Belleruth Naparstek

Hello again.

I’ve been looking at the research and pondering how far we’ve come from those early days when we were first learning about guided imagery as a possible, bona fide addition to the cancer treatment toolkit.  

Back in the 80’s when guided imagery was first getting promoted by Bernie Siegel, Stephanie & Carl Simonton, Jeanne Achterberg and Frank Lawlis, there was a lot of excitement about its potential.  Early pilot studies showed a lot of promise (early studies often do – perhaps because of the excitement the investigators feel about their intervention), and there was a lot of talk about how ‘visualization’ could wipe out cancer cells.  People were encouraged to imagine Pac-Men, a popular video game at the time, eating up cancer cells, before, during and after chemotherapy.

In those days, the imagery was strictly visual – the other senses were not called into play – and that made it hard for the half of the population that’s not especially well wired for visual memory or fantasy.  We’ve since learned that all the senses need to be brought to bear, and that perhaps the most potent and impactful sense is the kinesthetic one – imagining the feel of things inside the body. We also figured out that for most people, when the imagery has a strong emotional flavor to it, it gets potentiated to a greater extent and has more impact. 

The research at that time showed that the proponents of visualization were over-promising.  These early visualizations helped cancer patients with motivation, coping, anxiety and the side effects of chemotherapy and other medical procedures  but didn’t make a dent on the progress of the cancer itself.  Investigators reluctantly backed off from their ambitious early claims and stuck with side-effects and coping benefits.

But fast forward to just a few years ago and you’ll find more sophisticated, powerful imagery and randomized, controlled clinical trials that are a lot more nuanced and scientific.  Blood assays have in fact been revealing the immuno-modulatory effects of relaxation training and guided imagery. In 2009, Eremin, Walker et al, demonstrated significant differences for breast cancer patients in the number of CD25+ (activated T cells), CD56+ (LAK cells) and the number of CD3+ (mature) T cells.

Additionally, those who rated their imagery highly had significantly altered their   NK, LAK cell activity and IL1beta levels. Also, their relaxation scores correlated with their number of CD4+ (T helper) cells, the CD4+:8+ (helper:cytotoxic) ratio, and IL1beta levels. Bottom line: their bodies’ cellular defenses responded significantly during and after treatment for cancer, making guided imagery a valuable adjuvant therapy.

Similar findings were reported in 2008 by Lengacher, Bennett et al and in meta-analyses and reviews by Trakhtenberg and by Gruzelier.

In other words, we’ve come full circle.  Those early claims are starting to look a lot more justified, although more work needs to be done to consistently establish this, and then to break down what it is about the imagery that potentiates these effects – were they there all along, and we just weren’t doing fancy enough blood tests to show it?  Or has the imagery itself gotten better, and if so, in what ways? 

So stay tuned.  We’re on the cusp of finding out a lot of useful things in this here decade.

Take care and be well,

Belleruth

———–To see the links to reference in this article click here.

Dr. Jeanne Achterberg, a leader in imagery exploration and application, refers to imagery as “the thought process that invokes and uses the senses: vision, audition, smell, taste, the senses of movement, position and touch. It is the communication between perception, emotion, and bodily change.” Guided Imagery can evoke change through the senses both physical and imagined by skillful guidance.

Guided Imagery Experienced

A definition does not capture the experience of working with a trained Guided Imagery practitioner.  And most people who have not had experience with this approach want to know about research on efficacy of Guided Imagery for changing symptoms, behavior before deciding to try it out.  Imagery International’s professionals have written about their work over the years and through articles in Imagery International’s newsletter – ImagiNews -  discuss how they have incorporated their Guided Imagery training into their practices.

Our membership is comprised of diverse licensed and certified professionals who show how this work is useful to virtually all types of work.

To see these articles that range from relevant research citations to treatment of symptoms and behavioral problems visit our About Guided Imagery page.

All types of professionals are not represented here.  We will be adding information as articles are submitted.

Martin Rossman, MD

I have been thinking a lot about Integrative Medicine lately. I want to share my thoughts about some of the principles and practices that have caused me to dedicate my life to practicing this way and the important contributions that Integrative medicine has to offer patients, physicians, and society alike. As always, I welcome your feedback, questions, and thoughts.

