Acupuncture is an ancient technique in which a skilled practitioner inserts hair-thin needles into specific points on the body to prevent or treat illness. Practiced for over 2,500 years in China, where it originated, acupuncture is part of the holistic system of traditional Chinese medicine (TCM), which views health as a constantly changing flow of energy, or qi (pronounced "chee"). In TCM, imbalances in this natural flow of energy are thought to result in disease. Acupuncture aims to restore health by improving the flow of qi.
While acupuncture was mentioned in Western medical texts more than a hundred years ago (Sir William Osler's Principles and Practice of Medicine, published in 1892, recommended it for sciatica and lumbago), it wasn't until 1971 that U.S. citizens really became aware of the technique. It was then that New York Timesreporter James Reston, stricken with appendicitis while in Beijing, was treated successfully with acupuncture for post-surgical pain. In a front page Timesstory, Reston wrote, "I've seen the past, and it works!"
This exposure came at a time when many Americans were looking for a more holistic, naturalistic approach to health care, and it caused quite a stir among the Western medical community. Since then acupuncture has become a widely accepted form of treatment in the U.S., practiced by M.D.s, D.O.s (osteopathic physicians), D.C.s (chiropractic physicians), and N.D.s (naturopathic physicians) who have received special training in its methods, as well as by professionally trained acupuncture practitioners (L.Ac.s, M.Ac.s, O.M.D.s), who specialize only in acupuncture and related traditional Chinese medicine (TCM) therapies.
According to the principles of TCM, qiflows through the body via 14 primary meridians or channels. To strengthen the flow of qi,or remove blockages in the meridians, an acupuncturist inserts a number of tiny, sterile, flexible needles just under the skin at certain specific points (called acupoints) along the channels. There are four to five hundred named acupoints along the meridians, some of which are associated with specific internal organs or organ systems. If you are suffering from nausea, for example, needles might be inserted into acupoints on your wrist, while a vision problem might be treated with needles in the foot. (Additional ear, scalp, and hand points are also commonly used by some practitioners.) Acupuncture practitioners believe that the therapy stimulates the body's internal regulatory system and nurtures a natural healing response.
Although Western science has neither proven nor accepted the notion of qi, a large body of evidence is accumulating indicating that acupuncture leads to real physiologic changes in the body. Numerous studies have shown, for example, that inserting needles into the skin stimulates nerves in the underlying muscles. This stimulation, researchers feel, sends impulses up the spinal cord to a relatively primitive part of the brain known as the limbic system, as well as to the midbrain and the pituitary gland. Somehow that signaling leads to the release of endorphins and monoamines, chemicals that block pain signals in the spinal chord and brain.
In one study, researchers using brain scans discovered that acupuncture can alter blood circulation within the brain, increasing the blood flow to the thalamus, the area of the brain that relays pain and other sensory messages.
Hundreds of studies are now ongoing in the United States and elsewhere seeking to prove the usefulness of acupuncture for various ailments.
On your first visit to an acupuncturist, the practitioner will take a thorough medical history, then may three pulses on each wrist, examine your tongue, take note of how your breath and body smell, and "palpate" (or feel) certain areas of your body. Depending on your ailment, you may also have your first acupuncture treatment at this time. In general, visits occur once or twice a week over several months until therapeutic results are achieved.
While the needles can feel uncomfortable at times, they rarely hurt. They are very thin (only about three times the thickness of a human hair and much finer than the hypodermic needles used to give injections) and are designed to enter the skin with little resistance. Once the needles are inserted (generally from one to 15 are used), the acupuncturist may twist them manually or send a weak electrical current through them to increase the energy flow. The needles may be left in for 15 to 40 minutes, depending on the ailment. Some practitioners also use moxibustion, which involves heating the needles or acupoint with a slowly burning herbal agent (primarily the dried herb mugwort) to hasten healing.
Different people experience different sensations from acupuncture. Some describe a tingling pins-and-needles feeling, others may feel numbness or nothing at all. Most find the sessions relaxing, and many fall asleep during or immediately after treatment.
Some patients notice rapid improvement after just a few sessions. In those whose conditions have taken years to develop, treatment may take longer.
While scores of illnesses have traditionally been treated by acupuncture in Asia, its primary use in the United States has been to relieve chronic pain--caused by such ailments as arthritis, headache, PMS, and back pain--and to assist withdrawal from addictions such as drug and alcohol dependency. Today more innovative applications for acupuncture are being explored by both conventional and alternative practitioners, including its use as an analgesic to reduce pain during surgery.
In 1997, an advisory panel for the National Institutes of Health (NIH) evaluated hundreds of acupuncture studies and concluded that the therapy is an effective treatment for postoperative pain after dental surgery and for nausea induced by chemotherapy, pregnancy ("morning sickness"), and anesthesia. The NIH panel also called acupuncture a useful adjunct and acceptable treatment for a variety of conditions, including fibromyalgia, stroke rehabilitation, asthma, headache, and carpal tunnel syndrome.
There are an estimated 13,000 licensed and certified acupuncturists in the United States. Most states allow physicians to perform this procedure (the basic level of acupuncture training for medical acupuncturists is a 200- to 300-hour course). It's best to look for a physician acupuncturist who meets specific state acupuncture requirements, who is a practicing member of the American Academy of Medical Acupuncture (AAMA) in Los Angeles, CA, and/or is certified by the American Board of Medical Acupuncture.
Professional acupuncturists (L.Ac is the usual title) are licensed in 39 states and the District of Columbia. Standards are becoming more uniform across the country, but in some states acupuncturists were initially "grandfathered" into licensure status without meeting the current, more rigorous standards. It is therefore important to get a referral from your doctor and check that your practitioner has been certified by The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) in Alexandria, Virginia, and seks continuing education in the field.
Naturopathic physicians (N.D.s) and chiropractic physicians (D.C.s) should have at least 200 hours of acupuncture training and be approved by their state licensing boards in order to practice acupuncture in their state.
The best known and most widely used alternative therapy in the United States today, chiropractic focuses on the manipulation of the spine and other joints to help treat a variety of problems involving bones, joints, muscles, ligaments, and tendons.
Chiropractors primarily use their hands to apply pressure to a joint or group of joints. (In fact, the name "chiropractic" is derived from Greek words meaning "done by hand.") This treatment is known as an "adjustment" or a "manipulation." The aim of using manipulation is to provide relief for pain or stiffness, and to improve posture as well as the function of nerves, joints, and muscles.
Spinal manipulation has been practiced for thousands of years; there are records of it from ancient Egypt and China. The birth of modern chiropractic, however, is often cited as September 18, 1895, the date that Daniel David ("D. D.") Palmer, a grocer and apprentice of magnetic healing in Davenport, Iowa, reportedly restored hearing to a man who had been deaf for 17 years, simply by adjusting his misaligned vertebrae.
In the years that followed, Palmer founded the first chiropractic school and refined his discipline, becoming convinced that pinched nerves caused by misalignments of the vertebrae were responsible for nearly all disease. His work remains the foundation of many aspects of chiropractic today.
Chiropractic takes a structural, nutritional, and emotional approach to health care. The chiropractor aims to gently restore the natural and delicate balance that exists in all healthy individuals.
To do this, a chiropractor examines the bones of the vertebrae, and locates those that do not move properly or are out of alignment. These areas, called subluxations, can cause pain and dysfunction not only in the surrounding nerves and muscles, but also in the internal organs located within the body at the same level as the subluxation. Chiropractors treat subluxations by adjusting the vertebrae (and the associated muscles, tendons, and ligaments) gently with their hands. When misalignments are corrected, according to chiropractic theory, the integrity of the nervous system is restored, ensuring optimal function of the entire body.
After reviewing your medical history, the chiropractor will ask you about your general health and conduct a thorough physical examination, which will include orthopedic and neurological evaluations. The session might include a review of past X rays and new ones may be requested. The course of treatment will likely include a series of adjustments to help realign your spine, neck, or other problem areas.
The chiropractor may ask you to lie down on a padded massage-type table for spinal adjustments or you may be seated on a stool or in a chair that allows access to your back. You may remain fully clothed or be asked to undress and wear a hospital gown.
Before beginning any manipulation, the chiropractor should explain exactly what the process involves. Typically, chiropractic is performed using very little force, although techniques vary. As the chiropractor applies pressure to your spine, you may hear (and feel) a popping sound, like a knuckle cracking. You should not feel any serious discomfort from the adjustment, however. If you do, it is important to let the chiropractor know immediately. Many patients find the experience of chiropractic treatment quite relaxing. Afterward, most describe feeling reduced pain, less tension, and more flexibility in the areas that were adjusted.
Some chiropractors (those known as "straight" chiropractors) adhere strictly to D.D. Palmer's theories, using only spinal adjustments to treat problems. Others (known as "mixers") combine spinal adjustments with adjunct therapies such as massage, heat or ice treatments, rehabilitative exercises, acupuncture, cranial manipulation, and nutritional counseling.
An initial visit usually lasts at least an hour. Subsequent visits may take only 10 to 30 minutes. Sometimes one session with a chiropractor is all that is required to relieve pain. For an acute problem, an average course of treatment involves three to five visits per week for two weeks.
Chiropractors generally have working relationships with M.D.s and D.O.s (doctors of osteopathy) and will refer you--often to an internist or a neurologist--if your condition persists and further testing or treatment appears necessary.
Chiropractic has been shown to be a particularly useful treatment for the relief of acute (or temporary) low back pain. In 1994, the United States Agency for Health Care Policy and Research recommended chiropractic manipulation as a safe initial form of treatment for acute low back pain in adults. The agency urged most patients to try conservative treatment such as chiropractic first, before opting for more aggressive measures such as drugs and surgery.
Chiropractic care can also ease pain in the mid-back and neck, and in the joints of the arms, hands, and legs. Although scientific research has not conclusively proved its effectiveness, many people report that chiropractic provides relief from the pain of migraine and other headaches, muscle spasms, and nerve inflammation that can cause numbness and tingling.
Chiropractors are licensed in all 50 states and the District of Columbia, and must pass a certification exam with the National Board of Chiropractic Examiners. A Doctor of Chiropractic (D.C.) usually has a bachelor's degree, four to five years of graduate study in chiropractic care, as well as clinical training. Many health insurance policies cover chiropractic.
