Nov, 51(11):761-9.
Louie SW. The effects of guided imagery relaxation in people with COPD. Occup Ther Int. 2004 11(3):145-59.
Maher-Loughna GP, Macdonald N, Mason AA, Fry L. Controlled trial of hypnosis in the symptomatic treatment of asthma. British Medical Journal. 1962 (2): 371-76.
Morrison JB. Chronic asthma and improvement with relaxation induced by hypnotherapy. J R Soc Med. 1988;81:701-704.
National Center for Health Statistics. http://www.cdc.gov/nchs/fastats/asthma.htm Accessed November, 2005. Accessed June, 2006.
Olness K. Imagery (self-hypnosis) as adjunct therapy in childhood cancer. Am. Journal of Pediatric Hematology/Oncology. 1981 3 (3) 313-320.
Piecoro LT, Potoski M, Talbert JC, Doherty DE. Asthma prevalence, cost, and adherence with expert guidelines on the utilization of healthcare services and costs in a state Medicaid population. Health Services Research. 2001, June; 36(2): 357-71.
Rabatin JT. A guide to the treatment of occupational asthma. Clin Proc (Mayo Clinic). 2001 June 76(6):633-40.
Rand CS, Wise RA. Measuring adherence to asthma medication regimens. Am J Resp Crit Care Med. 1994 149: S69-76.
[no authors listed] Report. Alternative Health practitioner: The Journal of Complementary and Natural Care Fall/Winter, 1997 3 (3).
Sauni R, Oksa P, Vattulainen K, Uitti J, Palmroos P, Roto P. The effects of asthma on the quality of life and employment of construction workers. Occupational Medicine (London), 2001 May 51 (3): 163-7.
Shames RS, Sharek P, Mayer M, Robinson TN, Hoyte EG, Gonzalez-Hensley F, Bergman DA, Umetsu DT. Effectiveness of a multicomponent self-management program in at-risk, school-aged children with asthma. Ann Allergy Asthma Immunol. 2004 Jun;92(6):611-8.
Stewart JH. Hypnosis in contemporary medicine. Mayo Clin Proc. 2005 Apr;80(4):511-24.
United States Department of Labor Department of Labor Occupational Safety & Health Administration.
www.osha.gov/SLTC/occupationalasthma/index.html Accessed June, 2006.
Wyler-Harper J, Bircher AJ, Langewitz W, Kiss A. Hypnosis and the allergic response. Schweizerische Medizinische Wochenschrift. Supplementum. 1994, 62:67-76.

Mindful Relax and Renew

During deep relaxation, all the organ systems of the body are benefited. A few of the measurable results of relaxation are the reduction of blood pressure and the improvement of immune function, as well as improvement in digestion, fertility, elimination and the reduction of muscle tension, general fatigue will just simply melt away.

A short relaxation exercise you can practise at home.

Lie down and make yourself comfortable perhaps with a little pillow under your head, cover yourself with a blanket if its cold. Have your feet hip distance apart and falling outwards (if you have a lower back problem, bend your knees and keep your feet flat on the floor, alternatively put a cushion under your knees so your lower back is relaxed) close your eyes (if you have one use an eye mask as it really does help with relaxation) and place you hands on your tummy, the idea is to be able to feel your tummy moving up as you inhale, and down as you exhale. Become aware of  your breathing, notice that it flows in and out like the ever present waves on the sea shore, rolling in and rolling out.

Then take five to ten deep breaths feeling your hands rising and falling, just let your exhale fall out of you without effort or strain and at the same time say out loud or think the word "Relax"

If you think the word and little sighs come out, this is fine as it’s a good sign that your letting go of tension.

After the five to ten breaths, just breathe at a normal pace and stop thinking or saying the word relax when you exhale. Take your hands off your tummy and place them next to your body, palms facing upwards.