The First Principle: Do No Harm

“Primum Non Nocere” is a cherished medical principle dating back to the time of Hippocrates. It cautions us not to make anyone worse through treatment than they were already. It is a precaution that is violated every day in the practice of modern conventional medicine, especially in treating people with chronic medical conditions, and the harm done can be serious, even fatal.

Regrettably, modern medicine has become the 3rd or 4th leading cause of death in America. In 1998 the Journal of the American Medical Association published an article ascribing 106,000 deaths a year to adverse reactions to prescription medication in hospitals. For perspective, compare that to 40,000 deaths a year from breast cancer. Remarkably, and discouragingly, this number is for reactions to “properly prescribed” medications, not medical errors, which in themselves knock off another several hundred thousand Americans. While there is a very active movement in medicine to reduce the number of errors through better oversight and electronic medical records, there is little to no movement seriously looking at whether or not we really need to be on an average of 5 prescription medications at age 65, or whether there are real alternatives to “better living through chemistry.”

As a former Emergency Room physician, I can affirm that desperate times can call for desperate measures. When you are faced with treating acute heart attacks, multiple gunshot wounds, or injuries from a 54 car pileup on Hwy 5, it isn’t the time for lifestyle counseling, or dietary change. In these situations, as with acute infections, flares of serious illnesses, heart attacks, strokes, or out of control infections, proper use of medications may save lives and reduce future illness or disability. My hat is off to the many talented and dedicated surgeons, emergency room doctors, and specialists who treat patients with critical illness. With these conditions, the risk of heroic medical interventions is usually less than the risk of NOT using them.

But with the 90% or more of patients who have chronic conditions, stress related illnesses, chronic pain, inflammation, or evolving risk factors for illness, the situation is different. There is no need for 20,000 people a year to die from Advil, Alleve, and similar drugs when natural anti-inflammatory substances like turmeric, ginger, boswellia, and fish oils, taken at proper doses equal the effects of these medications after three weeks of regular use. There are no known side effects and NO DEATHS from any of these natural substances. A significant advantage, I think.

It is pretty safe to take the anti-inflammatory medications short term. They are hundreds of times more powerful than the nutrients, and they can give you quick temporary relief. But the longer you take the medications the more likely and severe the adverse effects because, like almost all pharmaceuticals, they work by interfering with normal cell functions. Over time, this can lead to stomach ulcers, bleeding, hypertension, liver and kidney damage.

The best way to integrate the advantages of both the medications and nutrients is to keep the inflammation down with an anti-inflammatory (basically Mediterranean) diet, supplements, and acupuncture, and use medications intermittently and sparingly for flare-ups. This maximizes benefits and minimizes risk.

Next time I will share with you a way I have found useful to assess the risks and benefits of almost any medical treatment, whether conventional, complementary, or alternative. Till then, I wish you the best of health and life.

Dr. Rossman

P.S. I will be talking with Thuy Vu about The Worry Solution on KPIX TV Channel 5 Friday Feb 25th at 7:30 PM [San Francisco, California]. I‚m also scheduled on KRON TV (Channel 4) this Sunday the 27th at 8:15 AM, with Henry Tenenbaum.

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The Worry Solution
415-925-8600

http://www.worrysolution.com

1341 South Eliseo Drive
Greenbrae, CA 94904
USA

PS Dr. Rossman’s private practice website is http://www.drrossman.info/

[If you are interested in following up on the organizations mentioned in Naparstek's article, you will find links in the original article here. We made those links bold and have not linked them in this excerpt.]

Belleruth Naparstek

Hello, everyone.

Well, I’m just back from the Military Health System Conference held at National Harbor, MD, and there seems to be plenty of reason to be encouraged about guided imagery and other mind-body therapies gaining respect, visibility and usage within our Armed Services.

For one thing, holistic health and mind-body therapies are a key element in the new, Patient-Centered Medical Home model which is being implemented in Army clinics nationwide. This model is a gigundo improvement over existing health and mental health services, and, as far as I’m concerned, they can’t implement these enlightened, holistic, one-stop medical care changes fast enough.  And let’s hope the rest of the world follows suit.