Massage is the manipulation of the soft-tissues of the body. It helps to ease stress and muscular tension, relieve pain from injuries, and speed healing from certain acute and chronic conditions. Today millions of people worldwide visit massage therapists as a form of regular health-care maintenance.
The practice of massage has been used for thousands of years. As early as 2700 B.C., the Chinese text, The Yellow Emperor's Classic of Internal Medicine, recommended that "breathing exercises, massage of the skin and flesh, and exercises of the hands and feet" should be used to treat paralysis, chills, and fever. In 400 B.C., the Greek physician Hippocrates wrote about the necessity for all physicians to use rubbing as a remedy, particularly to treat sports and war injuries. Ancient records from Japan also refer to massage therapy, and the technique is known to have been used by other cultures as well, including the Egyptians, Romans, and Arabs.
The roots of modern, science-based massage therapy begin with Per Henrik Ling (1776-1839), a Swedish fencing master and gymnastics instructor who developed a therapeutic system that included both massage and exercise. In 1813, Ling established the Royal Central Gymnastic Institute to make his methods available to the public. At the time, Ling's program included what he called "medical gymnastics" and "Swedish movement cure." Later the combination of the two came to be known as Swedish massage.
After studying in Sweden in the 1850s, two physician brothers, George and Charles Taylor of New York City, introduced massage therapy to the U.S. The technique gradually gained credence and was widely used by doctors until the early 1900s. But as biomedicine and new "high tech" equipment came into play, physicians lost interest in this labor-intensive therapy. A small number of massage therapists carried on the tradition until the 1970s, when a revitalized interest in alternative medicine sparked a demand for this healing technique.
Today there are some 80 different types of massage and related forms of bodywork. These techniques are generally organized into five broad categories:
Traditional European massage. This includes methods based on conventional Western concepts of anatomy and physiology. Five soft-tissue manipulation techniques are typically used: effleurage (long, gliding strokes); petrissage (kneading and compression strokes); friction (deep circular rubbing); tapotement (percussion tapping); and vibration (very fine, rapid shaking movements). Swedish massage, the most widely employed massage technique in the world today, is the primary example of traditional European massage.
Contemporary Western massage. Also based on modern concepts of anatomy, this category includes a wide variety of manipulative techniques that go beyond the original framework of Swedish massage. These include neuromuscular massage, (a form of deep massage that is intended to reach the connective tissues, tendons, ligaments, and nerves, and release knots of tension called trigger points); sports massage (a combination of Swedish massage and deep tissue massage that deals specifically with the effects of athletic performance on the body); myotherapy (a specialized form of muscle massage and stretching that uses deep manual pressure to release trigger points).
Structural realignment and movement integration. These techniques place an emphasis on body structure and movement. The methods organize and integrate the body in relationship to gravity through manipulation of the soft tissues and/or through correcting inappropriate patterns of movement. Examples include: Hellerwork, Rolfing, Feldenkrais, and the Alexander technique.
Oriental massage. Based on the principles of traditional Chinese medicine, Oriental massage techniques assess and restore the vital energy that is believed to flow through invisible channels in the human body. These methods include acupressure and Shiatsu.
Energy-based methods: These techniques, which are not founded in traditional Chinese medicine, are intended to affect the energy field that is believed to surround and infuse the human body. This is accomplished either by applying pressure and/or manipulation to the physical body, or by the passage or placement of the hands in or through the energy field. Examples of energy methods include polarity therapy, therapeutic touch, and Reiki.
Many massage practitioners use a combination of these methods, depending on what the client needs at the time. For more information on different massage techniques, see the individual entries in the WholeHealthMD Reference Library.
Most types of massage affect the body in a similar way. When muscles are overworked, body waste products such as lactic acid can accumulate, causing soreness, stiffness, and even muscle spasms. Massage in general--and Swedish massage in particular--improves blood and lymph circulation and brings fresh oxygen and other nutrients to the affected tissues. This helps to flush out the toxins and enhance recovery.
Tense muscles may also compress blood vessels and stretch nerves, restricting blood flow and causing pain. As the affected area is massaged, the muscles gradually release their strangle hold on the irritated nerves, and the pain eases. The same mechanisms also make massage helpful in the recovery process for an injured muscle.
In addition, massage has been shown to increase the body's production of pain-killing endorphins and the mood-altering hormone serotonin. It can also slow the release of the stress hormone cortisol. For this reason, massage is often prescribed as an adjunctive therapy for people whose immune systems are compromised by stress.
The Alexander technique is a method of movement and alignment that teaches people to use their bodies more efficiently. It helps individuals improve their posture, let go of muscle tension, and move with greater ease. The goal of this technique is to eradicate such poor habits as slouching and tensing (which can lead to pain, decreased mobility, and other health problems) and replace them with good postural habits.
The originator of this technique was Frederick Matthias Alexander (1869-1955), an Australian actor who suffered bouts of hoarseness on stage. When medications and rest failed to help him, Alexander found his career in jeopardy. Using mirrors, he observed that the way he lowered his head and tensed his neck muscles when he recited his lines was restricting his vocal cords. He realized these habits were so ingrained that they had probably become second nature to him. He worked hard to correct his posture, and found that when he did so his voice was restored. Based on this personal success, Alexander created his eponymous technique around 1896 and published his first book about it, Man's Supreme Inheritance, around 1910.
Alexander was so successful that other actors and artists, George Bernard Shaw among them, sought his help. Eventually he stopped acting and created a formal program to promote his method. Today the Alexander technique is taught all over the world. Many performing arts schools incorporate Alexander's precepts into their curricula, and athletes also use it to help prevent injury. In addition, people suffering from back problems and other types of chronic pain have turned to Alexander's methods to ease their discomfort and to improve postural habits.
The philosophy behind the Alexander technique is that the correct relationship between the head, neck, and spine is critical to good health. Proponents of the technique call this three-way relationship "primary control" because they believe it is key to maintaining proper posture, breath, and movement.
An incorrect position of the head in relation to the neck and spine, for example, can create muscle tension and cause pain. Once a person's head, neck, and spine are brought into proper alignment, however, the rest of the body should "fall into place." Not only can muscle tension and pain be reduced, according to Alexander practitioners, but some bodily functions, such as breathing and movement, may become easier and more natural as well.
You can learn the Alexander technique privately or as part of a group. At a lesson, which lasts about 45 minutes, the instructor will observe the way you walk, stand, sit, lie, and bend. (You should wear loose clothing so you won't feel restricted.) You will be coached to relax your neck muscles so your head balances freely on top of your neck and allows your back to lengthen.
Through verbal instruction and gentle touch, the instructor will then teach you to improve your posture during a variety of everyday activities, such as sitting at a desk and talking on the phone. A poor habit, such as cradling the phone between your head and shoulder (which can put your neck out of alignment) will be replaced with a good habit, such as sitting upright with your shoulders straight while holding the phone to your ear.
Instructors, who are encouraged to be nonjudgmental and supportive, typically recommend one-on-one tutoring to tailor the Alexander technique more fully to your personal activities. If you are a dancer, for example, the instructor may work with you on improving your dance movements; if you are a tennis player, the teacher may coach you on maintaining proper form while you play.
The instructors then encourage you to apply what you have learned to events in your daily life. Gradually--sometimes with as few as six to eight lessons--students can begin to use their bodies more effectively.
Better body awareness and posture, improved coordination, decreased tension, and more efficient movement have all been credited to the Alexander technique. In addition, for many it improves overall physical and mental health.
People suffering from chronic neck and back pain, and other painful conditions such as arthritis and fibromyalgia, report finding relief after learning the Alexander technique. Also, the technique may help stress-related problems such as migraines and anxiety attacks.
It is important to note that there have been very few science-based studies evaluating the Alexander technique, and therapeutic claims are primarily anecdotal.
Look for an instructor who is certified by the North American Society of Teachers of the Alexander Technique. To earn this certification, instructors must complete at least three years of training in the technique. Alexander Technique International in Cambridge, Massachusetts, can refer you to a certified instructor.
When taught by a qualified instructor, the Alexander technique is safe for everyone, even pregnant women. In fact, many pregnant women report that the technique helps them adjust to the changes their bodies are going through and relieve some of the pressure their growing bellies are putting on their spines.
Energy healing is a broad term for any type of healing that smoothes out, manipulates, restores, or balances the flow of energy in the body. It is grounded in the belief that, in addition to its physical and biochemical systems, the human body is made up of a complex system of invisible energy. Often referred to in English as "universal life force energy," it is called by different names in different cultures: The Chinese know it as qi; the Japanese refer to it as ki; in India, it is prana. The NIH's National Center for Complementary and Alternative Medicine, charged with researching the effectiveness of such therapies, categorizes the various modes of energy healing as "biofield therapies."
It is believed that this vital life force energy continually flows throughout the body in organized patterns, just as blood does. Unlike blood, however, life force energy does not stop at the surface of the skin but extends several inches beyond the body, thereby creating a unique energy field (the biofield or aura) for each individual.
When a person's energy flows freely in a balanced, symmetrical manner, good health can be maintained. However, when the energy flow becomes restricted, disordered, or weakened, an imbalance occurs and an excess or deficiency of energy results. This can lead to symptoms of emotional and physical distress and eventually to chronic pain and disease.
Many traditional health systems have long recognized this vital life force principle and have employed it in healing. Indeed, such widely known systems as East Asian medicine (acupuncture, acupressure, shiatsu, and so on), homeopathy, naturopathy, Ayurvedic medicine, anthroposophical medicine, traditional osteopathy, chiropractic, and shamanistic healing use some aspect of the vital life force principle in diagnosis and treatment. In addition, practices such as yoga, tai chi, qi gong, and some forms of meditation incorporate perceiving and directing this energy flow in one's own body. Lesser known therapies that use energy healing include crystal and gem therapy, Bach flower remedies, magnet therapy, and craniosacral therapy.