Next state each body part direction out loud or silently before you relax it, it doesn’t have to be this exact order, just start at your feet and let your mind and body lead you: -

• I now relax and let go of any tension and stress in my feet and ankles
• I now relax and let go of any tension and stress in my calves and knees
• I now relax and let go of any tension and stress in my thighs and hips
• I now relax and let go of any tension and stress in my tummy
• I now relax and let go of any tension and stress in my back
• I now relax and let go of any tension and stress in my chest
• I now relax and let go of any tension and stress in my shoulders
• I now relax and let go of any tension and stress in my neck
• I now relax and let go of any tension and stress in my face and head
• My whole body is now calm and relaxed

Its nice to repeat the final whole body one 3 times as you are really giving your body permission to relax (out load the first time, whispering the second time and silently the third is excellent as you are then talking to every level of your body but anyway will be fine)

Now just let go in this wonderful place of relaxation, a nice affirmation to say as you breathe in and out is "as I inhale, I relax body and mind, as I exhale I smile"

When you are ready to come back, first tell yourself you can return to this place of relaxation at any time. Start to slowly move in anyway that feels good, before rolling over onto your right hand side and using your hands to help you (this protects your lower back) push yourself into a seated position. Take a few minutes here to become aware of your surroundings before you return to your day.

The Secret Power of Affirmations

This is why stating your goals and dreams in a positive and healthy way is so important, otherwise you are constantly undermining your efforts. In the example we used, a better way of thinking would be "I feel slim today or I love eating healthy food" If you state your goal in the present tense rather than something you want in the future, even if its not true now your sub-conscious mind will work to change the behaviour and motivate you in that direction.

The Mindful Coach uses positive Affirmations during some therapy sessions and on many of the well being CD's as they strongly reinforce and motivate you towards the positive healthy changes you want to make in your life. Because they become even more powerful if they are made up of words that you normally use, we also offer Affirmation sessions where we work together to create your own personal affirmations, these would then be added to a personalised CD for you to use at home. 

The best way to use affirmations at home is to repeat them as soon as you wake up as it will help you focus your day, and just before going to sleep so that your sub-conscious mind can be working on them as you sleep. You should also try to fit your affirmations in two or three more times during the day, it doesnt really matter when, but if they are spaced out you will find they work much better. The general rule is that you keep working with your affirmation until it becomes your reality. Remember that when you affirm something you are telling your sub-conscious that it is true, your sub-conscious then goes on to change your behaviour so be carefully what you ask for!

• They should always be stated in the present tense so rather than saying "I want to be healthy" say "I am healthy" it doesnt matter that it might not be true at this very moment, but your sub-conscious will start motivating and changing your behaviour towards your goal.


• Ancient traditions advises that where possible say your affirmations 3 times, the first time should be out load (so that your hearing starts to work with it) the second time should be whispered and the third time should be said internally. This way you are working with different levels of your consciousness.


• Say your affirmations as if you really mean them! make them even powerful by putting lots of feeling into them.


• At least once a day stand infront of a mirror, look yourself in the eyes and repeat your affirmation really positively (this gets your sense of sight working with the affirmation too) Very often we find it easier to accept what other people tell us, so look yourself squarely in the eye and talk to yourself! if you find this hard to start with, keep with it as it will get easier and the results will be worth it


• Write your affirmations down and stick them to the fridge, put them by your computer screen, in your purse so you see it when you open it or where ever you will see them during the day.


• If you catch yourself engaged with negative self talk, acknowledge that you need to change it but don't get upset. Its actually good that you have started to become aware of what is going on inside your body. Write down the negative and turn it into a positive that you can use instead. For example if you are working towards being someone who used to smoke, instead of affirming "smoking relaxes me" replace it with "I am healthy, relaxed and free from nicotine"


• Remember that negative self talk is a habit that like any other habit can be changed.


• Finally, have fun with your affirmations!

Some Sample Affirmations to get you started.