Cindy and Jerry had a Health Journeys booth there, and the Playaway people were a presence there as well.  They happily reported they had multiple visits from various TriCare folks, along with a lot of serious interest from health providers in all branches of the service.  Now, if TriCare decides they like guided imagery (and given the cost savings to insurers and HMO’s demonstrated by the Schwab et al Blue Shield of California Study, it’s surely in their enlightened self-interest to do so), a lot of troops, vets and families will be getting guided imagery.

There’s also great interest in mind-body methods for treating PTS (posttraumatic stress) and TBI (traumatic brain injury) over at DCoE, (Defense Centers of Excellence), the umbrella organization that includes both the Dept of Defense and the Veterans Administration, tasked with finding new, effective ways to deal with the multiple psychological and neuro-physiological challenges our troops face.

Just last week I learned that DICoE is about to include guided imagery as a “promising practice” in a review paper that’s ready to launch next week, titled “Promising Integrative Practices for Regulating Stress, Emotions, and Arousal”.  This document will feature a dozen integrative health practices, ranging from manipulative body-based and touch techniques, to yoga breath routines, to mindfulness and meditation based practices.  So, how do you like them apples?

For the rest of this story and links of visit Belleruth Naparstek’s website.

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Belleruth Naparstek is a sychotherapist, author and guided imagery pioneer. She is the creator of the popular, 55-title, Time Warner Health Journeys guided imagery audio series. Her first book, Staying Well with Guided Imagery (Warner) is a widely used primer on imagery and healing.

Her second book, Your Sixth Sense (Harper Collins) has been translated into 9 languages, with a new 2009 edition just released. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award and was released in paperback January of 2006. Highlighted in their 20th anniversary edition of their seminal book, Courage to Heal, Ellen Bass and Laura Davis call Invisible Heroes “the most useful book for trauma survivors to be published in the last decade”.

As Prevention Magazine recently noted, Belleruth has been quietly creating an underground revolution among mainstream health and mental health bureaucracies, by persuading major institutions such as the U.S. Veteran’s Administration, the U.S. Dept of Defense, The American Red Cross, Aetna U.S. Healthcare, Kaiser Permanente, Blue Shield of California, United Health Care, Oxford Health Plan, GlaxoSmithKline, Ortho Biotech, Roche, Abbott, Amgen, and nearly 2000 hospitals, mental health centers, recovery clinics and vet centers to distribute her guided imagery recordings, in most instances free of charge to recipients.

In addition, her audio programs have been involved in over two dozen clinical trials, with nearly a dozen studies completed to date. Efficacy has been established for several psychological and medical challenges, most recently for PTSD at Duke University Medical Center/Durham Veterans Administration Hospital.

Her audio programs, books and huge resource library is located at Health Journeys online site.

The three points Dr. Morris focuses on are:

1. Admit government cannot do it all.
2. Confront our unholy love affair with technology.
3. Stop skittering around end-of-life issues.

I’ve been studying alternative approaches to health and wellness for the last 30 years. My working hypothesis is that unrecognized trauma (trauma includes experiences that do not fit with the definition of PTSD) can generate symptoms that are misdiagnosed and mistreated as disease.  Medicine/medical doctors do not recognize the difference between trauma based symptoms and organic symptoms in diagnosis and treatment.  If treated as a disease, trauma symptoms do not respond as expected. People who are not cured will have a chronic problem that often requires maintenance with drugs.

An alternative response to failure of medications to work is ‘we need more tests’ or lets try another drug.  Where there is good research showing alternative approaches achieve excellent results, that approach is not likely referred – Irritable bowel is an example.

Dr. Morris discusses his hard hitting observations about fear of death and the focus on death panels. He believes that patients are kept alive at great expense because of fear of death and not for love or care.

I believe the even greater over-arching unconscious motivation is fear of loss.

Medical practice called defensive medicine is done out of fear of malpractice suits from a patient or family member’s loss.   The legal system will make the problem worse as lawyers have carte blanche to assault and make innocent medical professionals and traumatized patients appear guilty in their quest for justice.

Heart disease is major health concern in the US that needs to be part of the national dialogue.  It is no small thing that the heart can grow capillaries to repair itself.  Dean Ornishe showed with graphic pictures that heart disease can be reversed without drugs in his book Reversing Heart Disease. We are led to believe that doctors respond appropriately to what good scientific finds. Yet cardiac specialists typically do not include the information about Ornishe’s work in consultation with patients.

