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Dr. Juan Paolo Bellosillo

Dr. Juan Paolo Bellosillo ND, MCL, DWMS, DAAIM, MAURP

C.Homotoxicology

BellosilloDr. Juan Paolo Bellosillo, was named after and blessed by the late Saint John Paul II in the Philippines Nunciature and has embarked on Preventive Medicine Campaign through Medicine and Media, showing compassion and nobility in service with every beat of his heart.

He had finished his schooling from the Ateneo De Manila University Loyola Schools in Economics, which included additional concentrations in Natural Sciences, Math, Law and Foreign Languages. Subsequently, he pursued his Masters at the School of Urban and Regional Planning as University Scholar in the University of the Philippines while juggling work in wellness and healthcare. He has undergone and survived two near death experiences, that took him to the Emergency Room brought about by progressed arteriosclerosis and atherosclerosis of the heart. Consequently, he pursued his Natural Medicine and Energy Medicine at the IFP Institute Official School of Naturopathy and Natural Sciences and graduated Magna Cum Laude.

The desire to prevent the growth of mortalities due to heart attacks from house to community, to city, to region, and eventually, nationwide gave him the perseverance and determination to study in Germany’s International Academy for Homotoxicology to augment his arsenal against acute, chronic and degenerative diseases. He also pursued his continuing naturopathic doctor education in the areas of preventive cardiology, nutrition, anti-aging medicine, sports medicine through the University of Bridgeport, US. Moreover, he furthered his knowledge in Metabolic Cardio treatment through the Institute for Integrative Medicine supplemented by the teachings of his Uncle, Dr. Adolfo Bellosillo the former president of the Philippine Heart Association. Having gone through training and education in sports and nutrition, he supports athletes and the general public; fueling their performance in competitive races or the race of life. He too was educated and trained under the Philippine Red Cross in the areas of life support and first aid. He was President of his class composed of 70 nurses and allopathic doctors. Combined with Tactical Medicine through a Multi Jurisdictional Task Force program (US), he led a team of Coast Guard Auxiliary and First Responders in a Medical Psychological Mission in the heart of Tacloban Leyte, during Typhoon Yolanda-Haiyan.

Dr. Pao, as he is fondly called in television, has gone from resource speaker to hosting stints in some TV programs such as Doctor’s on TV, Rise and Shine, Good Morning Kuya as well as an Eco Travel Show in Studio 23, ABS-CBN. He uses television to educate, reach out to people and inform them of the ways and means to avoid diseases as well increase their quality of life, an application of public involvement and participation metrics.

He manages his profession and advocacies in providing quality healthcare and wellness on the individual level, organizational level (corporate: Nutra, Pharma Healthcare, ICT-BPO, Distribution-Logistics, Hospitality Tourism, Schools, Retail, Real Estate-Development), and city levels. He has served through establishing programs and multi-medical system centers from Northern Luzon (La Union) down to Quezon City and as way South to Bicol’s Legaspi. For this reason he was given awards and recognition in the City Levels especially when disasters struck, Asian Achiever award in Naturopathy and Dangal ng Bayan Award.

Notably, he has successfully aided in the reversal of hypertension, cardiac insufficiency, diabetes, atherosclerosis, arteriosclerosis, chronic kidney diseases and the like through using combined whole medical systems and integrative medicine methods- Holistic Medicine.

To date, he holds a Diplomate in Naturopathy and Energy Medicine in the IFP, First Filipino Diplomate in Whole Medical Systems and Diplomate in Integrative Medicine in the American Association of Integrative Medicine. Furthermore he holds an International Membership with the World Society of Interdisciplinary Anti-aging Medicine, membership with the Philippine Stem Cell Society, membership with the Philippine Institute of Environmental Planning, membership in the Philippine Society of Biochemistry and Molecular Biology, Registered Triathlete with the Triathlon Association of the Philippines and was granted membership in the prestigious American Board for Certification in Homeland Security. He believes security in health is affected by the quality of security we have at home and in our homeland. Security about Him and for Him, is another story to be shared.

He serves the movers and shakers in the Philippine society in the areas of private and public hierarchies including key positions in law enforcement, congress, business and humanitarian. John Paul the II had a noble heart and this has inspired Dr. Pao in his vocation and profession to help one and all: “Live a Legacy”.


The Flu and Prevention

The Flu and Prevention

Published April 14th, 2015 in Alternative PerspectiveAlternative Therapies

by Tammera J. Karr, PhD

This year, that flu “vaccine will only reduce your risk of ending up in the doctor’s office with the flu by about 23 percent. The vaccine was developed nearly a year ago in February, 2014, and it’s not an ideal match for H3N2, the strain of the virus prevalent this season. That mismatch — along with H3N2’s reputation for causing higher hospitalization and mortality rates — led the Centers for Disease Control and Prevention to predict a severe flu season this year.

That prediction has been borne out, with more flu-related doctors’ office visits this year than last year. In Virginia, flu activity remains high after peaking in late December, according to the state health department. As the air gets drier, it sucks the moisture out of those mucus droplets. As the droplets shrivel and crystallize, the reduction in water increases the concentration of salts and proteins and changes the acidity.” (http://www.sciencedaily.com/releases/2015/02/150202105403.htm_br)

Linsey Marr, a professor in the Charles E. Via Jr. Department of Civil and Environmental Engineering at Virginia Tech, is obsessed with flu transmission. “Marr found that between 50 percent and 98 percent humidity, the virus doesn’t survive well — the droplets dry out just enough to be inhospitable. But at very low humidity — like you’d find indoors in the winter — droplets can dry out completely, preserving the virus-like microscopic beef jerky.”

“As recovering flu victims struggle back to work and school, and new cases keep cropping up, the question on everyone’s mind is: What can people do about it?”

  • Washing your hands, is a start, and then there is the tried and true home remedies of garlic, onions, bone broths and a diet rich in real foods versus processed foods.
  • Optimal vitamin D3 levels (optimal levels fall between 65ng/ml & 85ng/ml), vitamin C rich foods and naturally fermented healthy bacterium rich foods, also improve your ability to ward off viruses. If you can’t handle fermented foods increase your probiotic supplement use.
  • Getting out from under florescent lights also improves your body’s ability to fight viruses, along with the use of cheap air filters to reduce airborne molds and dander that weaken your immune response.
  • Use a humidifier on your wood stove to improve the humidity during flu season in your home.
  • Change out air filters in your heating system even if you think they don’t need it to improve air quality in your work and home.
  • And lastly, a good night’s sleep makes a world of difference. You should wake feeling rested, not run over by a truck. If you don’t feel rested consider your bed may be the problem before you run off to the doctor for a sleeping pill.

To Your Good Health and Information –

Sources

http://www.newswise.com/articles/reasons-why-winter-gives-flu-a-leg-up-could-be-key-to-prevention_truncated

Reasons Why Winter Gives Flu a Leg Up Could Be Key to Prevention. (n.d.). Retrieved from http://www.newswise.com/articles/reasons-why-winter-gives-flu-a-leg-up-could-be-key-to-prevention_br
Reasons why winter gives flu a leg up could be key to … (n.d.). Retrieved from http://www.sciencedaily.com/releases/2015/02/150202105403.htm_br


Depression School: A 3-Session Group Crisis Stabilization Intervention

Depression School: A 3-Session Group Crisis Stabilization Intervention

Jolene Oppawsky, PhD, LPC, ACS, DAPA
University of Phoenix

Abstract

The rapidly changing mental health care environment has many treatment and financial implications for therapists and clients.  The changes place new and acute demands on providers and caregivers to meet clients’ needs with time-limited, innovative therapies without compromising care.  Innovative perspectives in clinical practice should stimulate research on practical therapeutic interventions developed by clinicians who depend on their own creativity and resourcefulness to help clients.