For Weight Reduction: -

• "I am feeling fit and healthy"
• "I am feeling slim and only eat when I am hungry"
• "I eat healthy food"
• "I feel lighter today"
• To repeat as part of your walking programme (n.b. match the words to the walking rate) "Fat burning, muscles toning"

For self esteem:-

• "I feel gorgous"
• "I release all my negative emotions, I am confident and happy"
• "I am achieving my goals and dreams"

For Health and Wellness:-

• "I feel wonderful"
• "Every day in every way I am getting better and better and better"
• "I am smiling and every cell in my body smiles with me"
• "My blood pressure is already getting lower"
• "My heart valve is already healing"

Medical treatment:-

• I am prepared emotionally for my treatment.
• I am prepared mentally for my treatment.
• I am prepared physically for my treatment
• I am peaceful and calm during my treatment
• My immune system is healthy throughout my body
• My body and mind are completely healed

For Smoking Cessation: -

• "I breathe clean, fresh air, I am stronger than any habit"
• "I smell nice"
• "Every day I am healthier, happier and richer"
• "I can handle any stressor that comes my way without smoking"
• I am healthy and free from nicotine"

For Relaxation and Stress relief: -

• "I have the power to come to this place of relaxation and calmness whenever I choose"
• "I am relaxed and safe"

What exactly is a habit? well according to medical journals, "its a behavioural response or practise that is learned and established by the individual frequently repeating the same act" You start a pattern of behaviour for one reason or another, and after a while it becomes so ingrained that typically you may not even be aware your doing it. Some habits are good, for example eating fruit every day with your lunch or cleaning your teeth, but some become a nuisance or dangerous and we want to change them.

Your mind is made up of 2 parts, the conscious and the sub-conscious, which ideally you want working together so you can achieve your goals and dreams. Very often though, even without us being aware, they are working against each other.

You could call the conscious mind your awareness, it's where your short term memory is held and it is responsible for letting you know whats going on around you. This is the part that many people find hard to quieten down, its on the go all day and is sometimes referred to as the 'Monkey Mind' (see the section on Stress for more information) Size wise, imagine your conscious mind as the tip of an iceburg, the part visable above the sea.

The sub-conscious mind is the rest of the iceburg, hidden under water and out of your awareness. It gets on with the day to day tasks of keeping you alive and breathing, its also the place where you keep your memories and those patterns of behaviour we talked about before. Interestingly your sub-conscious mind cannot process negatives, it interprets everything you think as a both a postive thought and the truth. For example if you were to think "I don't want to be fat" your unconscious mind focuses on the 'fat' and, because it doesnt recognise negatives, the thought becomes "I want to be fat" and to make matters worse your sub-conscious mind now thinks this is your goal and helps you keep repeating patterns of behaviour to make this happen - Definately not what you wanted!

This is why stating your goals and dreams in the positive is so important, otherwise you are constantly undermining your efforts. In the example we used, a better way of thinking would be "I feel slim" If you state your goal in the present tense rather than something you want in the future, even if its not true now your sub-conscious mind will change your behaviour (for more info see the the section on healthy affirmations) and if you keep repeating this, you will be motivated in that direction.

So how can this knowledge help us change the habits and behaviours we no longer want or need? Hypnotherapy works by relaxing the conscious mind and allowing communication directly with the subconscious mind. In this way the therapist can make positive suggestions and affirmations directly to your sub-conscious so that the two parts work together to change your behaviour.

How does Healing Rhythms work?

As you enjoy the breathing, relaxation and meditation exercises in the program, the changes in your physiology are related back to you in real-time, on-screen, in the form of images from the biofeedback sensors.

Biofeedback Shown to Help Children with Autism

—Autism Today

Every parent knows the challenges that stress plays in day-to-day life. And, parents of a child with autism frequently experience how stress can overwhelm the child and provoke a wide spectrum of behaviors, including complete withdrawal.  

While stress cannot be completely eliminated from anyone’s life, tools are available that can significantly help reduce it. Biofeedback, for example, has been used for many years to produce a positive effect on emotional and physical well-being, particularly stress-related conditions.  

And, for parents of children with autism, the benefits of biofeedback are quite promising. Scientifically proven to be effective, biofeedback can help teach a child how to recognize, monitor, and work through stress.   

A recent study by Ingrid M. Loos Miller and Hendricus G. Loos found that stress in children with autism can trigger a sequence of behaviors. The behavior begins with looking away and being distracted. When the child is pressed too far, stress increases, and the behavior progresses into minimal responsiveness, finally resulting in a complete shutdown in which the child goes to sleep.  