More recently, the term "energy healing" has come to refer to the abilities of individual healers who diagnose and treat energy imbalances in clients using their own energy fields. In some cultures such healers are considered to have God-given spiritual gifts. However, as energy healing has become more widely recognized, the methods of energy healing taught in various cultures are now being integrated into training programs and professional schools. In such programs, practitioners learn to develop their innate talents in a consistent manner. Common hands-on energy healing practices taught in the United States include Therapeutic Touch, Healing Touch, Reiki, polarity therapy, and Jin Shin Jyutsu.
For more on these and the other energy healing methods mentioned above, see the WholeHealthMD Reference Library.
Those who have had success with energy healing believe that the treatments work by manipulating the energy that pulsates in and around all living beings. Energetic intervention by a practitioner, either through the hands or other methods, can serve to correct imbalances in energy flow, restore symmetry, and re-establish the free flow of energy through the body's energy pathways. These pathways are known in energy healing as channels (meridians), chakras, and etheric levels.
Channels. According to traditional Chinese medicine, shiatsu, and other acupressure systems, energy flows through a person's body via various acupoints that are organized into channels, or meridians. The meridian system contains several hundred points that can be manipulated to promote energy balance in parts of the body that experience discomfort or disease. Although Western science has been able to measure the existence of the acupoints using their electrical properties, researchers are still investigating ways to measure the groupings of points in the meridian channels. Studies have shown that stimulating acupoints can release chemical messengers in the body, including endorphins, the body's natural painkillers.
Chakras. In Indian or Ayurvedic medicine it is believed that the body's vital energy flows up from the feet to the top of the head and concentrates at different levels in the body called chakras. Maps of the body's chakras generally show seven major chakras along the centerline of the body, and multiple minor chakras outside the body and along the extremities. The state of each chakra reflects the health of a particular area of your body. It also reflects your psychological, emotional, and spiritual well-being. When chakra energy is blocked or misdirected, emotional and physical illness can arise.
Etheric levels. According to energy healing, just above the skin's surface, the human energy field is divided into so-called etheric levels. Each of these levels is three dimensional and envelops the body like a sheath or shell. The levels closest to the body are the physical, emotional, and mental. The physical level is linked to vitality and is the one most easily seen in a person's aura. The emotional level contains the energy associated with both positive and negative emotions. Because physical and emotional energies are interconnected, emotions can have a profound effect on how the body functions. The third level is the mental field and contains energy associated with thought, conceptualization, rationalization, and interpretation of events. Energy from this layer surrounds and interfaces with the emotional level, intensifying the relationship between thoughts and feelings.
In diagnosing and treating a client, a practitioner of energy healing will look at the pattern of energy flow in one or more of these pathways, and manipulate energy wherever it is blocked. Often during a session, a client will achieve a deep state of relaxation. Western science tells us that such deep relaxation helps to balance the autonomic nervous system and possibly trigger the release of hormones and neurotransmitters, which can help to decrease pain and increase a sense of well-being.
Energy healing can also release emotional energy and create increased awareness of mind-body patterns that contribute to energy imbalances. Most people who receive an energy healing session note an immediate decrease in their stress level, which has long been recognized as a major contributor to wellness.
Receiving energy healing should be a soothing experience. A session typically begins with a thorough health history, as well as a discussion of the conditions for which you are seeking relief. The practitioner will likely ask you about any previous medical problems in addition to learning about your diet and exercise habits, your home and work life, and your general mental and emotional health.
The practitioner will then do an energy "diagnosis," using various techniques that can reveal the major areas of imbalance. Among the diagnostic methods that may be employed are body scanning (either visually or with the hands on or off the body), use of a pendulum to read the energy flows at each chakra, and applied kinesiology to uncover imbalances that can lead to muscle weakness.
As the practitioner gets information from the body, various possibilities for treatment will be discussed. A well-trained practitioner may specialize in one method of energy healing or may be able to provide various therapies. These may include hands-on healing techniques such as Therapeutic Touch, Healing Touch, Reiki, and shiatsu, as well as the use of scents (aromatherapy) and flower remedies. Some therapists may also incorporate the use of colored light, tuning forks or the voice (harmonics), movement therapies, and dialogue. Depending on your ailment you may also be referred to an acupuncturist, chiropractor, osteopath, homeopath, or behavioral health practitioner for additional treatment.
An energy healing session usually lasts an hour, depending on the condition being addressed. For basic stress reduction, a few sessions may be all that are needed, with follow-up sessions scheduled if necessary. For the treatment of chronic diseases, long-term treatment, often in conjunction with a conventional medical doctor and/or one or more other medical practitioners, (e.g., naturopath, osteopath, chiropractor), may be required.
There have been few controlled studies showing direct health benefits from energy healing, but there is much anecdotal history, some of it dating back centuries, about the efficacy of the techniques that are used. It is important to note that energy healing is not a substitute for conventional medical care. However, as an adjunctive treatment it can be a very effective and noninvasive approach.
Of the various energy healing practices, Therapeutic Touch, Healing Touch, and Reiki have been the most widely and successfully used in hospitals, hospices, and out-patient facilities. Each of these practices has been found to accelerate healing, quicken recovery from surgery and trauma, reduce pain, lessen stress, and assist with emotional and spiritual healing.
Among the specific ailments for which energy healing has been found effective are chronic tension and migraine headache, chronic neck pain and low back pain, osteoarthritic pain, digestive complaints, fibromyalgia, respiratory problems, hypertension, mild depression, and anxiety. Some people like to use energy healing as a preventive therapy, believing that blockages in energy flow can occur before actual medical conditions begin to manifest themselves.
For more information on the health benefits attributed to specific energy healing modalities see the WholeHealthMD Resource Library.
There is no national certifying agency for energy healing practitioners, however, many practitioners who were originally trained and licensed as nurse practitioners, massage therapists, physical therapists, and physicians may have added energy healing to their professional skills.
To date, there are no national standards providing for licensure of energy healing practitioners. In many states, however, energy healing is considered a spiritual practice and registered clergy are exempt form state regulation. In other states practitioners may need to qualify under massage regulations in order to do hands-on healing.
The Florida State Board of Independent Education recently licensed the Professional Brennan Healing Science Program, part of the Barbara Brennan School of Healing in Boca Raton, FL. Brennan has been a pioneer and innovator in the field of energy healing for more than 30 years and her program is designed to give students comprehensive instruction in self-transformation, hands-on healing techniques, body-oriented psychotherapy, high sense perception, meditation, creative arts, channeling, ethics, and professional practice development.
In 1997 the Healing Touch International Foundation was established to receive and distribute funds to assist, encourage, and advance the philosophy, objectives and techniques of Healing Touch therapy and other energy-based healing techniques. Healing Touch was developed in the late 1980s by Janet Mentgen, R.N., B.S.N., of Denver, CO. Today the program offered by Healing Touch International is endorsed by the American Holistic Nurses' Association (AHNA). As participants develop their expertise through extensive experiential learning, they become eligible for international certification. The courses are open to all registered nurses, physicians, body therapists, counselors, psychotherapists, and other professionals and individuals desiring an in-depth understanding and practice of healing work using energy-based concepts.
To find an energy healing practitioner near you, ask a trusted bodyworker, a friend, or your primary-care physician for a referral. You may also want to check the Find a Practitioner database on the WholeHealthMD home page.
The Feldenkrais Method is a form of "body education" that teaches students how to move their bodies more efficiently, improve coordination, expand range of motion, reduce stress on joints, and increase flexibility. It is often referred to as "bodywork," but this is a misnomer because the intention of the Feldenkrais instructor is to teach rather than perform direct manipulation of the body tissues and structure.
Often sought out by those who have movement dysfunction and pain, the Feldenkrais Method is also very popular with dancers, actors, musicians, and athletes who regularly challenge their bodies with repetitive motion.
Russian-born physicist Moshe Feldenkrais (1904-1984) developed the method after he suffered a knee injury that was expected to prevent him from walking. A student of physics, psychology, and biology (with a black belt in judo), Feldenkrais melded his diverse interests and knowledge to create his method, which he actually conceived as he taught himself to walk again without pain.
The Feldenkrais Method utilizes many strategies in teaching students to listen to what their bodies are telling them. Based on the idea that the central nervous system plays an enormous role in a person's comfort, the method encourages awareness of one's skeleton, muscles, and joints, and also draws attention to negative patterns of posture and movement.
The intent of the Feldenkrais practitioner is to enable students to refine their body awareness, so that each body part participates more fully in every action and no one body part is stressed more than any other. According to Feldenkrais, when a student unconsciously allows the skeleton to provide the support for which it was intended, the muscles begin to feel more relaxed and less tense, allowing for expanded range of motion and flexibility.
In teaching the method, the Feldenkrais instructor may ask the student to repeat simple movements many times with slight variations. Doing so offers fine sensory cues to the central nervous system and aids in shifting the patterns of automatic movement and posture so they're more efficient and comfortable.
Recent advances in the scientific study of the nervous system recognize that "neural plasticity," or the ability of the nervous system to learn and adapt, has been a previously underestimated factor in conventional health care and rehabilitation. The Feldenkrais Method is one way to access this ability of people to "self-improve."
The Feldenkrais Method has two components. Students may use one or both.
In Awareness Through Movement® (ATM) classes, which are taught to groups in a classroom, students explore basic movement themes to improve movement quality, awareness, and function. The themes utilize ordinary body positions, such as lying on the back, stomach, or side; standing up; or sitting in a chair. In a typical hour-long ATM class, the students focus on one movement theme, guided verbally by the instructor. Often the instruction will cue into the potential mobility in forgotten parts of the body, such as the thoracic spine or ribs of the chest area.
Functional Integration® (FI), a one-on-one learning process that usually takes place in a Feldenkrais instructor's office, individualizes the Feldenkrais method. Sessions, which are tailored to meet a student's individual needs, generally last 45 minutes to an hour. The student frequently lies fully clothed on a padded table while the instructor uses slow, gentle touch, and sometimes verbal suggestions, to introduce movement relationships among the various body parts. Positions such as sitting, kneeling, or standing may also be used.
In all cases, touch is used to communicate, not to correct, and there is no therapeutic pressing or stroking. The instructor's goal is to bring sensory attention to habitual patterns, while also suggesting new options. Through exploration and experimentation, the student seeks an optimal, individualized style of movement. Changes occur spontaneously rather than through willful determination.