In this article, we present the process and protocol of Depression School, an innovative 3-session depression group for crisis stabilization of depressed clients.  Also included are examples of the clients’ written work, a tangible form of accountability, the results of a before-and-after Beck Depression Inventory taken by each client as evidence of the initial depth of depression and successful treatment.

 

Introduction

The rapidly changing mental health care environment has acute implications for therapists and clients.  The number and nature of authorizations for therapy have changed.  Due to economical considerations, authorizations of brief treatment models, with a reduction of the number of therapy sessions, have increased.  There has also been an increase in authorizations for group therapy, although the evidence that group therapy is more cost effective than individual therapy is still debated (McCrone, A. et al, Shapino, J. 1982, MacKenzie, C. & Ray, K., 1995, Tucker, M. & Oei, T. P.S. 2006).  Additionally, hospitalization authorizations by HMOs for mental health problems have decreased.  These changes place new and acute demands on therapists to meet their clients‘needs without compromising care.

It is far beyond the scope and purpose of this article to review the ever-growing amount of financial research and clinical-use literature on the above topics.  It is the author’s hope that this perspective in clinical practice will stimulate research on practical therapeutic interventions developed by clinicians who depend on their own creativity and resourcefulness to help clients.

In the following article, this author and facilitator of the group presents the instructions and process for facilitating a 3-session depression group and gives the protocol for facilitating the group.  The group, whose members were selected by the intake therapist, agreed to participate in this innovative crisis stabilization treatment.  The group was named Depression School by the initial clients, and the name stuck.  The group members met weekly for crisis stabilization of their depression before they were transferred to five sessions of individual therapy.  Also included in this article are examples of the clients’ written work and a tangible form of accountability, the results of a before-and-after Beck Depression Inventory ( Beck, A. T., Rial, W. Y., & Rickets, K. 1974;  Burns, 1992 ) taken by each client as evidence of the initial depth of depression and positive treatment outcomes.  An additional bonus is that the clients can use this instrument at home to gauge their moods and ward off depression.

After the 3-session group, the clients participated in five weekly sessions of individual therapy as a time-limited treatment and were then discharged.  Treatment was completed in eight weeks (60 days).

Depression School

Building the Group

Depression school is a name coined by the first group of clients who participated in a new and innovative three-session crisis stabilization group therapy model for depression as part of an eight-session therapy plan developed by this author, as a time-limited treatment.  The remaining five sessions were individual sessions.  This name, Depression School, has been accepted by all subsequent groups conducted by this therapist/writer resulting in a permanent name for this writer’s groups on depression.  The group members can be a mix of ages, races and sexes, or women’s and men’s groups can be formed.  Groups of children and adolescents can also be established.  Extremely psychotic clients would not be appropriate for this model because of the level of group participation necessary to make the workbooks and interact effectively with the other clients in developing their own treatment.

The Beck Depression Inventory

BDI usage

The BDI is actively used today in numerous statistical efficacy studies, among many others, (Enrichd Investigations, 2003; Thompson, L.W., Coon, D. W., Gallagher-Thompson, D., Sommer, B.R., & Koin, D., 2001).

BDI results in Depression School are gathered to judge therapy outcomes and to help the clients use this instrument at home to gauge their depression if they are using The Feeling Good Book (Burns, D., 1992).  The intent of using the BDI in Depression School is not to obtain statistical data, but rather to be used at home by clients to help make them active participants in their treatment.  It also gives them a preventative tool to help them manage their moods.

Each client should have two scores, one score from the beginning of therapy, and one after the third session.  Each client’s BDI results are put on individual graphs and added to their workbook.

The Process

The group’s goal was established by this therapist/writer, that of understanding, managing and defeating depression through group effort, and the objectives were defined.

Group objectives

  • To gain an understanding of depression and develop a group definition of depression
  • To explore, as a group, your old ways of handling depression that have not been helpful (“bummers”)
  • To understand, through group sharing, the circumstances that brought you to therapy
  • To develop and explore, as a group, new ways of dealing with depression
  • To try these new ways in real life

 

Session one

The first session starts with an introduction by the therapist about his or herself and about the upcoming group work, followed by an invitation for the clients to introduce themselves and make a short statement about what they would like to accomplish individually and as a group.  The Beck Depression Inventory (BDI) is then explained and given to each client.

After the BDI is taken, the clients are asked to described their depression to the group, generate a group definition, and develop a motto.  Clients also share with the group what happened in childhood and along life’s way to set the stage for depression.  The therapist, co-therapist or selected group member should record the definition and motto.  Recording a few key words of the clients’ descriptions of depression and what happened in childhood is also necessary.  After generating lists of current and childhood experiences, which the clients feel caused their depression, the group members extract main themes from the information.  The designated scribe also records these.  These records are then used in the development of the group’s workbook.  Computers may be used, which are especially welcomed and effective when working with teenagers.  This means that client writings are generated right in the group.  Kelly (1990) and Oppawsky (2001) suggest that client writings in therapy can enhance cognitive awareness for clients.  For homework, the clients are asked to think about how their workbooks could be embellished with art work, photographs, or poems, and to bring anything they would like included in their workbooks to the next session.  The process of this type of group usually initiates a significant amount of group interaction and the clients are asked to give and receive feedback and support from their peers.  Personal items help clients share personal information and help them discover or elaborate on any negative or positive thoughts.  The clients are encouraged to discover the universality of any items brought in for their workbooks, such as a photograph of a client as a child laughing, playing, or with siblings or family, or of a pet.  This task helps clients discover just how well they can identify with others.  This connectivity also helps bridge social and cultural lines leading to positive cross-cultural interactions within the group (Oppawsky, 2009).

Session one should close with an exploration of any issues arising from the session and a safety check, meaning a danger-to-self and a danger-to-others check and an affirmative statement from each client about him or herself.

Session two

The group opens with a short round-about with each client telling about his or her week.  Then, clients are invited to explore old ways of dealing with depression that have been counterproductive or have not worked, and generate a bummer list.  The word bummer to describe this list was client-initiated, and has stuck.  This part of the group work usually generates significant interaction among members and this interaction should be encouraged.  Again, the bummers are recorded for the workbook.

After the bummer list is generated, the group is invited to explore and develop new ways of dealing with depression and to generate a new ways list.  This list may be made up of things that have worked for the clients in managing their depressive moods in the past, or things that they would like to try.  Accepted cognitive behavioral techniques, such as negative thought stopping, journaling, and identifying triggers that lower moods, can be introduced by the therapist (Corey, 2001).  These are also recorded for the workbook.  After generating the new ways list, each client contracts to try a new way in vivo in the next week.

Again, session two closes with an exploration of any issues arising from the session or during the week, a safety check, and an affirmative statement by each client about him or herself.