According to Miller and Loos, “Techniques that encourage the child to work through stress will teach him to ignore sensations, which are vital for his functioning. With proper training, the child could instead be taught to recognize the signs of stress and to use the tools at his disposal to reduce it. This ability to self-manage is a ‘pivotal’ skill which can produce improvements in wide areas of functioning.” 

Biofeedback can provide children with autism with tools and self-managing skills, helping them fend off stress before it has a chance to trigger a shutdown.  

Reducing stress is vital to overall well-being. According to Miller and Loos, stress reactions severe enough to cause shutdowns can lead to pathological changes in the brain and developmental delays. Repeated shutdowns can damage the nervous system. Symptoms such as overly emotional behavior, fearfulness, and social withdrawal can escalate. The child might also struggle further with learning difficulties, language difficulties, and excessive rhythmic behaviors, such as an increased desire to sit on a swing for long periods of time. 

Today, the stress reduction benefits of biofeedback are available literally right at your finger tips. Healing Rhythms, a computer program from Wild Divine, Inc., integrates biofeedback technology with computer-generated breathing, meditation, and relaxation exercises. It’s effective, fun and easy to use, and affordable. 

“What Healing Rhythms does stabilizes the human brain and harmonizes the central nervous system. It is not a correction, but a wonderful supplement for treating individuals with ADD, ADHD and Autism,” says biofeedback therapist Michael Pizhadze, PhD.  

Biofeedback sensors provided with Healing Rhythms attach to ones’ fingertips and connect to any home computer. The child practices the exercises driven by the Healing Rhythms software while the biofeedback sensors pick up signals from the child’s own body to monitor physical and emotional responses. The changes are tracked and fed back in real-time, on-screen, in the form of beautiful, transformational images or as graphs that you can save. One can see and experience instant results and can track progress.  

"The deep breathing and meditation exercises in Healing Rhythms help promote relaxation. As you become more relaxed, your brain wave activity slows. According to psychotherapist Gary Ames, "Quieting brain waves is tightly linked to symptom (autism) reduction." 

As a teaching modality, computers have been shown to be effective for children with autism, thus making a tool like Healing Rhythms even more beneficial. According to Miller and Loos, “The visual and tactile elements of computer programs keep children interested and focused on their task.” In a 2002 study, autistic children spent more time with reading material presented on a computer and were less resistant to its use.  

The unique stressors of autism touch the entire family, including parents, siblings, and grandparents. Research indicates that parents of children with autism experience greater stress than parents of children with mental retardation and Downs Syndrome. Feelings of isolation, grief, financial worries, and concern over future care can add to the wear and tear daily stress has on your family.  To counter the effects of stress on a family life, it’s important they take time for themselves and other family members.  Healing Rhythms can be used by, and benefit, the entire family.

Insomnia is the difficulty in falling asleep, in staying asleep or disturbed sleep patterns resulting in insufficient sleep.  Sleep trouble is increasingly becoming a problem in our high-stress, fast-paced world. Very often, when we go to bed, our minds are still racing with thoughts and lists of things we need to do, and we find it impossible to stop our mental chatter.

Apart from having a check  up with your Doctor to make sure there are no under-lying health reasons for your disturbed sleep patterns, there are various self-help ways to improve your sleep, they are: -

• Establish a regular sleep schedule.
• Establish a regular bed time routine.Check that your bedroom is set up for sleeping and not other activities such as watching the TV or doing the paperwork!
• Take regular exercise, this promotes sleep and reduces stress, however avoid exercising in the late evenings as it stimulates both your cardio-vascular and nervous system which could interfere with falling asleep at bedtime.
• Learn how to relax.
• Listen to some music you find relaxing or some specific Sound Therapy tracks.
• Avoid drinking alcoholic or caffinated drinks, smoking, eating caffeinated food (e.g. chocolate) or taking prescription diuretics near to bedtime.
• Wear an eye mask if you are disturbed by lights, and so called white-noise such as a fan can infact help eliminate disturbing noises. If you are kept awake by a snoring partner, consider investing in either a Hypnotherapy session or CD which helps your sub-conscious mind become distracted from the sound.
• Consider investing in a Meditation Machine (see the shop page) The new Mind Spa includes light-glasses based on cutting edge research at one of the worlds most prestigious medical schools. It has been found that when the retina is exposed to light it acts to reset our internal body clock. This light can bu utilized to treat a range of circadian disorders such as seasonal affective disorder (SAD) jet lag, sleep pattern problems and a range of related issues. 