ATM classes are typically offered in a series of four to six sessions, meeting once a week. The schedule and frequency of the individual FI sessions is determined by a student's goals and the recommendations of the practitioner.
Better body awareness, easier movement, and a sense of relaxation and well-being have all been credited to the Feldenkrais Method. For those who come to classes experiencing pain, the sessions often reduce it; those with movement dysfunction can improve strength and coordination.
While students of Feldenkrais always emphasize that the focus is on individual learning rather than on the treatment of a particular condition, they often report success with specific ailments such as carpal tunnel syndrome and headaches.
Some Feldenkrais instructors specialize in working with people with orthopedic and neurologic conditions that cause pain or limit movement, such as arthritis, stroke, whiplash, multiple sclerosis, and cerebral palsy. Others work specifically with performers or athletes in order to relieve pain, recover lost functions, or refine specific functions.
Because most medical research measures isolated parameters rather than overall function, designing research specific to the Feldenkrais method continues to be challenging. While there have been a few studies evaluating Feldenkrais for those with multiple sclerosis, rheumatoid arthritis, and neck pain, most health claims for the method are based on anecdotal evidence.
The certified training programs for Feldenkrais practitioners involve putting in 800 to 1,000 hours over a three- to four-year period. Graduates are qualified to give group ATM lessons after the first two years of training and individual FI lessons after the full four years. In the United States, look for a practitioner who is certified by the Feldenkrais Guild of North America (the professional association for the discipline), located in Portland, Oregon.
It is not necessary to have medical training to be a Feldenkrais instructor. However, many physical therapists, massage therapists, and other health practitioners are Guild-certified Feldenkrais practitioners. Insurance rarely covers Feldenkrais sessions unless they are performed by a professional licensed in another health profession such as physical therapy.
The Feldenkrais method is considered to be safe for everyone, not as a medical treatment, but as movement education.
Hellerwork is a type of bodywork created by Joseph Heller, a former NASA aerospace engineer. Like Rolfing, Hellerwork uses deep-tissue massage to help reduce stress and ease mobility.
Heller was originally taught Rolfing by Ida Rolf, Ph.D., a Columbia University trained biochemist, who created the therapy in the 1930s. In 1976 he became the head of the Rolf Institute, now located in Boulder, Colorado, which oversees the training of Rolfing practitioners. Two years later he developed his own variation on the method, which added verbal dialogue and movement exercises to the hands-on work.
Like Rolfing, Hellerwork is based on the premise that physical and emotional stress--as well as gravity--can throw the body out of vertical alignment and cause the connective tissue known as fascia to become rigid and inflexible. (Fascia encases muscle and connects muscle to bone.) These problems can then lead to more stress, illness, and a loss of general well-being.
Hellerworkers seek to realign the body by using intense pressure and stroking to stretch shortened and tightened fascia back into shape. The goal is to make the fascia softer and more flexible, and to restore its natural balance in relation to muscles, tendons, and bones.
The two components that distinguish Hellerwork from Rolfing--verbal dialogue and movement exercises--complement the massage component. Through verbal dialogue, Hellerworkers help clients explore attitudes, feelings, and past traumas that may be contributing to their current physical and emotional state. Using movement exercises, clients are taught how to sit, stand, walk, run, bend over, and perform other ordinary actions in a stress-free, efficient way. This threefold approach aims to realign the body and release deeply held tensions, which, it is believed, will help increase energy, flexibility, and overall health and well-being.
Hellerwork usually consists of 11 sessions, lasting an average of about 90 minutes each. Sessions one through three, known as the "superficial" sessions, typically focus on the surface layers of the fascia. These layers are associated with the muscles that are near the surface of the body. Sessions four through seven involve the deeper fascia and muscles and are called the "core" sessions. Sessions eight through 11 are the "integrative" sessions, which aim to synthesize the work of the earlier sessions.
At the first session, the practitioner will ask you about your medical history, so you can discuss your specific needs and how Hellerwork might address them. For this and subsequent sessions, you will be advised not to eat for a couple of hours prior to the session, and you will be asked to undress to your underwear.
Each session will have a theme related to the part of the body that is being worked on. An example of such a theme is "Inspiration." During this session, the practitioner--through bodywork, dialogue about what inspires you, and exercises--will focus on aligning your rib cage vertically over your pelvis and opening up your breathing.
Some of the deeper work during the 11 sessions may hurt, but it should never be unbearable. You should feel relaxed and energized at the end of each session. The verbal dialogue portion of the therapy will not require you to discuss subjects you may find too difficult or painful.
The practitioner might take photographs or videos of you throughout the 11 sessions to help you follow your progress. The final appointment will be a review session. Your practitioner may recommend postponing further sessions for several months until your body can process the changes and adjustments you have made so far.
Proponents of Hellerwork claim that it can relieve respiratory conditions and problems related to muscle tension and stress, as well as treat sports injuries, carpal tunnel syndrome, and back and neck pain.
While some forms of bodywork, such as massage, have shown clear benefits in studies, few studies have been done with Hellerwork. Even so, many Hellerwork patients are very positive about its effects.
If you'd like to try Hellerwork for a specific problem, you should first consult a doctor to rule out any serious underlying medical condition.
There are more than 300 official Hellerwork practitioners in the United States. To obtain certification, a person must undergo a 1,250-hour study and training program. The training is generally divided into intensive courses lasting 12 to 15 days, including weekend classes, over a period of one to two years.
Some insurance companies may cover a portion of the cost for Hellerwork treatments. Contact your own carrier to find out about its policy.
Myotherapy ("myo" is from the Latin for muscle) is a specialized form of muscle massage and stretching that uses deep manual pressure on specific spots on the body to release trigger points. Knots of tension, trigger points usually occur within a taut band of skeletal muscle or in the muscle's fascia (connective tissue encasing the muscle). Because these points are painful upon compression, they can "trigger," or cause, pain in other parts of the body. Myotherapy aims to relax these muscle knots and quickly relieve muscle-related pain.
Myotherapy grew out of myofascial trigger point therapy, which was pioneered in the early 1940s by Janet Travell, M.D., who later became the White House physician to John F. Kennedy, and Dr. David G. Simons. Dr. Travell's therapy (which she used to treat Kennedy's back pain) involved injecting saline and a local anaesthetic (procaine), directly into the painful trigger points. She would follow the injections with a series of gentle stretches and a coolant spray.
In 1976, Bonnie Prudden, a leading authority on exercise and health, came upon what she later called myotherapy rather serendipitously. While assisting a Massachusetts doctor in preparing a patient for injection therapy, she unintentionally pressed too hard on one of the patient's trigger points. Almost immediately the patient felt much better. Prudden began to theorize that trigger points could be released simply by applying manual pressure. She was soon on the phone to her friend Travell, who encouraged her to experiment further with her theory. Prudden's efforts were met with great success as many patients reported dramatic improvements in a shorter time than with the invasive injections.
Over the next ten years, Prudden gradually developed a training system for practitioners of the myotherapy. Today "Bonnie Prudden Myotherapy" (see "How to Choose a Practitioner," below) is the most widely known certification program for myotherapists in the U.S. and abroad. There are, however, other training programs that teach the principals of myotherapy to those in the massage, physical therapy, and pain management professions.
According to practitioners of myotherapy, trigger points can result from birth trauma, falls, strains, sprains, disease, occupation, or misuse or overuse of certain parts of the body. In addition, such trigger points are the defining hallmark of the muscular condition known as fibromyalgia (see "Health Benefits" below). Even though trigger points may lie dormant for years, they can "fire" and cause the muscle to go into painful spasm in the presence of physical or emotional stress. Repeated spasms can keep the muscle continually contracted and subsequently cause trigger points to develop. These not only generate ongoing pain, but also interfere with posture, balance, and muscle function. Myotherapy uses manual pressure to break this cycle of localized muscle spasm and pain.
In the Bonnie Prudden system, the body is divided into five zones with 17 distinct segments. Each segment contains several trigger points, and pain in a certain area of the body corresponds to specific trigger-point segments. If you have back pain, for example, all the trigger points on your back as well as on the front of your torso would be "erased," or treated, to relax the affected muscle and get rid of the pain.
Using a systematic hands-on investigation of your body, the myotherapist will look for the tense and painful trigger points that specifically relate to your problem. To treat the affected trigger points, the practitioner will apply pressure with the fingers, knuckles, and/or elbows to each point for five to seven seconds. The pressure will probably feel painful at first, but, according to those who have experienced treatment, it will ultimately bring about considerable pain relief.
An initial visit to a myotherapist could last up to 90 minutes. Subsequent treatment sessions are about an hour. On the first visit, the practitioner will take an extensive history to help determine where your trigger points are and what might have brought them on. You will be asked questions about your occupation, recreational activities, and other pastimes. Since chronic muscle pain can be related to emotional stress, the practitioner may well explore issues in your life that might be triggering your discomfort. Your muscle strength and flexibility will also be evaluated.
The practitioner will then spend the remainder of the session treating your trigger points. While the initial pressure on a trigger point may result in a loud "Ow!" most people describe the pressure as "feel-good" pain. This is because stimulation of the body in this manner releases natural analgesic chemicals known as endorphins, and the treatment gets less and less uncomfortable as the session progresses.
Because developing flexibility and strength is a key component of myotherapy, the practitioner will also stretch your affected muscles and teach you some corrective exercises to do at home. While you may find the exercises painful at first, they need to be done several times a day for myotherapy to be effective. As you gradually recover, the exercise program may be expanded into a program of general fitness. Indeed, most myotherapists try to promote a sense of personal responsibility in their patients, encouraging them to exercise more, eat a proper diet, and be conscious of the stresses in their lives.
Most people seeking myotherapy need about five sessions to feel better. However if you suffer from a myofascial pain syndrome such as fibromyalagia, you may need regular treatments over a much longer period of time, depending on the basic cause of the pain and the number of flare-ups.
Some physicians working with myotherapists may suggest trigger point injections either before or after your massage session. Only an M.D.or D.O. can administer such a treatment, however.