Session three

Session three starts with group members sharing how they made out using new ways during the past week.  This usually generates significant group interaction.  Group support is imperative if some of the members were not successful in adopting a new way.  If a client was not successful, the client selects another new way to be tried in vivo in the following week.

Clients are then asked to retake the BDI and compare their results to their initial BDI.

A group discussion of their results follows, again with group and therapist support if  a client’s mood has not improved, and encouragement and support if it has improved.

The clients are then asked to make their workbooks with supplies usually provided by the therapist and/or agency.  Some supplies that are useful are colored construction paper for the cover and yarn or colored thread to bind the workbook.  The clients often bring pictures or poems to develop cover pages.  Often, pictures are included inside the workbook, as well.  Children and teenagers like to put their own pictures on the front of their workbooks or draw a cover picture.  This writer usually generates copies of the individual BDI results, the objectives, the group motto, the bummer list, and the new ways list on the computer and then provides them to the clients for their workbooks.  Frequently, a group member will do this as homework.

The group closes with each member giving another member a positive affirmative of something he or she has observed about the member during the three weeks.  An exploration of any issues arising from the group or during the group’s duration follows.  A safety check is made, and the clients are transferred to their individual therapists for their remaining five individual therapy sessions.  The group members are encouraged to take their workbooks with them to their first sessions of individual therapy.

Suggestions for Follow-up

Each client is transferred from Depression School to individual therapy.  After five sessions of individual therapy, all clients are usually discharged having attained their treatment goals and with moods that are continuing to improve.  The clients are asked in individual therapy to make a commitment to monitor their moods at home and continue using the new ways developed in Depression School in individual therapy and after discharge.  The clients are usually encouraged by the individual therapist to join a self-help depression group or a bereavement group in the community.  A list of community resources should be given.

Contraindications

Therapists should initially assess the clients for danger to others and/or dangers to self.  These assessments should be done throughout the duration of therapy as well.  Clients who are suicidal, or have vague threats of harming others, can participate in this innovative model with proper precautions such as no-suicide and no-harm-to-others contracts.  Clients who have active intentions to harm themselves or others are not appropriate for this group.  Clients who become seriously suicidal in the group with a plan and/or means to commit suicide, or trigger a Tarasoff response, should be referred out of group to appropriate services.  Occasionally, some clients may experience deepening depression or mental decompensation while in group and should be transferred immediately to more intensive care.

Vignette Protocol of a Depression School Therapy

The following is the protocol of an authentic Depression School that includes the group’s definition of depression, the motto of the group, the themes from the group, the bummer list, the new ways list, and the results of the BDI, pre and post-treatment.

Client Selection

All the eight participants – five women and three men of different ethnic backgrounds, White, African American, and Hispanic, and ranging in age from 25 to 58 – had a psychiatric diagnosis of Major Depression, severe or moderate, determined during his or her biopsychosocial intake assessment at an outpatient crisis intervention and brief treatment facility.  All participants had denied suicidal ideation or homicidal ideation during intake.  All clients had had previous suicidal ideation but had made no attempts.  Some had had vague thoughts of harming others in the past but with no plan or intent.  All signed no-harm contracts.  All the participants had refused medication.  Each client was granted eight sessions of brief treatment by his or her mental health provider and agreed to participate in this innovative plan for therapy.

The group’s definition of “a depressed person” was: “one who is not able to deal with things in life, who feels down all the time, who is not able to make decisions, has mood swings, is angry, who is tired all day, and wants to kill/hurt someone.”

Their mottos were: “Find your own life,” and “Depressed people are sensitive, we feel, it hurts, it is risky – but we wouldn’t have it any other way, but without depression, look inside, listen to self.”

After generating lists of current and childhood experiences, which the clients felt had caused their depression, main themes were extracted from the list by the group members.  The following themes were generated by the group:

  • Loss of love
  • Loneliness
  • Financial problems
  • Threatened autonomy
  • The need for unconditional love, unconditional acceptance

Bummers

A bummer is something used to try to deal with depression that has not worked.  Sharing bummers with each other helped the group avoid unsuccessful coping methods.  Group support also helped clients relinquish steadfast bummers.  The following were examples of bummers generated by the group.

  • Drinking and drugs
  • Not crying
  • Anger – gets you nowhere
  • Letting people back/drive you into a hole, not standing up for yourself
  • Denial
  • Sleeping all the time, boredom
  • Hurting yourself or others
  • Fighting and domestic violence
  • Losing sight of yourself and your needs
  • Hooking up with people or getting married to someone you don’t love out of feelings of being needy
  • Making wrong decisions
  • Settling for less
  • Not being able to accept reality
  • Letting depression immobilize you
  • Running from a situation
  • Setting yourself up for bad things
  • Engaging in work activities that don’t have anything to do with your dream, staying in a bad job, or poor work atmosphere
  • “Absorbing shit” instead of dealing with people

New ways

The new ways list contained examples of things that group members had successfully used   in the past to manage and defeat depression, or ones they wanted to try.  Each client selected a new way from the list and made a commitment to try a new way between the second and third session.  Each client also committed to relinquishing his/her bummers and using new ways during individual therapy and after discharge.  The new ways were:

  • Crying and grieving, grief work
  • Activities such as music, church, art, reading helpful and powerful books, hobbies, fitness, participating in groups, such as Divorce Recovery or Parents without Partners
  • Do something innovative despite not having the money
  • Validate yourself and your feelings, don’t let yourself be put on the back burner (take affirmative action)
  • Reach out to others
  • Make a plan and carry it out
  • Take time out for yourself , enjoy time to yourself

BDI  results

The BDI results were gathered to judge therapy outcomes and to help the clients use this instrument at home to gauge their depression if they were using The Feeling Good Book.  Each client had two scores, one score from the beginning of therapy, and one after the third session.  All the clients were in the moderate, severe, or extreme depression categories initially except one client with mild mood disturbances.  All responded to the therapeutic effects of this group intervention with improvement in mood.  Six out of eight clients showed more improvement in mood on inventories than the other two.  The client who scored in the mild mood disturbance category reported that she was feeling better, and her score did not rise within the category.  Each client’s BDI results were put on individual graphs and added to their workbooks.

Discussion of Depression School and the Vignette

The Beck Depression Inventory (BDI) was designed as a standardized tool to assess the depth of depression and is widely used throughout the United States and Canada as well as abroad (Corey, 2001).  It is a formal screening tool for depression with good reliability and validity (Beck, Rial, & Rickets, 1974).  A review of evidence-based studies shows that both the BDI and the BDI-SF (Short Form) are used (McFarland, K., 2005).  The BDI and the assessment scale are published in Burn’s (1992) self-help book, making it an accessible and affordable resource for clients.  Many clients come to therapy with the book or have the book at home.  Many mental health centers have the book available for clients and therapists to use, and it is also readily available in most public libraries.

In Depression School, the depth of depression for each client was assessed in the first few minutes of therapy.  The initial results stressed each client’s reality without disputing or prescribing their symptoms.  The final BDI was a tool of accountability of therapy, a tangible product of what really went on in therapy, as well as a measure of positive outcome.

The rapidly changing mental health environment, in which the number of therapy sessions is reduced, should awaken therapists to a need for innovative and new ways to increase the effectiveness and efficiency of therapy, as well as aid in the accountability of therapy without compromising care.  Enrolling depressive clients in crises in a weekly 3-session Depression School for crisis intervention and stabilization before they are transferred to individual therapy is warranted.

