Posts Tagged ‘holistic’

Acupuncture and Oppositional Defiant Disorder

Tuesday, June 7th, 2011

Recently there has been some degree of outrage about a 14 year old “asbo yob” receiving taxpayer funded acupuncture treatment in an attempt to moderate his behaviour. One senses that some of the outrage may stem from the belief that “yobs” should be punished, not given what may be perceived as “feel-good” treatments, but this misses the point completely – if the treatment works and the boy in question stops causing such mayhem, then everybody wins.

However, opposition to the acupuncture treatment also comes from the belief that there is no evidence that acupuncture works for “Oppositional Defiant Disorder” which is – apparently – the diagnosis which has been made in this case. My colleague Sean Barkes was recently asked to discuss this case on BBC Radio Humberside. The debate became one of research availability. Whilst the detractors argue there is no evidence to suggest that traditional acupuncture might be helpful for ODD, Sean argued that there was. My colleague’s point was that there is an abundance of research to show that acupuncture is helpful in improving health in humans, including mental health. Inevitably, physical and mental health status affects behaviour. The other point he was trying to make was that, even if positive research evidence were available relating to the acupuncture treatment of ODD, it would not be relevant for this specific case as it is the cost to society that is the key point here.

There is a lot of research to show that acupuncture has a positive effect on people both mentally and physically; for example, it is at least as effective as anti-depressant medication in treating depression (1), it is more effective than hypnotic drugs (sleeping tablets) at treating insomnia (2), and is at least as effective as drug-therapy for managing migraines (3). Therefore we can say that it is likely to have a beneficial effect in this case. If orthodox solutions have been tried and not been effective, something needs to be done. If we know that acupuncture may have a positive effect on this individual’s mental states, it may well be that acupuncture is worth trying. What, after all, is the alternative? The alternative is probably to lock him up. This, I don’t doubt, would be a whole lot of a bigger financial burden on the tax-payer than a mere £40 a week acupuncture treatment. So there is a case to be made that trying acupuncture may well save the tax-payer a lot of money; furthermore, if it is successful, it may encourage further research in the area, which might just mean that the tax-payer saves an awful lot of money.

It is too simplistic to argue that there is no research to support the use of acupuncture in this case. Evidence for the efficacy or otherwise of any treatment for any condition does not just appear. If you have a condition for which you do not have an effective treatment, you have to try something. If you have positive results, and you can repeat these in a few other cases, you can start thinking about doing some proper research. I would think that the people responsible for trying acupuncture here deserve some credit for a bit of initiative, and in fact for looking for a solution which is much more economical than most.

A further relevant point here is the way that research is done on the effectiveness of a holistic treatment such as traditional acupuncture. Such treatment is targeted at the individual patient, rather than at the specific condition, such as ODD. However, the usual research methodology, epitomized by the Randomized Controlled Trial, focuses down onto the condition, and pretty much ignores the larger context of the patient’s general health. An RCT investigating the effectiveness of a drug to counteract high blood cholesterol, for instance, may conclude that the drug in question is effective in lowering cholesterol levels, but it does not measure or take into account such things as the side effects of that drug. The question such a trial should really address is, do people live longer when they are on the drug in question – and, perhaps, do they have a better quality of life. If people’s life expectancy is not improved by the drug, and if their quality of life is impoverished, then the fact that their cholesterol levels are lowered is of little consequence. This example illustrates the main weakness of modern western medicine, which all too easily falls into the trap of treating the condition rather than the person. It is no good improving one isolated aspect of the person’s health if their overall health suffers.

So similarly in a case like this, one would want some research which investigated, say, whether traditional acupuncture treatment reduces the cost to society of young offenders, rather than whether it helps with ODD specifically. After all, it would be of little consolation to anyone if the lad in question displayed improvement in the symptoms of ODD, such as fewer angry outbursts and less resentment, but continued with a life of crime anyway.