As with many other hands-on treatments for muscle pain disorders, published clinical studies on myotherapy's effectiveness are lacking. Case reports appearing in various massage and bodywork journals do suggest that myotherapy can help all types of muscle-related pain, including back, shoulder, and neck pain; tension and migraine headaches; menstrual cramps; repetitive motion injuries such as carpal tunnel syndrome; temporomandibular joint syndrome (TMJ); and injuries caused by accidents or playing sports.
One of the most popular uses of myotherapy is for fibromyalgia, a disorder characterized by widespread muscle pain and fatigue. Doctors are not sure exactly how the so-called "tender points" of fibromyalgia develop, but for most people it is probably a muscular reaction to chronic stress. If you choose to use myotherapy for fibromyalgia, make sure the treatment is performed when the involved muscle is as relaxed as possible. If your muscle is in spasm or very tense, the treatment will be too painful. Practitioners often suggest a hot soaking bath before the treatment to get the muscles as relaxed as possible. Myotherapy is also excellent for myofascial pain syndromes other than fibromyalgia. These can follow an injury such as whiplash, or occur because of some sort of misalignment in the skeleton.
The therapy has also been used to treat impotence and incontinence resulting from spasms in the muscles of the pelvic floor. Some people suffering from lupus, arthritis, and multiple sclerosis, which all affect muscles that house trigger points, have also found pain relief.
Some chiropractors and osteopaths recommend myotherapy as an useful complement to spinal adjustments. It is felt that once the trigger points are erased, and muscle movement increases, the spinal adjustment has a better chance of staying in place. The therapy can also complement craniosacral therapy, Rolfing, certain forms of physical therapy, and acupuncture. In addition to pain relief, myotherapy my also produce a dramatic increase in mobility, flexibility, and stamina. Posture, gait, and sleep patterns may improve as well.
You can find a certified Bonnie Prudden Myotherapist through the Bonnie Prudden School for Physical Fitness and Myotherapy in Tucson, Arizona. Certified Bonnie Prudden myotherapists must train for 1,300 hours over a nine-month period, pass a board certification exam, and update their training every two years. In some states, myotherapists are also required to earn a massage therapy license.
If your myotherapist hasn't been certified in the Prudden method, be sure to inquire about his training and experience. A good myotherapist should be highly knowledgeable in the areas of musculoskeletal anatomy, kinesiology, corrective and therapeutic exercise, and myofascial dysfunction. Be aware, however, that most myotherapists will not have had comparable biomedical and psychological training to physical therapists, nurses, and chiropractors. Myotherapists are not qualified to diagnose and treat internal illnesses or serious emotional disorders that can cause muscle pain. It is therefore important to discuss the therapy with your primary-care physician before beginning treatment.
Some insurance companies cover the cost of myotherapy if the patient is referred by a physician or if the practitioner's treatments are supervised in the office of a licensed physical therapist. Check with your plan benefits office. Typically insurance plans that do cover these treatments require your doctor to make a written referral, stating your diagnosis, listing exactly what's going to be done, and requesting a specific number of sessions (usually six to eight) at one hour each. Even if myotherapy is not covered by your health plan, it’s a good idea for your doctor to confer with you and your myotherapist about your progress.
A little known but growing specialty in complementary medicine today, naprapathy utilizes hands-on healing techniques as well as nutritional counseling, exercise, and relaxation methods to treat a range of health problems. The word comes from the Czech napravit meaning "to correct," and the Greek pathos, for "suffering," and doctors of naprapathy (D.N.s) are dedicated to this cause.
Naprapathy was developed in the late 1800s by Dr. Oakley Smith, who departed from his original chiropractic training after that method failed to work for his own chronic back pain. After much experimentation on himself (with the help of his brother), Smith cured his back problem by manipulating the soft body tissues (muscles, ligaments, tendons) surrounding the spine, rather than treating the spine itself.
Smith came to believe that it was energy blockages in the soft tissues that not only caused back problems like his but also led to a variety of other physical complaints. These blockages, he suggested, appeared as muscular contractions in response to psychological conflicts, physical injuries, poor nutrition, and improper posture. The concept that disease results from blocked energy was hardly a new one-Oriental and Ayurvedic medicine were founded on it-and yet Smith's theories were considered highly innovative. In 1907 he founded what is today known as the Chicago National College of Naprapathy, one of two accredited schools for this profession in the world (the other is in Sweden, see How to Choose a Practitioner).
Today, naprapathy is used to treat a wide array of ailments. Most common are back, neck, and hip problems, which in turn may produce systemic complaints such as low energy, tension headaches, digestive disorders, or unexplained depression, for example. During treatment, the spine is at times manipulated, but only to use the vertebrae as "levers" for stretching the soft tissue, not to alter their position (as in chiropractic subluxation).
Because Smith's teachings emphasized specific stretching or "mobilization" of soft tissues, naprapathic manipulation is not highly forceful. After locating areas of pain or rigidity (called "ligatites"), a naprapath will gently manipulate the tissues, stretch and massage constricted areas, and apply pressure to specific places (called trigger points) until the muscle, tendon, or ligament loosens.
The goal of this therapy is to restore natural flexibility and release tension, leaving the connective tissues pliable and in balance. This not only relieves pain and improves mobility, but enhances blood flow, nerve conduction, and the body's own healing energy. Like chiropractors, naprapaths will employ nutritional supplements and herbs to facilitate the body's ability to heal itself.
Most insurance carriers reimburse visits to a naprapath. In Illinois, where the National College is located, naprapathy is covered by 90% of insurance programs. Most PPO plans from major carriers in other states will also cover naprapathy, but if you're concerned about getting reimbursed, call your insurance provider to check before you schedule a visit.
A doctor of naprapathy carries the designation D.N. Many naprapaths are found in the Midwest, because the four-year Chicago National School of Naprapathy is located there. To be credentialed, naprapaths must complete a minimum of six years of higher education. The Chicago school accepts some candidates with a science background after two years of college.
After graduation, candidates take a licensing examination given by the state of Illinois. This is a limited professional health-care license similar to those received by doctors in specialties such as optometry, chiropractic, and podiatry. To maintain their credentials, naprapathic doctors are required to take 30 hours of certified continuing education every year. Because of naprapathy's success in treating joints and injured extremities, some naprapaths are now entering the field of sports medicine.
The only other existing recognized institution of naprapathy is located in Sweden, and credentials from the Scandinavian College of Manual Medicine should be considered reliable. Always check that anyone claiming to be a naprapath has been certified by one of these two institutions. A new U.S. school of naprapathy, which will be affiliated with Western New Mexico University in Silver City, New Mexico, is currently in the planning stages.
Check with the Chicago National School of Naprapathy to locate a D.N. in your area.
Reflexology is a technique in which pressure is applied to specific points on the feet (and sometimes the hands) to promote relaxation and improve overall health. Proponents of reflexology believe that the foot surface contains a coded map of the entire body and that particular points on the feet correspond to particular organs, glands, and body systems. Pressing these points with the fingers and thumbs is thought to encourage healthy functions in the corresponding areas of the body.
The precise origins of reflexology are obscure, but ancient illustrations and other records reveal that Chinese, Indian, and Egyptian peoples worked on the hands and feet to foster good health.
Modern reflexology grew out of a technique known as "zone therapy," which was developed in the early 1900s by American physician and ear, nose, and throat specialist William H. Fitzgerald. Fitzgerald claimed that applying gentle pressure to specific areas on the hands and feet could trigger health benefits in corresponding "zones" of the body.
In the 1930s, Eunice Ingham, a physical therapist and a colleague of Fitzgerald, took the therapy, further postulating that working on just the feet (not the hands) was the best way to affect the health of the rest of the body. Ingham contributed a crucial tool to the discipline: She drew up detailed "maps" of the feet that showed exactly how particular parts of the foot relate to other body parts. She found, for example, that the toes correspond to the head and neck; that the balls of the feet reflect the lungs, heart and chest; that points on the right foot relate to the right side of the body and that points on the left foot relate to the left; and so on. Charts based on her maps are still used by reflexologists today.
Exactly how reflexology works remains unclear, although several possible explanations have been put forward. One is that the body contains an invisible life force, or subtle energy, similar to the concept of qi in traditional Chinese medicine. When this energy is blocked, illness can result. The nervous system provides a "keyboard" to access, control, and release the subtle energy patterns. It is thought that stimulating some of the more than 7,000 nerve endings on the foot can unblock and increase the flow of this vital energy to various parts of the body and thus promote healing. The reflexology theory is consistent with the theory behind acupuncture and acupressure, in which mapped points on body parts such as the ear or hand are treated to affect corresponding remote organs or body zones.
A more conventional medical theory suggests that the pressure exerted by reflexologists releases nerve transmitter chemicals such as endorphins and monoamines, compounds that control pain.
When you see a reflexologist, you will probably begin with a conversation about your general health and lifestyle. The practitioner may inquire about chronic health problems or any issues that are currently concerning you. You will then be asked to remove your shoes and socks and to sit in a reclining chair or lie down on a padded table. The reflexologist may show you a map of the foot that pinpoints specific areas--called reflex points or reflex areas--that relate to other parts of your body.
At first, the practitioner will rub your feet lightly for a few minutes to warm them up and feel for tense areas. When an area of the foot feels taut and sensitive, that's a sign, practitioners say, that the corresponding body part has an energy blockage. The reflexologist will then focus on these tense areas for the duration of the session, which may last from 30 to 60 minutes.
As a particular area of the foot is pressed, you may feel a tingling sensation in the part of your body being treated. The practitioner may use significant pressure, but the therapy should never be painful. Any discomfort you feel should ease as the tension dissipates under the practitioner's touch.
Treatments may be given once a week initially and then taper off to an occasional basis. Once you learn where the appropriate points are for your condition, you can perform reflexology on yourself or have it done by a friend.
Reflexology is recommended as an adjunct therapy, and is never the main treatment for a condition. Proponents say that it is particularly useful for stress-related conditions, including headaches and digestive disorders. It may also be helpful for asthma and irritable bowel syndrome, for easing symptoms of PMS (premenstrual syndrome), for skin conditions such as acne and eczema, and for chronic pain from conditions such as sciatica and arthritis.