In Depression School, clients were viewed as active agents who were able to derive meaning out of what they were going through and were helped to take action to modify their depression.  Their written work and BDI results enriched this model by encouraging processes of self-expression, which were documented.  Additionally, clients’ written work helped the clients understand their therapy and the therapeutic process.  Their workbook became a tangible form of accountability for them.  The universality of the group members’ problems and their interactive approach to understanding, managing, and defeating their depressions helped the clients to acquire effective strategies in dealing with their moods in a timely fashion.  Indeed, all clients in the vignette, except one with initially mild mood disturbances who retained the same results, showed improvement.  Six clients out the eight showed more improvement in their moods than the other two.  Depression School, as a crisis intervention/stabilization therapy, with its goals of helping clients understand, manage, and defeat depression, worked for these clients.  By divorcing themselves from bummers and using new ways, the Depression School actually became a coping skills program for clients in crisis and paved the way for successful individual therapy.

After the three sessions, the eight clients who participated in the group and were presented in the vignette were transferred to five sessions of individual therapy, wherein the clients’ problems past and present problems leading to depression were explored in depth.  Their commitments to understanding, managing, and defeating depression were reaffirmed.  All the clients’ BDI scores improved by the end of the three sessions with the exception of the one client whose BDI showed mild mood disturbances initially.  Her BDI stayed in that range.

At the time of discharge, after eight sessions (3 group sessions and 5 individual sessions), all clients were in the mild mood disturbances range of the BDI, substantiating significant improvements in their moods.  The one client who was in the mild mood disturbance range initially reported that she felt significantly better having moved higher within her range.  The clients were discharged by mutual client/therapist agreement with treatment completed.

Research Possibilities and Multiplication Factors

Serious psychotherapy is a blend of art and science.  Experienced therapists understand that the need for brief treatment modalities calls for creative and innovative interventions.  These therapists also know that they must use what works.  This model of treatment was designed by this writer from her significant experiences practicing psychotherapy in agency settings in Arizona, where resources and the number of sessions allowed to clients are limited.  The use of this innovative and creative practice illuminated the need for research on this group model.  It is the author’s hope that this perspective in clinical practice will stimulate research on practical therapeutic interventions developed by clinicians who depend on their own creativity and resourcefulness to help clients.  For example, on this group model, statistical tests on the results of the BDI could be done to determine if the changes the clients’ recorded were statistically significant.  The number of group sessions compared to individual sessions was arbitrarily picked by this writer based on her experience with and need for brief therapies.  Further research on the exact number of group versus individual sessions needed to stabilize moods could be researched.  Furthermore, the use of this model with children and adolescents could be practiced and researched.

This writer has since successfully conducted many 1-3 session Depression Schools with medicated and non-medicated adult clients with major depressions, dysthymia, and bipolar disorder.  After stabilization, these clients were transferred to various services, such as meds only groups, case management services, primary care physicians, self-help groups, and to individual therapies of different lengths of time.

 


 

References

Beck, A. T., Rial, W.Y., & Rickets, K. (1974). Short form of depression inventory: Cross-validation.  Psychological Reports, 34(3), 1184-1186.

Burns, D.  (1992). Feeling good  The new mood therapy.  New York: Avon Books.

Corey, G. (2001). Theory and practice of counseling and psychotherapy.  Pacific Grove, Ca: Brooks/Cole Publishers.

ENRICHD Investigators. (2003). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The enhancing recovery in coronary heart disease. Patients (ENRICHD) randomized trial.  Journal of the American Medical Association, 289, 3106-3116.

Kelly, P.  (1990).  The uses of writing in psychotherapy.  New York:  Haworth Press.

MacKenzie, C. & Roy, K. (Eds.), (1995). Effective use of group therapy in managed care.  American Psychiatric Publication on Clinical Practice No. 29. British Columbia: Clinical Practice Publisher.

McCrone, P., Weeramanthri, T., Knapp, M., Rushton, A., Trowell, J., Miles, G. Kolvin, I.  (2005). Cost-effectiveness of individual versus group psychotherapy for sexually abused girls. Child and Adolescent Mental Health, 10(1), 26-31.

McFarland, K., (2005). Battling late-life depressions: Short term psychotherapy for depression in older adults-A review of evidence-based studies since 2000.  Annals of the American Psychotherapy Association, 8(4), 20-27.

Oppawsky, J. (2001).  Client writing: An important psychotherapy tool when working with adults and children.  Journal of Clinical Assignments, Handouts, and Homework in Psychotherapy Practice, 1(4), 29-40.

Oppawsky, J. (2009). Grief and bereavement. A how-to therapy book for use with adults  and children experiencing death, loss and separation. Bloomington, IN: Xlibris Press.

Shapiro, J. ( 1982). Cost effectiveness of individual versus group cognitive behavior therapy for problems of depression and anxiety in an HMO population.  Journal of Clinical Psychology, 38(3), 674-677.

Thompson, L.W., Coon, D.W., Gallagher-Thompson, D, Sommer, B. R., & Koin, D. (2001). Comparison of desipramine and Cognitive/behavioral therapy in the treatment of elderly outpatients with mild-to-moderate depression.  American Journal of Psychiatry, 9(3), 225-240.

Tucker, M. & Oei, Tian P.S. (2006). Is group more cost effective than individual cognitive  behavioral therapy?  The evidence is not solid yet.  Behavioural and Cognitive Psychotherapy, 35(1), 77-91.

 


 About the Author

Oppawsky_JoleneJolene Oppawsky, PhD, a Diplomate Psychotherapist, Licensed Professional Counselor in Arizona, and an Approved Clinical Supervisor is a University of Phoenix faculty member and supervisor in the graduate counseling program in Tucson, Arizona. Formerly, she taught for Boston University in their graduate overseas counseling program. She has taught psychology and psychotherapy at the University of Warsaw twice and at the University of Lithuania. She does psychotherapy on a contract basis in Tucson, Arizona. She has several professional publications to her credit.


The Use of Hypnosis in the Treatment of Migraine Headache: A Case Study

By: Edward Mackey CRNA, MS, MSN, Ph.D.

Assistant Professor

West Chester University of Pennsylvania

Abstract

Migraine headaches significantly impact the lives of those who suffer from them.  This case report discusses a patient suffering from frequent and almost incapacitating migraine headaches that lasted over a period of fifteen years and were unrelieved by conventional methods.  Here I present my experience with this patient utilizing hypnotherapy techniques as an adjunct to her pharmaceutical regimen.  The patient participated in a once weekly, hour-long session of hypnotherapy.  After weekly hypnotherapy for a period of two months, the patient reported definite improvement, a decreased number of migraine headaches, and was feeling more comfortable with using self-hypnosis.  It is interesting to note that after eight sessions of hypnotic intervention, the patient improved drastically.  The patient remains migraine-free ten months after her last office visit.  The patient has consented to allow presentation of this case material.

Keywords: Migraine Headache, Ideomotor Movement, Self Help, Brief Focused Therapy

Learning Objectives:

1)      The reader will understand the use of ideomotor questioning in hypnotic interventions,

2)      identify differences in direct suggestion and indirect suggestion,

3)      and identify a method of inducing glove anesthesia.