I learned from one doctor in a public forum about heart disease that he does not offer any information on this approach as the capillaries are small and can be easily undone in a short period of time. This doctor prefers to do bypass surgery which is good for about 10 years.  (Smokers are denied the surgery.)  The cardiologists are focused on diet and exercise and leave out the really critical piece.  Dialoging with the heart – a Guided Imagery approach was used in Ornishe’s program. Asked to  Imagine what an ailing heart looks like, the patient begins a very personal linking of the mind with a vital body part that is in pain and dysregulation. This kind of work is not the same as making a person responsible for his or her illness. It is making them aware on a deeper level about what is missing or needed for better health and wellness.

If you read the articles on our website about how Guided Imagery is used in working with chronic illness, death and dying, and a host of medically diagnosed conditions you will find that Guided Imagery works with symptoms resistant to medical treatment.

The government’s plan to make everybody pay for insurance will not fix the broken health-care system.

Money and insurance are not going to fix what is wrong with the “healthcare” system.  Thank you Dr. Morris for offering a sensible discussion on what to address in the broken health-care system.

Sandra Warnken, CCHT, SEP

Dr. Morris writes
Who takes care of people with no health insurance? For more than two years, the debate has been front and central. A new Congress now faces public hostility mixed with public expectations for action on this question. Whether the health-reform legislation passed last year stands up under the scrutiny ahead, too much of the discussion about health-care reform misses the mark.

Addressing the fractured economics of the health industry does not automatically make people healthier. I hope that, as a nation, we can move the discussion to three focused priorities that address true health.

* Admit government cannot do it all.

Washington needs to admit it does not have the ability to improve the health outcomes we need in America. Money alone will not make anyone healthier. And whether people agree with health-care reform or not, too many perceive that, because the government is involved, local clinics no longer need private support. Nothing could be further from the truth. Even when the health-reform legislation is fully implemented in 2019, at least 23 million people will remain uninsured — and probably many more.

Twenty-four years ago, I opened the Church Health Clinic in Memphis, Tenn., to care for the working uninsured. We’re hard at work every day answering the question, “Who takes care of people with no insurance?” by saying “We do!” We are not federally funded, yet we care for 55,000 people in our city. More than 600 physicians volunteer their services, and
every hospital in the city supports our work. The Church Health Center provides the same quality of care you would insist on for your mother. Hundreds of charitable clinics around the country make a difference in hundreds of thousands of lives without depending on government funds.

We’ve seen a growing number of patients whose working hours have been cut to below 30 hours a week, which means they lose their insurance. Others who made $100,000 in 2008 now work in small stores earning $19,000 with no benefits. More and more middle-aged people who worked in one trade for 30 years now try to live on $104 a week in unemployment benefits. We see these people every day. We know their names and faces and stories. The best improvements in health for individuals will come at the local level, including clinics that do not depend on government funds. Click here to read the rest of the article.

He concludes “Let’s not waste any more energy or money arguing about how to pay for legislation that skirts the real issues that would make Americans healthier.”
The author is founder of the Church Health Center, Memphis, Tenn., and wrote the newly published book “Health Care You Can Live With,” (Barbour, 2011). Visit his website http://www.healthcareyoucanlivewith.com

2011: A Year of Transformation & Renewal

(Co-Sponsored by Beyond Ordinary Nursing and the Healing Touch Program)

Our 1st American Holistic Nursing Association Regional Meeting of the Year

Lunch and 4 contact hours provided for $40. Space is limited.
Presentations will be experiential and applicable to practice.

Click here to download the flyer.

Leslie Davenport, MFT

Healthcare is in need of healing — as is the environment, food production, finances, and education.  We human beings, with our evolving minds and emotions, have such a marvelous capacity for inventiveness. Yet it is tragically easy to recognize that most of our systems are radically out of balance.

Part of the reason we careen down these dangerous paths is that most of us are not using our whole brains as we navigate decisions. As guided imagery enthusiasts and advocates, you are well aware that the area of human perception where images arise is underutilized and undervalued in our culture. Many of the subtle, intuitive, and soulful aspects of life which would provide life-affirming balance within our institutions are blind to the analytical lens we see through so much of the time.