So, far from outrage, a more reasonable response to this story would be to welcome the possibility that a very economical holistic therapy such as acupuncture may have an important part to play in managing these kinds of anti-social behaviours in a cost-effective way. But the research which needs to be done to find out whether this indeed may be a viable approach needs to avoid over-focusing on conditions such as ODD and measure whether there is a reduction in violent and anti-social behaviour.

1. http://www.acupuncture.org.uk/research-fact-sheets/1277-acupuncture-and-depression.html
2. http://www.acupuncture.org.uk/research-fact-sheets/1283-fact-sheet-acupuncture-and-insomnia.html
3. http://www.acupuncture.org.uk/research-fact-sheets/1148-acupuncture-and-migraines.html

Tags: , , , ,
Posted in Uncategorized | No Comments »

More harm than good?

Wednesday, April 27th, 2011

Sometimes we see patients, the most credible explanation of whose symptoms are that they are caused by the pharmaceutical medication they are taking. For instance, a patient presents with depression, fatigue, and nausea. The nausea is so bad that they have a hard job eating at all, which may fully or partially account for the fatigue and perhaps the depression also. If you don’t eat, you have no energy. There is no obvious reason for this patient to be depressed; it has just come upon them.

It turns out that for ten years or so they have been taking three different kinds of medication to treat their high blood pressure. If you look up the possible side effects of these drugs, you find that two of them may cause nausea, two of them may cause depression, and two of them may cause fatigue! But that is just the beginning of the story. A few years after going on these drugs, omeprazole is also prescribed, apparently to prevent ulceration in the stomach. Possible side effects of omeprazole: nausea, fatigue and depression. A few years later, like many other people, the patient is put on simvastatin to lower their blood cholesterol level. Possible side effects of simvastatin: depression, fatigue, gastro-intestinal disturbance.

For two years now the patient is also taking anti-depressants. One of the antidepressants she is currently taking can cause nausea, suppressed appetite and weight loss. The antidepressants don’t appear to be having much effect on the depression.

So why is the patient depressed? Of course one cannot rule out the possibility of some unconscious conflict, even though the patient is clearly sincere in their belief that they have nothing to be depressed about. But to me the most likely reason must be that the cocktail of drugs they are taking is lowering their mood, making them nauseous, and tiring them out. The nausea stops them eating well, indeed makes it difficult for them to eat at all, thus exacerbating the fatigue and depression. They are now taking four different drugs which can cause nausea (plus one which admits only to the more generalised ‘gastro-intestinal disturbance’), four which can cause depression, and four which can cause fatigue! On top of all that, there is the question of how these drugs interact with each other, which is perhaps something of an unanswerable question.

Listening to these stories, it is hard not to start getting depressed oneself. Do they really need to be on all these drugs? For all I know, at each stage in their medical history, whoever has prescribed the next drug may have done their best to weight up the pros and cons of that drug and decided it was the best step to take, and thought hard as to whether the patients problems were caused by the side effects of the drugs they were already on. But the patient themselves is clearly not aware of anything like that having happened. I seriously wonder if conventional treatment is just so over-reliant on pharmaceuticals that that is the only treatment option available, with the results being, sometimes, like this one.

I am not of course advocating that such a patient just stops taking their drugs. But at least questions should be asked. Do they really need the omeprazole, given its possible contribution to the nausea, fatigue and depression? Do they really need the simvastatin? Do they really, in fact, need the antidepressants, if I am right in surmising that the depression is caused by the other drugs? Above all, they need to be able to make an informed choice about what they take.

Suppose this patient had been treated holistically from the start. OK, they start off with high blood pressure. From the holistic perspective of Traditional Chinese Medicine, when a patient experiences a symptom, it is considered that their body and mind are out of balance. Treating this imbalance with acupuncture, and perhaps making suggestions as to how they could take the initiative themselves in restoring harmony, may well have had a knock on effect in bringing down the blood pressure. At least it may have meant that less pharmaceutical intervention was needed – maybe one or two drugs instead of three, maybe a lower dose. Maybe if these drugs still made them feel sick, we could have helped alleviate that nausea.