 


 

Introduction

            Migraine headaches are vascular in origin, yet they are often mixed with components of tension headaches as well.  In fact, up to half of patients with migraine headaches also meet the criteria for tension headaches.  These patients are labeled “mixed migraine and tension headache” (Crasilneck & Hall, 1985; Barabasz & Watkins, 2005; Turk & Garchel, 2002).   Migraine headaches can be episodic, with attacks lasting anywhere from several hours to several days or a week.  They are frequently accompanied by nausea and vomiting, as well as sensitivity to light and sound (Turk & Gatchel, 2002).  Psychotherapeutic interventions for migraine headaches as well as headaches in general are only used when other physical or organic factors such as tumors or chronic sinusitis are ruled out.  Once other causative factors are ruled out, psychogenic factors involved in migraine or tension headaches seem to respond well to hypnotherapeutic initiatives (Andreychuk & Skriver, 1975; Barabasz & Watkins, 2005; Blumenthal, 1963; Graham, 1965; Kroger, 1977; Olness & Kohen, 1996).  Hammond (2007) reviewed the efficacy of clinical hypnosis with headaches and migraines, and his paper provided an up-to-date review of the literature on hypnotherapy.  He concluded that it was “efficacious, virtually free of side effects, risks of adverse reactions, and ongoing expense associated with medication treatments” (Hammond, 2007, p.207).  Directive hypnotherapy has been used successfully with premenstrual migraines and premenstrual tension (Kroger, 1977).  Self-hypnosis training was shown to be effective in reducing the frequency of headaches in children ages 6-12 years with classic migraines (Olness, MacDonald & Uden, 1988).  Using suggestion and imagery so the patient can visualize his or her extremities warming, direct suggestion has been used to redirect blood flow and create vasodilatation in the peripheral vasculature, which decreases blood volume in the brain and alleviates the migraine headache (Barabasz, 1977; Barabasz & McGeorge, 1978).  Bassman and Wester (1997) devised an integrative approach to headaches and pain control using a four-session approach to alleviate discomfort through the use of hypnosis, glove anesthesia, metaphor, and direct and indirect suggestion.  This provided practitioners with a workable program to use with patients with headaches and other discomfort.  This case study outlines a process of hypnotherapeutic intervention including ideomotor questioning, the teaching of self-hypnosis to the patient, guided imagery, and post-hypnotic suggestion to work in conjunction with the patient’s current medical regimen.

Case History

Johanna Marx (not her real name), a mother, wife, graduate student and OR nurse was originally diagnosed with migraine headaches when she was 30 years old.  JM is now 45 years of age.  JM had heard of my work in hypnosis with patients suffering from headache and migraines in particular and had decided to seek my assistance after thinking, “I am at the end of my rope.”   During the intake session, JM told her history of incapacitating headache pain associated with nausea and vomiting, as well as sensitivity to light and sound lasting from hours to several days.  These incapacitating headaches would impact both her personal and professional duties.  She found herself using an inordinate amount of sick time at work, and at home she found she was unable to perform activities required of a busy mother and homemaker.  She had suffered from “severe headaches” for a number of years prior to being officially diagnosed by her primary physician at age 30.

Medical History:  30-year-old female in no acute distress (NAD) with exception of frequent debilitating attacks of migraine headaches.  Her medical history at age 30 revealed hypertension with blood pressure ranging from 140-150’s systolic over 90’s diastolic.  The medical record revealed no psychological or psychiatric diagnosis or distress.  JM stated her Marriage was “fulfilling” and “very satisfactory” with no evidence of any sexual dysfunction or concern. Regular monthly menses with frequently associated migraine events were reported.  With the original diagnosis, JM was prescribed Percocet as needed (PRN) for headache.  JM mentioned there was no suggestion on any dietary modification or discussion on other treatment modalities given at that time by her physician.  JM intimated that: “I would not take the Percocet so I concentrated on the Dunkin Donuts plus Advil route.”  When asked what she meant, her reply was: “I did not like the way [the Percocet] made me feel, so I used caffeine and Ibuprophen.”

JM started to have more frequent headaches and went to see another physician who prescribed Imitrex nasal: 5mg and Ultram 50 mg. p.r.n. for headache pain, which seemed to work well for awhile and also did not make her “goofy,” in her own words.  She was also started on Toprol 50 mg BID for hypertension (HTN).  A few years later, when the headaches continued to get worse, her new primary physician referred her to a neurologist who did a complete workup, and as the headaches progressed, started her on Relpax (Eletriptan Hydrobromide) at 20 mg at the onset of migraine, repeated in two hours if there was no relief.  The Relpax gave her chest pain, which was then investigated with stress echocardiogram, which showed nothing abnormal.  Her physician then started her on the following medication regimen:

    • Imitrex (sumatriptan) nasal 25 mg p.r.n. at onset
    • Reglan (Metoclopramide Hydrochloride) 20 mg p.o. at onset
    • Celebrex (Celecoxib) 20 mg q. am
    • Verapamil 240 mg BID (instead of the Toprol; yes this dosage is correct)
    • Naprosyn (naproxen) 2 tabs prophylactic ally 2 days prior to onset of menses
    • Compazine (prochlorperazine) 25 mg PR if needed
    • Prednisone on a 4 –day pulse: 80-40-20-10 mg/daily

JM reported that within a short period after starting on this regimen, things were better.  Then, however, she had two episodes of intractable migraines, the first lasting 21 days with expressive aphasia and the second lasting 17 days without any aphasia.  Her physician then changed the Imitrex to Migranal (dihydroergotamine mesylate) nasal spray, with up to four sprays in each nostril as needed.  In her own words, JM stated: “at the peak of these headaches in 2007-2008, I had quite an arsenal of meds that I felt I needed to carry in my purse.”

At the start of our work together JM was currently 45 years of age, 15 years after the original diagnosis of migraines.  Her medication list was as above: Migranal, Reglan, Celebrex, Verapamil, Naprosyn, Compazine, and Prednisone.  JM was not taking any other medications or supplements except for a daily multivitamin.  JM was not taking any oral contraceptives except during the first few years of her twenties.  She preferred other methods of birth control, as she had been aware of estrogen-progestin combinations (oral contraceptives), a possible link to headaches and migraines in particular (Abrams, 2006).  JM exercised through daily 30-minute walks with her dogs.  She had been married for 20 years to the same spouse and rated the quality of her relationship as five on a ten-point scale.  JM reported frequent (2-3 times per week) discomfort in her joints.  She denied depression, anxiety, mood swings, repetitive thoughts or obsessions, homicidal thoughts, or suicidal ideation.  JM denied alcohol/drug abuse, eating disorder, learning disability, or trauma/abuse.  JM’s score on the Beck Depression Inventory (BDI) = 7.

Family history included:        Father – depression

                                                     Mother – anxiety disorder

                                                     Sister – depression

JM considered herself an intelligent person, willing to work hard and follow through on projects, and she believed she had a good support system of her spouse and friends.  JM was “hopeful” that hypnosis/hypnotherapeutic interventions would help her gain some relief over her migraine attacks.