• Please note, Meditation Machines should not be used by persons with brain or neurological disorders (such as epilepsy) which may be triggered or aggravated by rapid light fluctuations. Those with serious medical conditions, including those using a pacemaker or suffering cardiac arrhythmia or other heart disorders must consult a medical professional before beginning use.This product is not intended for use in the diagnosis or treatment of any medical condition. 


• Learn how to use Guided Imagery (see research on the next page)

I hope the above self-help tips and information helps you re-establish a healthy sleep pattern. Alternatively, the professional and modern mind/body therapies offered at the Wellness Centre can help you with your individual sleep problems. Please telephone to arrange your FREE initial consultation so together WE can change YOUR Life.

  How the fight or flight response affects the body:–

• The stress response is turned on and the Sympathetic nervous system swings into action. The endocrine system release hormones (including glucocorticoid secretions from the adrenal gland – long term flooding linked to depression) heart rate, breathing rate and blood pressure increase, muscles in the thighs, back and shoulders contract ready to escape.
• The body shuts down what it thinks of as “long term projects” and focuses on the perceived immediate need. This means for example digestion, growth and tissue repair and sex drive shuts down (women don’t ovulate and men have trouble with erections and secrete less testosterone) – 10 to 20 percent of our daily energy normally goes on digestion alone
• The immune system is inhibited, so anti bodies needed to protect you are not made and the system will not be working to spot cancer cells as it is not part of short term survival
• Cognitive and sensory skills and certain aspects of memory improve with low to moderate amounts of transient stress, but with severe stress this all goes and the hormones that are secreted lead to memory decline.
• All in all it has been proven that the Stress Response is more damaging than the stressor itself, especially when the stress is purely psychological (mind-body) we then leave ourselves open to stress-related disease i.e. heart disease, diabetes, digestive and reproductive disorders, infectious diseases and a badly depressed immune system as the body is so exhausted by keeping itself in readiness for the disaster that it ignores normal housekeeping needed to keep us healthy.

What is stress and the stress response?

• The stress response is an alarm mechanism whose purpose is to defend us from an external threat, this is a good thing and we all need a good stress response.


• A stressor can be anything that throws your body out of (homeostatic) balance. The body will turn on the stress response (your Sympathetic nervous system) to restore the balance.


• Our bodies do not know the difference between a real threat and an imagined threat, for example an actual car chase and one you watch on a film, the bodies response is the same! (your pulse goes up, breathing rate increases, fight or flight reactions take place - see next page)


• Continued activation of the stress response can lead to the body to forget how to turn the stress response (Sympathetic nervous system) off! not a good thing as high levels of both emotional and chronic stress can potentially increase susceptibility to illness by suppressing the immune system. If you already have a disease, then stress increases the risk of your defenses being overwhelmed by the disease.

• High Blood pressure
• Heart disease
• Insomnia
• Constant fatique
• Headaches
• Dizziness
• Palpitations
• Shaking hands
• Skin rashes
• Digestive problems
• Ulcers
• Colitis and IBS
• Eating disorders
• Muscle cramps
• Tension in the neck, back and shoulders (just check where your shoulders are right now - are they up by your ears?)
• Tension in your tummy (think of a happy baby, their tummy is big fat and relaxed, on the other hand an unhappy babies tummy is rigid)
• Frequent need to wee
• Nausea
• Breathlessness
• and a Dry mouth to name just a few!