Although scientific evidence is limited, a few studies have shown reflexology to be beneficial. In one study, 35 California women who suffered from PMS were divided into two groups. One group received true reflexology and the control group got a sham treatment. The women who received the real treatment reported a significantly greater decrease in PMS symptoms.
In another study of 220 Danish patients with tension or migraine headaches, 81% reported that reflexology sessions reduced or cured their headache pain.
And, in yet another recent study, it was found that breast and lung cancer patients experienced less anxiety after reflexology. The breast cancer patients also experienced a decrease in pain.
The best way to find a good reflexologist is to get a referral from your primary-care physician or from a physical therapist or other bodyworker you know and trust. Massage therapists, chiropractors, and podiatrists may practice reflexology as part of their treatments. Insurance coverage may be available if the reflexology is practiced by a physical therapist and you have a condition for which manual therapy is covered by your plan.
While there are no state laws regulating the practice of reflexology in the United States, there are training programs that do provide certification. The American Reflexology Certification Board (ARCB) in Littleton, Colorado, is one organization that certifies reflexologists who undergo 100 hours of training and pass a licensing exam.
Rolfing is a form of deep-tissue, structurally oriented bodywork that was created by Ida P. Rolf, Ph.D., a Columbia University trained biochemist in the 1930s. When she developed this therapy, Dr. Rolf was influenced by her knowledge of Hatha yoga, the Alexander technique, osteopathy, and homeopathy. She called her own approach structural integration because it dealt with the way the body's structure affects its function. It didn't take long, however, for the public to start calling it Rolfing--and the nickname stuck.
In 1971, Dr. Rolf established the Rolf Institute of Structural Integration, now located in Boulder, Colorado, with adjunct institutes in Munich, Germany, and Sao Paolo, Brazil, to oversee the standardization of the Rolfing method and the training of practitioners, known as Rolfers.
Today, Rolfing is employed primarily to help reduce stress and ease mobility, address posture problems, and reduce musculoskeletal and back pain. Proponents suggest that it can relieve a variety of other ailments as well.
Rolfing is based on the premise that physical and emotional stress--as well as gravity--can throw the body out of vertical alignment and cause muscles and the connective tissue known as fascia to become rigid and inflexible. (Fascia encases muscle and connects muscle to bone.) These problems can then lead to more stress, illness, and a loss of general well-being.
Rolfing aims to realign the body by using intense pressure and stroking to stretch shortened and tightened fascia back into shape. The goal is to make the fascia softer and more flexible, and to restore its natural balance in relation to muscles, tendons, and bones.
Practitioners manipulate the fascia rather than the muscles themselves. Pressure from the practitioner's knuckles, knees, elbows, or fingers on this connective tissue is said to release deeply held tension and stress. Rolfing results in ease of movement, improved posture, and overall emotional and physical health.
When you first meet with a practitioner, you will probably begin with a discussion of your medical history, including any former injuries, such as broken bones. The conversation may also include such topics as how you tote your shoulder bag and where you "carry your stress." The Rolfer will probably ask you to undress to your underwear and have you lie on a massage table for the treatment.
The treatment itself may begin with the Rolfer manipulating the upper half of your body to free any restrictions around the rib cage. This will help you breathe more easily, which will set the tone for the next sessions.
Typically, a full Rolfing course involves 10 sessions of 60 to 90 minutes each. Sessions one through three, known as the "superficial" sessions, usually focus on the surface layers of the fascia. These layers are associated with the muscles that are near the surface of the body. Sessions four through seven involve the deeper fascia and muscles, and are called the "core" sessions. Sessions eight through ten are the "integrative" sessions. They aim to synthesize the work of the earlier sessions.
As the sessions progress, the course of treatment will involve an increasing amount of pressure on the fascia. Because the practitioner is working so deeply, the treatment can be painful--rather than relaxing--but it should never be unbearable. And you should feel energized after each session.
In recent years, advanced Rolfers have been exposed to an updated curiculum that puts less emphasis on the 10-session model. The curriculum addresses a wider variety of manual therapies, including cranial, visceral, and joint manipulation.
There are few controlled studies of Rolfing that compare it with other therapies or with no treatment at all. Proponents, however, firmly contend that Rolfing can increase mobility, ease breathing, relieve stress, increase energy, and generally improve a person's well-being.
Many patients find that Rolfing aids in easing chronic back, neck, shoulder, and joint pain, as well as in relieving repetitive stress injuries and headaches. Some advocates also report that Rolfing helps digestive problems and asthma. Because of its clear focus on muscular problems, the therapy is often included in sports medicine treatment programs.
The Rolf Institute of Structural Integration oversees the certification of Rolfers, although there are practitioners who do Rolfing without certification. The basic training and certification program for Rolfers takes a minimum of one and up to two years, with additional training available for those interested in advanced certification.
If Rolfing is performed by a practitioner who is also a physical therapist or chiropractor, or if your primary-care physician recommends Rolfing, some HMOs may provide coverage. Call your insurance company about its policy.
Also known as Trager work or Trager psychophysical integration, the Trager approach is a unique method of "body education" that involves extremely gentle and painless hands-on manipulation of the limbs, joints, and muscles by a trained practitioner. It also includes the teaching of free-form movement sequences to increase body awareness and enhance agility.
The aim of this therapy is to impart a physical message to the unconscious mind that movement can be effortless. The Trager approach has been found to be particularly useful for chronic neuromuscular ailments, such as back and neck pain, as well as stress-related conditions, such as headache.
The Trager approach was developed almost by chance in the 1920s by Dr. Milton Trager (1908-1997). As a young man growing up in Miami, Trager dabbled in gymnastics and dance, and eventually began boxing. After a workout, he often received a sports massage from his coach. One day Trager offered to give the tired-looking coach a rubdown in return. The man was amazed at how rejuvenated he felt afterward. Trager then tried the same thing on his father, who suffered from chronic sciatica; the sciatica cleared up after two sessions.
These experiences encouraged Trager to begin experimenting widely with massage, treating people with ailments that ranged from back pain to polio. His work eventually led him to become a physical therapist, and he continued to improve and refine his technique. In his fifties, Trager became an M.D., and when he was almost 70 he began to teach his approach to others. In 1980 the Trager Institute was founded in Mill Valley, California, and Trager continued to teach there and throughout the United States and Europe until his death in 1997.
Today the Trager Institute is the only international organization providing certification in Dr. Trager's method. There are currently some 2,000 Trager practitioners in the United States, Canada, Europe, Israel, Africa, Australia, and Japan.
Trager therapy is based on the theory that discomfort, pain, and a reduced range of movement are physical symptoms caused by accumulated tension. This tension may be the result of trauma, weak posture, fear, emotional blockages, and/or stress. The feelings of lightness, openness, and peace that the Trager technique induces are believed to resonate throughout the nervous system. Not only does this ease tension, but it also changes your unconscious mental and physical experience of movement to one of pleasure rather than pain.
There are two components to the Trager approach. In the first, known as tablework (because the work is done on a special table), the practitioner gently and rhythmically rocks, shakes, and stretches various parts of your body, loosening tight muscles and painful joints. This rhythmic movement gradually induces a state of deep relaxation. Once relaxed, the person experiences just how pleasurable it is to move freely--a key step in learning to break free of the restrictive muscle patterns associated with physical tightness and pain.
During the second part of a session, the practitioner teaches you simple sequences of movements, which you can later do at home. Called Mentastics (short for mental gymnastics), these movements are designed to reduce tension and increase physical mobility. Unlike most exercises, which are done to improve strength or endurance, the goal of Mentastics is to achieve a relaxed, meditative state.
At the first visit, a Trager practitioner will typically take your health history and explore any physical problems you are currently experiencing. The practitioner may then discuss how you're feeling emotionally, since part of the treatment will involve helping you make connections between your state of mind and your physical problems.
For the tablework portion of the session, you will lie on a padded table, dressed in loose-fitting clothing that allows you to move freely. To better concentrate on you, the Trager practitioner then enters a meditative state (in Trager parlance called the "hook-up"). This allows the practitioner to more easily find areas of tension in your body and to feel your responses to the treatment.
According to Dr. Trager's principles, the calm, peaceful manner of the practitioner's "approach" is just as important as the technique itself. No oils or lotions are used. The practitioner moves your muscles rhythmically and lightly, lengthening and shortening, sliding, rolling, and flexing them. The movements are never forced and you should feel no pain. You should also begin to experience an invigorating sense of deep relaxation.
After the tablework, the practitioner will teach you some simple Mentastics movements in order to improve your awareness of your own body. Depending on your ailment, you may be asked to dangle or swing your arms or legs, shift your weight from foot to foot, or do big, dancelike movements. You will be encouraged not to resist or control these motions, but to "let go" completely.
The practitioner may also suggest that while you're moving, you ask yourself some key questions, such as "What can be freer, lighter, or softer in this movement?" or "What could make it more beautiful?" And though it may seem as if you are hardly doing anything physical, each movement is carefully designed to integrate mind and body and thus develop the power of your unconscious.
A typical Trager session lasts from 60 to 90 minutes. The number of sessions required will depend on your ailment. Some people feel better after just one session, but most people benefit from the cumulative effects of five or six once-a-week sessions. You will also be encouraged to do the Mentastics movements on your own. Two or three 10 to 15 minute sessions of Mentastics a day are recommended to start.
The Trager approach is particularly useful for relieving the everyday stress that can build up in muscles and joints. With its emphasis on self-awareness skills, this method is especially good for situations in which the physical patterns of stress recur due to ongoing emotional causes. In addition, the particular hands-on technique used by Trager therapists can be especially beneficial for difficult nerve and muscle problems that have not responded to other body-centered approaches, such as chiropractic, massage, or traditional physical therapy.
To date, no major controlled clinical research has been done on the Trager approach, although a few small studies have appeared in physical therapy journals. As with other "alternative" body treatments, scientific studies are difficult to conduct due to the small numbers of practitioners who are available to work in clinical research situations.
Nevertheless, those who have benefited from Trager therapy report that sessions can ease tight muscles and joints, while simultaneously producing feelings of relaxation and vitality. Some athletes credit the Trager approach with helping them focus, improving their stamina, boosting their speed, and making their movements more graceful. Because the therapy can also improve flexibility, it may help prevent injuries.