Description of Treatment

First Session

After filling out the H&P as well as other usual intake forms, JM and I discussed hypnotism, what are its uses in medicine and psychology, along with a discussion on commonly held misconceptions regarding hypnosis. All misconceptions regarding the use of a hypnotic intervention for JM were debunked.  JM was hypnotized using Chiasson’s technique and then deepened using a Fractionation technique.  Chiasson’s technique involves instructing the patient to place his or her hand in front of his face with his palm facing away and the fingers held together about one foot away from the face.  This position places a natural strain on the fingers to begin to spread, and when accompanied by suggestion, it can be enticing to the patient to “let go and enter the hypnotic state.”  Fractionation is a deepening technique utilizing arousal and reinduction of trance with each subsequent reinduction helping the patient to go deeper or further into hypnotic trance.  JM was given suggestions to draw her attention to the “hypnosis chair” she was reclining in and to “feel the comfort and safety of the hypnosis chair supporting her.”  JM was then given suggestions that if at any time during hypnosis she felt uncomfortable or unsafe, then she could immediately return to her safe place in the hypnosis chair.  Ideomotor finger signals for yes-and-no responses were established using her right index finger for “yes” and her right thumb for a “no” response, as well as an “I don’t know” response indicated by her right little finger, as recommended Brown, Scheflin, and Hammond (1998).  These finger signals were tested using quick response question and answers about time, place, and person.  Ideodynamic or ideomotor signaling methods date back to antiquity; it was utilized frequently by Milton Erickson during his early career in hypnotism (Mackey 2010).  Finger signaling (ideomotor movement) was described and streamlined by David Cheek and Leslie LeCron (Cheek & LeCron, 1968), and more recently by others (Ewin & Eimer, 2006).  A post-hypnotic suggestion (PHS) was given to JM to “allow her to rapidly go into hypnotic trance and go much deeper than before whenever I lifted her right hand and dropped it on the armrest of the hypnosis chair.”  JM was asked if this would be alright with her and she responded by raising her right index finger in a tremulous fashion.  JM was asked whether it would it be all right for her to have fewer migraine headaches and perhaps let go of all migraine headaches in the future.  Her right index finger rose, indicating a yes response.

Self-hypnotic technique was taught to JM and then rehearsed in hypnotic trance.  This technique included suggestion to raise her right index finger and hold it in place as she began slowly counting backwards from the number ten.  Suggestions were given that as each number is mentally recited, she could feel her finger getting heavier and moving downward, and that by the count of one her finger would have moved all the way down, and she would be in the familiar relaxing place she knows as trance.  Following self-hypnotic instruction, JM was given direct suggestion hypnosis (DSH) suggestions “that whenever you feel that familiar feeling you have prior to the onset of your migraine headache you will immediately begin to relax and warm the fingers of both your hands.”  Imagery of “turning on the faucet in your arms will allow more blood to flow into your hands and fingers allowing them to become very warm” thus “decreasing the discomfort in your head.”  JM was also given indirect suggestion hypnosis (ISH) via metaphor to increase her sense of comfort and relaxation throughout the day.  During post-hypnotic interview, JM reported that she definitely felt she was hypnotized and felt very relaxed during the trance.  She stated, ”I remember pretty much everything you told me.”

Second Session

A review of the prior week’s activities and self hypnosis practice was conducted prior to the formal hypnosis session.  JM reported that she had several migraines during the week but that they were not the usual duration and none lasted longer than 36 hours (an improvement per JM). She reported that she was using her self-hypnotic techniques on a daily basis to place herself in trance several times per day.  JM was asked if there were any other changes to her normal diet or medication protocol, to which she said no.

JM was directed to sit in the hypnosis chair, and when she was asked if she was ready to do some more hypnosis, she readily agreed with a handshake.  At that time, I dropped her arm on the armrest of the hypnosis chair, and JM went into trance (utilizing the post-hypnotic suggestion given to her at the previous session).  JM was deepened using an eyes-open, eyes-closed fractionation technique.  DSH was given to JM regarding using her hand and finger warming techniques anytime the “familiar sensations” began heralding the onset of a migraine.  ISH using analogies of “not knowing when you were hurt until sometime after the initial injury,” like “when you may have had a paper cut and did not realize it until much later” were given to JM along with suggestions that the same mechanism of “not feeling discomfort” were anchored to  specific words, “relax, relax, relax.”  JM was given a PHS to “not feel discomfort” by immediately using her self-hypnotic technique to enter trance and imagine herself on vacation. Direct suggestion was given “to see yourself as you desire to be… free from migraine headache… comfortable… at ease… in control… safe and secure.”  She emerged from trance, and during post-hypnotic interview mentioned that she did not recall as much about the session as she had the previous week.

Third Session

            JM reported she had used self-hypnosis to “see” herself on the beach when she had the familiar aura prior to getting a migraine.  She stated that “I did not have any migraine headache after using this technique but did have two migraines lasting 24 hours when I was unable to use the technique at work.”  JM reported that she was pleased that she had some control back in her life, and that she felt the hypnotic interventions were definitely working.  JM was directed to sit in the hypnosis recliner and an arm drop induction was utilized along with fractionation to deepen trance.  JM was taught glove anesthesia using imagery of an “ice bucket filled with ice cold water as cold as cardioplegia solution used in open heart surgery” alongside the recliner. This suggestion of “carioplegia solution” is a familiar term to JM, an Operating Room nurse with experience in Open Heart Surgery where cardiolplegia (an ice bath of various chemicals) is utilized to cool the heart muscle quickly and still the heart from beating.  JM was taught to imagine placing her hand into the solution and “feeling the numbness” begin and grow in her hand as it became colder and more numb.  She was then tested for anesthesia with application of hard pinch to the posterior surface of her hand.  JM was instructed to open her eyes and remain deep in trance.  She opened her eyes and the same hard pinch was administered to the posterior surface of her hand.  Her face remained expressionless as her hand was pinched.  JM was given DSH that she could give herself Glove Anesthesia during self hypnosis and then place her anesthetized hand to her head anytime she felt the migraine pain.  She was asked if this would be alright with her, and her right index finger rose slowly and in a tremulous fashion.  Hartland’s ego-strengthening suggestions were given along with a suggestion that when she is doing self-hypnosis and in trance, her right hand will slowly rise and then fall, deepening her trance.  She then emerged.  During post-hypnotic interview she stated, “I did not even feel you touching my hand,” when asked about any sensations felt during the trance session.

Fourth Session

Review of the previous week showed JM not having any migraine attacks.  “This is the first week in years that I have not had a migraine or headache of any kind” and “I am thrilled and pleased beyond imagination.”  JM was asked to have a seat in the hypnosis chair and place herself into a self-hypnotic trance.  After watching her right index finger rise and fall, therapeutic metaphor was used to suggest changing unpleasant circumstances and feelings into more pleasurable experiences.  Ego-strengthening suggestions were given and DSH was used to reinforce previous suggestions of glove anesthesia and also “…all these suggestions we have given you will remain with you and become stronger for as long as you desire them working in your life…” JM was emerged and during post-hypnotic interview, she recalled no specifics about the session.

Session Five to Seven

Sessions five through seven used DSH for reinforcement of previous sessions along with Hartland’s ego-strengthening suggestions.  JM was taught to anchor self-hypnotic trance with a personal three-word mantra (“relax, relax, relax”) that allowed rapid self-hypnosis and deepening with finger lift and lowering.  JM reported that she was having hand surgery for carpal tunnel and wanted to know if she could utilize her Glove Anesthesia technique for pre and post-operative pain relief.  JM had had several previous surgeries on this particular hand and was concerned with discomfort.  I assured her that the Glove Anesthesia would be perfect for her to use with the caveat that she let her surgeon know of her use of this hypnotic technique for both the pre and post-operative discomfort.  If there was no contraindication voiced by the surgeon, all would be well.