Actually the list goes on and on. Please bear in mind there maybe underlying conditions that present these symptoms and if they are persistent you need to get checked out by your Doctor or Medical practitioner. However when you take a few minutes to sit down and consider your stress you probably know intuitively what your own physical signs of stress are but we have included a simple and quick stress test on the next page.

The good news is that something can be done about your levels of stress and how you respond to triggers, you just need to learn how and this is where the Mindful Coach can help to support you.

This simple test will help you focus on behaviours and attitudes that contribut to stress. Mark your scores: Never = 1, Sometimes = 2, Most of the time = 3, Always = 4. Be as true to yourself as possible!

1. I need things my way
2. I blame others for how I feel
3. I find it difficult to show emotions
4. I find I can be angered easily
5. I find my work unfulfilling
6. I find my personal life unfulfilling
7. I focus on the negatives
8. I resist change
9. I find it hard to be decisive
10. I dont act for fear of failing
11. I respond poorly to criticism
12. I rush even when there is no hurry
13. I dont take time for myself
14. I feel I must say yes to requests
15. I feel unappreciated
16. I feel I have to do everything myself
17. If things dont workout I blame myself
18. I work flat out
19. I feel the need to compete
20. I find if hard to relax

Scores 1-20 You are very laid back, maybe a more pro-active approach to life and greater motivation would be good?

Scores 21-40 Things seem generally well balanced, learning how to relax deeply will only make things better.

Scores 41- 60 Things are starting to get a little out of control, learning how to manage your stress should be something you recognise you need.

Scores 61-80 Stress is the most dominant thing in your life at the moment and you need to get it under control as a priority.

The above self-test is only an idicator of behaviours and attitudes that can contribute to increasing our stress levels. We may fluctuate quite dramatically from time to time. Todays stressed out freak can become tomorrows creative and balanced person, and the laid back dude out there could become a bit more proactive and motivated! So treat the test as an indicator only and not a full description of your stress and motivation.

A simple loving kindness meditation, its a bit like giving yourself a nice big warm hug! a nice way to practise this meditation is to ask someone to read it out for you in slow relaxed voice, or better still record it onto CD so you are listening to your own voice. There are also self-help CD's available in the shop if you prefer.

Don't worry if you have never meditated before, just think of it as relaxing and turning your focus in on yourself rather than the outside world, research has shown that we spend over 80% of our time thinking of things outside ourselves, and only less than 20% on what is going on inside us. As you can only heal what you feel, its good to focus on yourself every day.

If you find your mind wandering, dont get upset, just acknowledge its wandered and bring it back to the sound of the voice, or your own breathing. If you would like to learn more, private sessions are available at the clinic.

• Sit where ever you feel most comfortably, turn off your phone and tell your family that you are taking some time for yourself


• If you want to you can close your eyes, allow your attention to come gradually to your breathing, dont try to change it, just notice how it is. If its fast, let it be fast. If its slow, let it be slow, if its shallow let it be shallow. If its deep let it be deep. You will probably find that by the end it has changed, but dont worry about it, just let it be


• Notice your breath coming and going all by itself within your body


• Take a few moments to allow the attention to gather within the even rhythm of the breath, like the waves on the beach, constantly moving in and out, it just happens all by itself


• Now turning gently within, begin to direct toward yourself feelings of loving kindness relating to yourself as though you were your only child. Silently as if talking to your own heart say “may I dwell in the heart. May I be free from suffering. May I be healed. May I be at peace”


• Just feel the breath breathing into the heart space as you relate to yourselves with mercy and loving kindness.


• Allow the heart silently to whisper the words of mercy that heal, that open. “May I dwell in the heart. May I be free from suffering. May I be healed. May I be at peace”


• Allow a willingness to be healed to converge in your heart.


• Whispering to yourself send feelings of well-being to you. “May my heart flower. May I know the joy of my own true nature. May I be healed into this moment. May I be at peace”


• Repeating gently with each in-breath into the heart “May I dwell in the heart”


• With each out-breath “May I be free from suffering”


• With the next in-breath “May I be healed”


• With the following out-breath, “May I be at peace”


• Repeating those words slowly and gently with each in-breath, with each out-breath. Not as a prayer but as an extending of a loving well-being to yourself.