In addition, the Trager approach appears to be beneficial for those with chronic neuromuscular pain, such as sciatica or back pain. It also has been used to treat hypertension, migraine, and anxiety disorders.
Some practitioners also report success in treating people with carpal tunnel syndrome, polio, muscular dystrophy, Parkinson's disease, and other disorders that cause weakness or paralysis.
As with all body-centered therapies, the success of Trager work is dependent on the skills of the practitioner. The therapist must be able to guide you into a deeper awareness of your body's chronic tension habits and their relationship to your current and past stresses. This process can be as important as the bodywork itself.
Most practitioners come to the Trager approach with a background in massage or other bodywork techniques, but some may have health-care or mental health backgrounds or practice Trager work as part of conventional physiotherapy. You may be able to get references to a Trager therapist from your current health practitioner or from prior clients of a particular Trager therapist. When you find a practitioner, be sure to start with a get-acquainted visit to determine if the therapist's approach is right for your needs.
It is also important to look for a practitioner certified by the Trager Institute, which maintains a database of certified practitioners worldwide. In order to achieve the degree of Certified Trager Practitioner (CTP), a trainee must first undergo Trager therapy sessions themselves, and then complete more than 250 hours of training. This typically takes one to two years. Once certified, a practitioner must participate in continuing education.
Your insurance company may cover part of the cost of Trager treatments if the Trager practitioner is also a licensed health-care practitioner, or if your plan has a "by physician referral" option that allows for nontraditional rehabilitative procedures.
Mind-body medicine combines the precision of modern science with the wisdom of ancient healing. Unlike conventional Western medicine, which typically classifies disease as either biological or psychosomatic in nature, the field of mind-body medicine prefers to look at a person's whole being, acknowledging that emotional, mental, social, and spiritual factors are just as important as physical symptoms in understanding and treating disease. Mind-body medicine believes that people can be active participants in their own health care and views illness as an opportunity for personal growth, self-awareness, and psychological transformation. Mind-body skills instructors are catalysts and guides in this process.
Today those who practice mind-body medicine and/or teach mind-body skills include integrative and holistic physicians, nurses, psychologists, social workers, and counselors, as well as chiropractors, hypnotists, bodyworkers, and traditional Chinese and Ayurvedic medicine practitioners. In addition, coaches, Lamaze instructors, doulas, and other educators may teach mind-body skills. (See also "How to Choose a Practitioner," below)
Not surprisingly, because the mind-body field is so broad-based, it includes a wide range of therapies. These include breathing, meditation, the relaxation response, somatic (body) movement education practices, cognitive-behavioral strategies, biofeedback, guided imagery, and self-hypnosis, as well as ages-old healing practices such as qigong and yoga. While good clinical practitioners will incorporate mind-body medicine into their one-on-one therapy plans, there is also an increasing demand for practitioners who can teach these skills to groups of people interested in improving their vitality and coping skills, as well as addressing specific health concerns.
For more information on the therapies mentioned above, see the WholeHealthMD Reference Library.
The nature of mind-body skills instruction and the learning commitment that is necessary depend on the nature and seriousness of your condition. A person facing an acute challenge, such as childbirth or elective surgery, for example, might require a shorter and more focused training program than a person with a chronic medical condition such as heart disease.
While mind-body skills can be taught in a one-on-one setting, most instructors prefer to work in larger classes, workshops, or retreats to encourage group interaction. You may be asked to sign up for six weeks of a weekly three-hour class with homework, or be invited to go on a two- to seven-day retreat, or attend a three- to six-hour one-day seminar or workshop. The goal is to give patients the tools to apply specific mind-body skills in their everyday lives and help them take advantage of the mutual support and common learning experience of the group.
A famous example of a major program that includes mind-body skills instruction is the Dean Ornish Program for Reversing Heart Disease, developed by the Preventive Medicine Research Institute, and now available at various hospital centers. The Ornish program has four components:
Participants learn to use these tools during an intensive 12-week program of four-hour sessions. Following the initial three-month period, the participants are assigned a program schedule based on the extent of their risk of significant cardiac events (an additional three to nine months at once a week for two to four hours). Following completion of the program, ongoing support is available as needed and through the program's self-directed community.
In addition to the proven benefits of Dean Ornish's cardiac care program, mind-body skills have also been found to help those who suffer from the physical and emotional pain of a number of other chronic conditions.
In a 2003 article, "Mind-Body Medicine: State of the Science, Implications for Practice," published in the Journal of the American Board of Family Practice, the authors concluded that, "There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions." According to the article, these conditions include not only coronary artery disease (e.g., cardiac rehabilitation), but also headaches insomnia, incontinence, chronic low back pain, postsurgical outcomes, and the disease and treatment-related symptoms of cancer (see also the WholeHealthMD Reference Library entry on Guided Imagery for the work of Carl Simonton on cancer). The authors found moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis.
Earlier, a 2000 JAMA review article on the cost-effectiveness of mind-body medicine showed mind-body therapies to be safe and relatively inexpensive interventions that can improve health outcomes and reduce the need for more expensive medical treatments. The article proposed that mind-body medicine is not something separate or peripheral to the main tasks of medical care but should be an integral part of evidence-based, cost-effective quality health care.
In addition to being used to treat chronic conditions, which are often made worse by anxiety and stress, mind-body skills are also frequently employed to relieve stress itself. Indeed, many people who turn to mind-body therapies simply want to find ways to relax in their daily lives and improve their overall mental attitude.
While additional research is needed to clarify the relative efficacy of different mind-body therapies and to determine factors, such as specific patient characteristics that might predict more or less successful outcomes, it is clear that mind-body skills can help people take an active role in their own wellness and well being.
Many of the therapies now termed "mind-body skills" were originally developed by licensed health-care practitioners or traditional healers in their patient care, or were taught as specialized courses to groups of health-seeking patients. As the value of these methods has gradually been recognized, many short courses, workshops, and programs have been designed to "train more trainers" to offer these services to the public. Each program has its own standards for its graduates, but most involve a standardized "teacher" or "facilitator" training that typically includes a supervised practicum or "student-teaching" component. This allows the graduates to offer a basic, uniform content and quality experience to future students.
The following offer excellent credentialing programs for instructors, as well as workshops for individuals seeking therapy:
The Mind/Body Medical Institute (M/BMI). Incorporated in 1988, the institute (located in Chestnut Hill, MA) evolved from more than three decades of work in the field of mind-body medicine by Herbert Benson, M.D. and his colleagues at Harvard Medical School. Their research led to the definition of the "relaxation response," which has been found to be an effective therapy for a wide range of ailments. Today the Mind/Body Medical Institute brings relaxation response-based programs to classroom teachers and students, the corporate sector, and the general public. It also trains medical students, postdoctoral fellows, and other researchers in mind-body interactions. Call (866) 509-0732.
The Center for Mind-Body Medicine. Founded and directed by James S. Gordon, M.D., who has devoted more than 30 years to mind-body medicine, the center (in Washington, D.C.) offers a certification program in Mind-Body-Spirit Medicine for professionals in medicine, psychology, social work, nursing, and other healing professions. Graduates have applied this training to their work with patients and clients, and to the establishment of mind-body programs in private practice, in hospitals, cancer centers, educational settings, and academic medical centers throughout North America and the world. Call (202) 966-7338.
The Center for Mindfulness in Medicine, Health Care, and Society (CFM). An outgrowth of the Stress Reduction and Relaxation Program, founded by Jon Kabat-Zinn, Ph.D. in 1979, the center (part of the University of Massachusetts Medical School in Worcester, MA) offers a comprehensive Teacher Certification Program in Mindfulness-Based Stress Reduction (MBSR). The CFM is the oldest and largest academic medical center-based stress reduction program in the country. Call (510)-981-1710.
The Middendorf Breath Institute. Dedicated to furthering the work of Professor Ilse Middendorf, who founded the Institute for the Perceptible Breath (now called the Experience of Breath) in Berlin in 1965, the institute (located in Berkeley, CA) certifies practitioners in Middendorf Breathwork, an artistic form of breathing education. The three-year training program is designed for professionals working in the somatic, psychological, artistic, or educational fields, or for persons who want to further their own growth. Call (510) 981-1710.
Peggy Huddleston Prepare for Surgery, Heal Faster Workshop. Peggy Huddleston, an educator and psychotherapist from Cambridge, MA, offers two-day training and certification workshops for health-care professionals working with patients facing surgery and chemotherapy. Research shows that her method of preparing for surgery helps people to feel peaceful before surgery, use less pain medication, and heal faster. Call (617) 497-9431.
To find a qualified mind-body skills instructor, ask a trusted personal health-care advisor or contact a nearby hospital, integrative health and wellness center, or pain clinic. You can also call one of the organizations mentioned above or use the Practitioner Database on the WholeHealthMD home page.
Guided imagery is the conscious use of the imagination to create positive images ("healing visualizations") in order to bring about healthful changes in both the body and the mind. Creating mental images is nothing new for most people. Everyone has daydreams, perhaps of a set of new clothes or of winning the lottery. Guided imagery takes this natural process a step further. By working with a trained practitioner, or using special audiotapes, you can learn to communicate more effectively with your unconscious mind, requesting that your body function in an optimal and healthy way.
The belief that the power of imagination can help people heal has ancient roots. Traditional folk healers known as shamans used guided imagery to treat ailments. In Eastern medicine, envisioning well-being has always been an important part of the therapeutic process. In Tibetan medicine, in particular, creating a mental image of the healing god would improve the patient's chances for recovery. The ancient Greeks, including Aristotle and Hippocrates (the "father of modern medicine") also had their patients use forms of imagery to help them heal.
It was not until the 1960s, however, that psychologists exploring the emerging field of biofeedback first began to appreciate the powers of the mind on the physical body. Through biofeedback, they could teach patients to slow heart rate, lower blood pressure, or open lungs stricken with asthma. Then, in the 1970s, O. Carl Simonton, M.D., chief of Radiation Therapy at Travis Air Force base in Fairfield, California, and psychotherapist Stephanie Matthews-Simonton, devised a program--today known as the Simonton method--that utilized guided imagery to help his cancer patients. The patients pictured their white blood cells attacking their cancer cells (sometimes in scenes that resembled the popular video game "Pac-Man"). Simonton found that the more vivid the images his patients used (for example, ravenous sharks attacking feeble little fish), the better the process worked.