Session Eight

JM reported that the hand surgery went well, she did not have any migraine headaches, and that the Glove Anesthesia worked well for post-operative pain control.  She reported that her surgeon had no reservations for her utilizing the glove anesthesia technique the she had learned. She reported that she and the surgeon had known each other professionally for some time, and that he respected her knowledge of pain control methods.  I encouraged JM to continue her self-hypnosis each and every day to the point where it is as “easy to enter trance as it is to take a deep breath.”  JM entered trance utilizing the arm drop PHS.  We deepened her trance level with the usual fractionation technique and then proceeded to utilize ideomotor finger signaling to identify any unresolved issues pertaining to her migraine headaches.  JM was asked, “is there any reason you cannot be free of migraine headache?”  JM’s “no” finger responded slowly.  DSH was given to continue daily self-trance, relaxation, and to utilize her techniques as needed.

Results and Followup

            JM continues to utilize self hypnosis on a daily schedule.  She is quite pleased with the outcome of the hypnotic sessions and with her use of self-suggestion.  Prior to treatment with clinical hypnosis interventions, JM had multiple severe and incapacitating migraines that were impacting her usual ADL as well as her work schedule.  This continued for a number of years (>15 yrs.) with little or no relief provided using conventional therapy or medication.  After eight weeks of clinical hypnotic interventions (in 2008), JM denied having any headaches and had already begun talking with her physician about decreasing and perhaps eliminating some of the daily medications.  JM reported being extremely pleased with her results and pleased with the use of self-hypnotic techniques in her life.  She remains migraine-free ten months after her last office visit.  As I am writing these revisions for publication (April 2010), JM reports that since our last visit (December 2008), she has had only one migraine, lasting 4-6 hours.  She reports that currently she only takes a daily multivitamin and Alleve for joint pain.

Discussion

            Migraine headaches are debilitating (Hammond 2007; Turk & Gatchel 2002).  According to Hammond (2007), hypnosis has an impressive track record in pain treatment.  A meta-analytic review (Montgomery, DuHamel, & Redd, 2000) indicated that hypnosis was an efficacious and specific treatment for pain that is superior to pill and psychological placebo.  Hypnosis has been shown in recent studies to decrease intraoperative anesthetic requirements as well as decreasing post-operative narcotic pain relief (Mackey 2010).  JM spent many years enduring the incapacitating symptoms associated with her migraine attacks.  She had endured multiple treatment regimens aimed at symptom relief and had become disillusioned with the current state of medical treatment for individuals with her condition.

It is important to mention that secondary gain issues prevent permanent change from occurring.  Likewise, sometimes secondary gains (as in holding on to symptoms) diminish and symptoms will disappear as there is no longer any need by the patient to hold onto the symptoms.  It is important for a practitioner to identify, early in the therapeutic process, the possibility that a patient has secondary gain issues.  This can be done conveniently by utilizing ideomotor movements (finger signals).  Asking yes-or-no questions concerning needs and desires while the patient is in trance is an efficacious method to uncover any resistance to suggestion (Cheek and LeCron, 1968: Ewin & Eimer, 2006; Mackey 2009).  Finger signaling was utilized early in the therapeutic interactions with JM to identify any possible resistance to hypnotic intervention. Ideomotor finger signaling has been described earlier in this work; however, it is important for those unfamiliar with this type of subconscious review to identify what these movements look like.  It is most important to identify and distinguish between conscious and subconscious ideomotor signals.  Subconscious signaling does not happen immediately after a question.  There is a delay that may be as long as 45-60 seconds before the finger begins to twitch slowly and move up and down.  Sometimes the delay in movement may be as short as 10 seconds, but in any case, there is never an immediate and deliberate movement of the finger.  A finger that is moving smoothly and deliberately is simply the conscious mind answering yes or no (Ewin & Eimer, 2006).

Hypnotic intervention worked well with JM, perhaps in part due to her desire and motivation to rid herself of migraine symptoms.  Because of this, the patient was self-motivated to follow suggestion and persevere with frequent self-hypnotic sessions in addition to the regularly scheduled office visits.  Obviously a single case report is not generalizable to the larger population with migraine symptoms, yet it does imply that perhaps hypnosis and suggestion can play a definite therapeutic role in the complementary treatment of migraine symptoms.  This case study, however, does represent one methodology to assist in the reduction of pain and discomfort for those who suffer from migraine headaches.  It would perhaps be beneficial to follow up reports such as this with a randomized and controlled research design to further investigate the significance of this type of intervention.


References

Abrams, A. (2006). Clinical drug therapy: Rationales for nursing practice. (8th ed.)  Philadelphis: Lippincott.

Andreychuk, T. & Skriver, C. (1975). Hypnosis and biofeedback in the treatment of migraine headache. The International Journal of Clinical and Experimental Hypnosis. 23: 172.

Bassman, S., W. & Wester, W., C. (1997). Hypnosis, headache and pain control: An integrative approach. American Society of Clinical Hypnosis Press

Barabasz, A.(1977). New techniques in behavior therapy and hypnosis. South Orange, New Jersey: Power Publishers.

Barabasz, A., & McGeorge, C. (1978). Biofeedback, mediated biofeedback and hypnosis in peripheral vasodilation training. American Journal of Clinical Hypnosis, 23, 23-37.

Blumenthal, L. (1963). Hypnotherapy of headache. Headache. 2:197.

Brown, D., Scheflin, A. W., & Hammond, D.C. (1998). Memory, trauma, treatment and the law: An essential reference on memory for clinicians, researchers, attorneys, and judges. New York: W.W. Norton & Company.

Cheek, D.B., LeCron, L. M. (1968). Clinical hypnotherapy. New York: Grune & Stratton.

Ewin, D. M., Eimer, B. N. (2006). Ideomotor signals for rapid hypnoanalysis. Springfield Illinois: Charles C. Thomas Publisher.

Graham, G.(1975). Hypnotic treatment for migraine headache. The International Journal of Clinical and Experimental Hypnosis. 23:165.

Hammond, D. C. (2007). Review of the efficacy of clinical hypnosis withheadaches and migraines. The international Journal of Clinical and Experimental hypnosis, 55(2): 207-219.

Mackey, E. F. (2010). Effects of hypnosis as an adjunct to intravenous sedation for third molar extraction: A randomized, blind, controlled study. The Interantional Journal of Clinical and Experimental Hypnosis 58(1): 21-38.

Mackey, E. F. (2009). Age regression: A case study. Annals of the American Psychotherapy Association 12(4) 46-49.

Montgomery, G. H., DuHamel, K. N., & Redd, W. H. (2000). A meta-analysis of hypnotically induced analgesia: How effective is hypnosis? The International Journal of Clinical and Experimental Hypnosis, 48, 138-153.

Olness, K. & Kohen, D.P. (1996). Hypnosis and hypnotherapy with children 3rd ed. New York: The Guilford Press.

Olness, K., MacDonald, J. & Uden, D. (1987). Comparison of self hypnosis and propranolol in the treatment of juvenile classic migraine. Pediatrics. 79, 593-597.