• Noticing whatever limits this love touching yourself, this mercy, this willingness to be whole, to be healed.


• “May I dwell in the heart. May I be free from suffering. May I be healed. May I be at peace”


• Continue with the rhythm of this breath, this deepening of merciful joy and loving kindness drawn in with each breath, expanding with each exhalation.


• “May my heart flower. May I be free from suffering. May I be whole. May I be at peace”


• Let the breath continue naturally as mercy for yourself, for this being within, deepens as it expresses itself. If you find emotions coming up, gently acknowledge them, be kind to yourself, give yourself time and space to feel what ever you feel in these moments


• Though at first these may only feel like words echoing from the mind, gently continuing, a feeling of warmth is drawn in with each breath, a sense of patience developing with each exhalation.


• Drawing in warmth, expanding patience.


• Room to live, room to heal.


• “May I dwell in the heart. May I be at peace”


• Each breath deepening the nurturing warmth of relating to one-self with loving kindness and compassion. Each exhalation deepening in peace, expanding into the spaciousness of being, developing the deep patience that does not wait for things to be otherwise but relates with loving kindness to things as they are.


• “May my heart flower. May I be free from suffering. May I be healed. May I be at peace”


• Allowing the healing in with each breath. Allowing yourself to heal into your true spacious nature.


• Continuing for a few breaths more this drawing in, this opening to, loving kindness. Relating to yourself with great tenderness, sending well-being into your mind and body, embracing yourself in these gentle words of healing, its really nice to finish this by wrapping your arms around yourself and literally giving yourself a hug with a nice smile on your face.

"May you dwell in your heart. May you be free from suffering. May you be healed. May you be at peace"

Kathy

Hypnosis "Eases pain of breast cancer ops" by Victoria Fletcher Health Editor of the Daily Express. August 29th 2007

Breast cancer patients should be offered Hypnsosis before surgery to reduce the pain they feel afterwards, a study claims. The therapy can also reduce the amount of anaesthetic needed for surgery, and save money and time, researchers suggest.

A team from the Mount Sinai School of Medicine in New York consulted 200 women about to have surgery for breast cancer. An hour before they were due to go under the knife, they were given either a 15-minute session of Hypnosis or a 15-minute chat with a Psychologist.

Those who had Hypnosis were told how to relax and how to visualise pleasant imagery. They were also told how to reduce the pain endured - during and after - how to reduce feelings of nausea and tiredness and how to perform self-hypnosis once home.The other patients were simply offered a session with a Psychologist to discuss the operation and their hopes and fears.

The team assessed how many sedatives and pain killers both groups needed during and after the operation. They discovered that patients given Hypnosis needed less anaesthesia and said they felt less pain, nausea, fatigue, discomfort and emotional upset following the operation. Their surgery lasted about 11 minutes less than the other group, which saved around £385 per patient. Dr Guy Montgomery, who led the study, said Hypnosis could prove a valuable new tool*

The study published online in the Journal of the National Cancer Institue, is the latest to show how hypnotherapy can help patients having surgery.

Allergic

In recent years an increasing number of patients have under-gone major surgery under only local anaesthetic and following Hypnosis. Although Hypnosis during surgery isn't available on the NHS, Doctors at the University Hosptial of Liege in Belgium have used the technique, combined with local anaesthetic, in more than 5,000 operations. Studies have shown that Hypnosis could be useful in cases where patients are allergic to anaesthetic or at risk of side effects.

Dr Sarah Cant, of the charity Breakthrough Breast Cancer, said "this is an interesting study and anything that can help reduce the side effects of breast cancer surgery is to be welcomed. However larger studies are needed before we can come to any firm conclusions about the benefits of Hypnosis prior to breast surgery. Anyone interested in using Hypnosis should discuss this with their breast care team first and ensure that they are using an appropriately trained and experienced Hypnotherapist".

*Note:- Hypnosis for surgery is nothing new, infact it was used during the 1st World War due to shortages in anaesthetic.