Since then, a good deal of research into mind-body connections has appeared in mainstream medical literature. And while many conventional physicians remain skeptical that the mind has an actual physical effect on the reversal of an illness, guided imagery (often conducted by psychiatrists or psychologists) is now used in many medical inpatient and outpatient programs throughout the world. Furthermore, many holistically oriented psychologists, trainers, and counselors routinely employ guided imagery for stress reduction, smoking cessation, weight reduction, immune stimulation, improvement in sports performance, as well as for the relief of both physical and emotional illnesses.
Practitioners say that guided imagery works because, in terms of brain activity, picturing something and actually experiencing it are equivalent. Brain scans have verified that this is the case. Stimulating the brain with imagery can have a direct effect on the nervous and endocrine systems and can ultimately affect the immune system as well. If you picture yourself luxuriating at the beach on a tropical island, your muscles will actually relax and your skin will "feel" the warmth of the sun's rays. Likewise, if you imagine yourself recuperating quickly and effortlessly from gallbladder surgery, you are more likely to heal faster and with less pain.
The brain's visual cortex, which processes images, has a powerful connection with the autonomic nervous system, which controls involuntary activities such as pulse, breathing, and physical responses to stress. Soothing, uplifting images can actually slow your pulse and breathing and lower your blood pressure, as well as help trigger the release of hormones such as endorphins, which make you feel good and nurture your body's restorative powers.
Although you can learn guided imagery techniques on your own from books, it is best to work with a practitioner or purchase an audiotape dealing with the issue important to you. If you're a creative individual, you can write your own guided imagery script, read it onto a tape, and then use the tape as your guiding tool. If you work with a practitioner, it will probably take only a couple of sessions to learn a technique that works well for you. The sessions may be as short as 30 minutes or as long as 90 minutes. It will speed the process considerably if your practitioner allows you to tape the session for home use.
During the first session, the practitioner, who may be a behavioral health psychotherapist (psychiatrist, psychologist, licensed social worker, or masters level counselor), nurse practitioner, or a trained educator will ask you your goal for the use of guided imagery and screen for any related physical or emotional health problems. The practitioner will probably also ask you questions about your favorite vacation spots and times of year, and about experiences that have made you feel confident and secure. Your answers will help you and the practitioner develop images that make you feel good.
Next, the practitioner will ask you to lie on a couch or sit in a chair. You will want to wear comfortable clothing and may want to take off your shoes.
Once you're settled in, the practitioner will lead you through a breathing exercise or relaxation technique. Then, the practitioner will guide you through a visualization exercise, using all five senses and perhaps focusing on a special place where you usually feel happy and peaceful. The practitioner may suggest some ideas, but will leave most of the imagining up to you, since not everyone sees things the same way. For example, you might find that imagining the sounds of the surf at the beach is relaxing, but another individual might find that the same sound brings up bad memories of living through a hurricane. The best images are the ones you conjure up yourself because they have personal meaning for you.
With practice, you will be able to relax and bring up healing images quickly--anytime, anywhere. You'll be able to use guided imagery to relax during stressful moments, as well as to treat a particular health problem.
While there is no scientific evidence indicating that guided imagery by itself helps to heal disease, this technique has been shown to promote relaxation and to improve quality of life. It is especially useful for conditions that are made worse by stress, such as high blood pressure, pain, and headache, as well as stress and anxiety themselves. It may also help certain eating disorders.
Guided imagery is a prime example of what is meant by a "complementary" health practice; one that's not necessarily curative when used on its own, but that assists in achieving your therapy plan or wellness goals more easily.
In a 1997 study at the University of Miami, researchers found that guided imagery helped elevate mood and decrease stress. The participants rated their moods before and after practicing guided imagery and had their blood levels of the stress hormone cortisol measured. The subjects who used guided imagery reported a significant decrease in depression, fatigue, and total mood disturbance, and measured significant decreases in cortisol, as compared to the control group.
Imagery has been successfully tested as a strategy for relieving nausea and vomiting associated with chemotherapy in cancer patients, and it has also been found to relieve stress and promote weight gain in those with cancer. Patients using the Simonton method (see "What Is It," above) have successfully used guided imagery as an adjunct therapy to conventional cancer treatments to mobilize their immune systems.
Other studies have shown that guided imagery is particularly helpful for patients preparing for and recovering from surgery. A 1996 study at the Cleveland Clinic showed that patients who used guided imagery prior to colorectal surgery had less anxiety before and less pain after the surgery than did the control group. The members of the guided imagery group used 37% less pain medication, regained their bowel function sooner, and were released from the hospital an average of a day and a half earlier. Blue Shield of California has even begun to distribute guided imagery recordings to its members scheduled for major surgery in the hope that the practice will decrease surgical complications and the pain and anxiety associated with surgery.
Actors, athletes, and public speakers also use guided imagery to prepare for important events. They say that picturing themselves performing at top form helps them do their best in reality.
There is no national or state certification or licensing for practitioners of guided imagery, although many professionals who practice it--psychiatrists, nurse practitioners, clinical psychologists, licensed social workers, and masters level counselors, for example--are licensed in behavioral health care and skilled in handling mental and physical illness-related problems. Guided imagery training is also availale as a self-help method for "healthy" people from some coaches, trainers, childbirth educators, physical therapists, and hypnotists.
Make sure that the practitioner you select is recognized by the relevant state licensing agency, has had some verified professional training in guided imagery, and has experience helping others with similar problems.
The best way to find a reputable practitioner is to seek referrals from a trusted health-care professional or from friends. Ask for references and check them. Be sure you feel comfortable with a practitioner's style before you begin to work together.
If you'd rather learn guided imagery on your own, look for a class at a local hospital, wellness center, or community center. Guided imagery tapes that help visualization are also widely available.
See also the WholeHealthMD Reference Library entries on Behavioral Health Practitioner and Mind-Body Skills Instructor. You can also check out the Find a Practitioner database on the WholeHealthMD home page.
Practiced for several thousand years, meditation is a mind-body technique in which a person engages in quiet contemplation in order to induce a state of mental and physical tranquility. Most types of meditation have come to the West from Eastern religious practices--particularly those of India, China, and Japan. It is only in the past three decades that the technique has begun to be used mainly for health purposes, particularly for treating stress and reducing chronic pain.
The three most popular meditation techniques in the United States are transcendental meditation (TM), breath meditation, and mindfulness meditation. In doing TM you repeat a simple word or sound (called a mantra) to yourself throughout the meditation to focus your thinking and help achieve a state of calm. Breath meditation calls for concentrating on the process of inhaling and exhaling to help clear the mind. Mindfulness meditation involves focusing on the present moment, acknowledging thoughts as they come up and observing them without judgment.
TM became a household word in the 1960s, when the Maharishi Mahesh Yogi (whose followers included the Beatles) brought it to the U.S. During this time, reports had reached the West of Indian yogis and meditation masters who were able to alter their states of consciousness and control bodily functions such as blood pressure. This sparked Western researchers and health professionals--and the public at large--to begin to explore the health-enhancing potential of this ancient technique. It gained further credence when Dr. Herbert Benson, a Harvard physician, published his continually popular book, The Relaxation Response in 1975. It showed how meditation could help treat high blood pressure, chronic pain, insomnia, and many other physical ailments.
Today, meditation is widely accepted as an adjunct therapy for pain reduction and stress management, and is taught and practiced in many hospitals and medical centers throughout the U.S. It is also an integral part of other mind-body techniques including yoga, qigong, and tai chi, which have gained popularity in the U.S. in recent years.
No matter which meditative technique is used, its effect on the body is similar. Researchers have found that meditating lowers levels of stress hormones, and therefore supports the healthy functioning of the immune system. In fact, by decreasing the level of one such hormone--epinephrine--meditation has been shown to reduce the amount of cholesterol in the blood and therefore help arteries to remain clear.
In addition, electroencephalograph (EEG) studies of the brain in those who are meditating show that meditation boosts the intensity of alpha waves--with quiet, receptive states--to levels not seen even during sleep. People who meditate also show improved blood circulation, which protects the arteries; lowered blood levels of lactic acid, which is associated with anxiety; and lowered heart rate, which places less demand on the heart. Another effect of meditation is that breathing slows, so the body uses less oxygen.
Meditation is easily practiced at home on your own. You can learn meditation techniques through books or audio or videotapes, or you can take a class in meditation to get started. Classes are frequently offered at yoga centers or community centers, and are usually taught by long-time meditators who are well versed in meditation practice. A typical class might meet for an hour once a week for several weeks and you might be exposed to one or more meditation techniques.
Whether you practice transcendental meditation, mindfulness meditation, or breath meditation, the goal is the same: inner peace and relaxation. In all three techniques, you sit comfortably with your back straight, either in a chair or on the floor, with your eyes closed, breathing deeply. The techniques do differ slightly in how they are performed, however.
When practicing TM, for example, you repeat a mantra (often a Sanskrit word) to yourself throughout the meditation. A teacher may give you the mantra or you may simply use a word that is calming to you, such as "peace" or "one." Saying the mantra helps prevent distracting thoughts from entering your mind and allows you to gradually relax and release stress. One goal during TM is a passive attitude that allows thoughts, images, and feelings to pass through your consciousness almost unnoticed.
Mindfulness meditation (a technique researched and popularized in the U.S. by Jon Kabat-Zinn, the director of the Stress Reduction Clinic at the University of Massachussetts Medical Center) helps you to become more in touch with what is happening in your body and mind at the time it actually is happening. In mindfulness meditation, you pay attention to your thoughts as they come up and observe them without judgment. This technique may include a body scan, in which you methodically bring attention to each part of your body from head to toe. As you let go of thoughts or images associated with a certain body part, the body part lets go, too, thus releasing much of its tension. The body scan has been found to be an excellent way to help people who are dealing with chronic pain. For best results, a body scan should take about 45 minu