Turk, D., C. & Gatchel, R., J.(2005). Psychological approaches to pain management: A practitioner’s handbook 2cnd ed. New York: The Guilford Press.

 


About the Author 

Mackey_EdwardDr. Ed Mackey received his diploma in Nursing from the Lankenau Hospital School of Nursing in 1983 and his BSN from Eastern University in 1986. He graduated from the Lankenau Hospital School of Nurse Anesthesia in 1988 and has been a practicing CRNA since that time. Dr. Mackey received an M.S. in Nurse Anesthesiology from St. Joseph’s University in Philadelphia Pennsylvania. He received an MSN in Community /Public Health Nursing from West Chester University and received a Ph.D. in Psychology from Northcentral University.

Dr. Mackey is an Approved Consultant in Clinical Hypnosis for the American Society of Clinical Hypnosis (ASCH), is a Diplomate in the American Psychotherapy Association (DAPA), and maintains a long standing private practice in hypnosis/hypnotherapy/psychotherapy in Kennett Square, Pennsylvania. Dr. Mackey is an Assistant Professor in the Department of Nursing at West Chester University of Pennsylvania. He is adjunct faculty at Villanova University’s graduate program in Nurse Anesthesiology and maintains a part time private practice in the administration of office anesthesia.

Dr. Mackey is a member of the American Psychotherapy Association (APA), The Association of Applied Psychophysiology and Biofeedback (AAPB), The American Association of Nurse Anesthetists (AANA), The American Society of Clinical Hypnosis (ASCH) and The Greater Philadelphia Society of Clinical Hypnosis (GPSCH).


The Integration of Classical Music Composition Theory in the Facilitation of Expanded Trust, Appreciation, and Utilization of opposites in Treatment

The Integration of Classical Music Composition Theory in the Facilitation of Expanded Trust, Appreciation, and Utilization of opposites in Treatment

By Bruce Gregory, PhD

Jung’s identification and appreciation of the transcendent function in the integration of the conscious and unconscious minds set the stage for almost a century of exploration and use of unconscious healing resources in a variety of treatment situations, which ultimately incorporated trust and appreciation of the use of opposites.  The integration of principles of classical music composition theory with Mind-Body Hypnotherapy supports the need to use opposites in treatment, and shows new pathways for the application of the implied directive, the equivalence principle set forth by Einstein, and the principle of correspondence used in the set theory of Cantor.  Classical music composition theory is applied primarily through the creative use of principles and processes involving tension and release, as well as the principles and processes of counterpoint.  The application of Mind-Body Hypnotherapy in the treatment of opposites is compared to other therapeutic modalities, principles of duality from oriental philosophy and martial arts.


Build Muscle

by Tammera J. Karr, PhD

One of the most feared events for the elderly is falling and breaking a hip, which leads to a lengthy and, sometimes, fatal stay in a hospital. When I say fatal, I don’t mean because the hospital did something wrong, however, complications outside of their control can occur. Many elderly individuals upon reaching the hospital are deficient in key nutrients such as vitamin D and B12, the lack of which contribute to impaired balance and osteoporosis. Combine those deficiencies with a lack of macronutrients, like protein, and recovery can be problematic.

“You are what you eat.” That is especially true when it comes to how your body manufactures protein for use in muscle health. Research supports the notion that elderly people are often times not consuming adequate protein. According to Nutrition Review, “It is well known that consuming protein stimulates the body’s cells to build muscle that includes our internal organs. Getting older combined with eating less protein rich foods can lead to a decline in the body’s muscle-building efficiency. Maintaining and building muscle is especially important for older individuals. Increased muscle mass can contribute to a healthier weight, better fitness and an improved quality of life. New research in the American Journal of Physiology — Endocrinology and Metabolism explore whether the amount and timing of protein consumption make a difference in the body’s net protein gains.”

(http://nutritionreview.org/2015/02/older-adults-need-to-double-protein-intake-to-prevent-muscle-loss/)

“Current US recommendations for daily dietary protein intake are 0.8 grams/kilogram of body weight (roughly 62 g of protein per day for a 170-pound person). Previous research has shown older adults need a protein intake of at least 0.40 g/kg of body weight at each meal.” (www.medhelp.org/user_journals/show/1412586/-current-dietary-guidelines-on-protein-intake_br)

The research team found, while the distribution of protein across meals did not make a significant impact, the total amount of protein consumed did. The authors wrote, “Whole body net protein balance was greater with protein intake above recommended dietary allowance.”

As is so often the case the RDA is horribly lacking, and insufficient in its recommendations.

 

To Your Good Health and Information.

 First published April 7th, 2015 in BlogEat for Health

(more…)


To Heirloom or Modern, That is the Question

By Tammera J. Karr

For those brave enough to try something new or different, you might find those heirloom purple potatoes are richer tasting; others might enjoy the spicier or bitter taste of greens like nasturtium, radicchio, or arugula. We encounter not only a cornucopia of foods and colors, but the names transport us to exotic lands or into whimsical fancy. We see names like: blackjack, Oak leaf, Batavian, and Fire Mountain. In salad greens there are, honey crisp, Melrose, Queen Victoria and Ozark apples. Some of my favorites are the berries: Cape fear, Brunswick, Wild Treasure, Summit and Jewel.

 

Nutrition Tips, May 2015: To Heirloom or Modern That is the Question…


Bereavement: Focus on Amish Rituals

By:Charlotte H. Mackey MSN, EdD

Edward F. Mackey CRNA, MSN, PhD

Grieving and bereavement are part of living.  How grieving is displayed is influenced by customs unique to each culture.  Different cultures have their own views on the meaning of death, as well.  Grief is a total response to the emotional experience of loss.  It produces behaviors associated with overwhelming sorrow or distress (Kozier, et al., 2004).  Some cultures, such as the Anabaptist societies, enjoy strong familial ties. The Anabaptist societies are composed of the Amish, Mennonites, Bretheren, and Hutterites.  These groups provide physical and emotional support to those suffering loss and grieving, through their close-knit communal ties.  Death is a part of life that all Amish know from early childhood, and Amish culture dictates that all members of the community assist family members in grieving and bereavement. 

Bereavement: Focus on Amish Rituals


Nutrition Tips April 2015: The Amazing Cranberry – an all American Food

Nutrition Tips April 2015: The Amazing Cranberry – an all American Food

By Tammera J. Karr, PhD

The cranberry, along with the blueberry and Concord grape, is one of North America’s three native fruits that are commercially grown. Cranberries were first used by Native Americans. Today, cranberries are commercially grown throughout the northern part of the United States and are available in both fresh and processed forms.


An Integrated Evaluation and Treatment Approach With Traumatized Clients

An Integrated Evaluation and Treatment Approach With Traumatized Clients

By  Dr. Donald Hutcheon, C.Psychol.(UK)., R.Psych. #1421

The article focuses on three identifying areas of interest: (a) a discussion of how different sample sub-types have reacted to stressful events which have caused trauma; (b) a range of evaluation using an assortment of psychometric tests to gain data about respondents’ reactions to traumas experienced; (c) a description of a treatment approach used with traumatized clients. Specifically, the article provides a descriptive analysis of the data from a small, mixed sample (N=12), and the relevance of using an integrated treatment format with individuals identified with trauma.