The benefits of guided imagery in a hospital setting are multilayered, because imagery is not only powerful in helping people heal, but also in transforming healthcare.  Patients who are introduced to imagery experiences in the hospital are awakened to their natural but dormant imaginative domains. Becoming empowered through imagery goes home with them, and some people are intrigued enough to continue developing imagery skills for a range of life experiences beyond their medical concerns. In this way, imagery grows organically into their lives, and the excitement of this valuable discovery often spills over to their work, and circle of family and friends. Physicians and other hospitals staff also become educated to the power of imagery as patients spontaneously report the benefits of their sessions, such as reduced side effects, deceased anxiety and overcoming insomnia.

We are fortunate that the guided imagery services, which are part of the Institute for Health and Healing, are well integrated into all medical units at California Pacific Medical Center in San Francisco. A team of twenty-four imagery practitioners provide imagery sessions in maternity, pediatrics, oncology, cardiology, transplant, surgery, palliative care and hospice. The imagery practitioners also participate in medical rounds, provide staff in-services, and facilitate imagery-based community support groups.

I began offering guided imagery in a hospital in 1989, and have since launched imagery programs at five hospitals. I would love to see more of these kinds of programs take root, and am excited to share what I have learned over the last twenty years.

You can visit the Institute for Health and Healing website to learn more about the Guided Imagery/Expressive Arts certification program. A student in the program has written about her experience here.

Imagery International hosts the Second Annual Conference:

Imagery for the Future: Illuminating Lives

Co-Sponsored by Beyond Ordinary Nursing

Integrative Oncology – How Medicine and Healing Can Work Together for YOU

with Martin Rossman, MD

Martin Rossman, MD is the author of “Fighting Cancer From Within”, and has produced a whole series of CD’s for those who are going through treatment for Cancer.  He’ll be speaking on how medicine and the Integrative Healing modalities can work together for you.  He will address how evidence of effectiveness and safety is evaluated, how you can best make decisions about what to incorporate in your personal plan, and how these modalities might fit into different stages of your journey through cancer treatment. While Imagery and Acupuncture will be stand-alone topics later in this series, he will certainly speak about them, as well as the area of Mind-Body medicine as it relates to Integrative Oncology.  Dr. Rossman has been a featured speaker all over the world, and we think you will find his talk a wonderful beginning for this exploration of Integrative Oncology.

Marin General Hospital and the Marin Cancer Institute present a New Integrative Speakers Series for the general public. Download a flyer 2010 Speaker Series Flyer.  This is the schedule for 2010:

Tuesday July 27
Martin Rossman, MD Tuesday,
“Integrative Oncology: How Medicine And Healing can Work Together for You”

Wednesday, August 25
David Gullion, MD
“Integrative Oncology: How to Talk about It with Your Oncologist”

Tuesday, September 21
Vicki Dello Joio & Denise Aubin
“Chi Gong: Cultivating Energy for Life”

Tuesday, October 19
Francine Halberg, MD & Regan Fedric
“Fitness: How It Fits Into Your Personal Plan for Survivorship”

Wednesday, November 10
Sharon Meyer, CN
“Nutrition for Survivorship”

Wednesday, December 8
Kathleen Colloton, RN, & Susan Ezra, RN
“The Magic of Imagery”

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Guided imagery is the practice of concentrating on vivid mental pictures – which may be evoked by a practitioner or by an audio recording – to promote healing. If you are considering or facing surgery, you may want to add guided imagery to your list of preparations. There is a growing body of compelling evidence for the supportive role of the mind-body connection to in facilitating healing, and guided imagery, in particular, may help augment the recovery process for surgical patients by:

1. Decreasing post surgical pain and the need for pain medication
2. Reducing the side effects and complications of surgery
3. Lessening stress and anxiety before and after procedures
4. Reducing recovery time
5. Improving sleep
6. Strengthening the immune system
7. Boosting self-confidence and self-control

If you wish to try guided imagery, consult an experienced practitioner about your challenges and goals. You may also choose to create and play personalized imagery CDs or MP3s both before and after surgery.

To see this article and Dr. Weil’s website click here.

Professionals who can help with Preparing for Surgery are available in Imagery International’s membership.