I’m not suggesting our medicine has all the answers. I’m just questioning whether the conventional approach to cases like this is over-reliant on pharmaceutical medications, and whether, therefore, there does not really need to be a more integrated, holistic approach to patient care, and whether the whole issue of side effects needs to be discussed much more fully and openly with patients, so that they can make an informed choice about their care.

Tags: , , , , , , , , , ,
Posted in Uncategorized | No Comments »

‘Fighting’ cancer or other life-thereatening diseases

Sunday, July 11th, 2010

I was just reading a Telegraph article today entitled “Socialising with others ‘can help fight cancer’”. The headline led me to ‘put pen to paper’.

From my clinical experience, one of the most prevalent causes of disease, whether it be a bad back or whether it be heart disease, is the unconscious refusal or inability to freely and honestly express ourselves as we truly are. The most common example of this is in the work we choose to engage in to earn a living.

The whole idea of recovering from a life-threatening disease, like cancer, being a ‘fight’, I find difficult to get my mind round. My appreciation of disease processes is clearly influenced by my style of medicine, Traditional Chinese Medicine (TCM) with its range of therapeutic techniques, such as acupuncture. TCM is holistic in its approach to healthcare. Holism states that body and mind are inextricably linked so what happens to one will have an inevitable knock-on effect on the function of the other. Holism understands that disease is not some random, chance occurrence that we have little or no control over. Even geneticists attribute only 25% of our state of health to our inheritance. My own personal experience of scrutinising my state of health, and intermittent fall from good health over the years, has yielded a clear connection between this and my thought processes. Scrutinising the health of thousands of others in my professional capacity, and studying research and the clinical experience of others far more experienced and talented than me, has corroborated my conclusions.

Gradually, modern medicine is starting to fully appreciate the huge influence our state of mind has on our health. This is really well summarised in Adrian Leader and    book “Why do People get Ill?” ), available from our online shop. Literally, we are what we think. It is becoming increasingly evident that our thought processes create our diseases, whether they involve physical or mental symptoms, or both. We can say that our heart condition has been brought on by working intensely under stressful circumstances for a prolonged period of time, but what thought processes have led us to work like this in the first place. For example, if during our upbringing, we have thought, for whatever reason, that we needed to ‘achieve’ in order to gain ‘acceptance’ or ‘love’ from our parents, then this might have trained the habit of ‘flogging’ ourselves in our work life.

Holistic healthcare is about helping each individual bring their unconscious motivations into conscious awareness whilst using tried and tested techniques to facilitate recovery from the current disease-state. We do this by stimulating the body’s own, already amazingly well-equipped self-preservation systems. When an individual understands their disease process as part of who they are, they see that there can be no ‘fight’ against cancer because the cancer is a part of them. There is no external ‘enemy’ to fight. They have literally created their circumstances by their thoughts words and deeds in their life to date. Therefore, the only long-term, sustainable solution is through new thoughts, words and deeds. So, in my mind, self-understanding is the key. As far as I can see, achieving self-understanding is a process, often long and arduous, which is why we are often well-advised to seek external help when experiencing a life-threatening disease state.

The word ‘fight’ often implies a struggle. Because of the negative connotations this idea holds, this is just likely to make the process of recovery that much more difficult. So, I believe that our best chance of survival is to embrace the symptoms we are suffering as messages sent from deep inside us as an aid to reaching fullness. This way we can utilise the healing power of love, love of our self and the people around us and of life. Being diagnosed with a life-threatening illness is probably one of the best wake-up calls we will ever get in helping us to express ourselves as we truly are. So let’s embrace it. Or, as the motif on one of the Tai Chi students in my class says: “make tea, not war!”

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Posted in Uncategorized | 2 Comments »