Ask an expert - neuro and psycho logical - phobias

6 questions

Over the years we have had a number of questions about phobias, and the most recent composite answer we gave about a fear of flying was:

It was always said that if you wanted to get a straight answer from a doctor, you should ask them, 'would you be happy for your wife to have this treatment?' So, I suppose if you said to us, 'would you recommend acupuncture to your family to overcome a fear of flying?', the answer would probably be 'no'. This is not to say that it might not work; over many years of practice we have heard of a number of almost incredible stories about changes which people have managed to make thanks to treatment, and quite often by the practitioner simply sticking to very basic traditional acupuncture. Extreme reactions of any kind are, from a traditional acupuncture perspective, indications that a part of the system is out of balance and generating inappropriate emotional or mental responses. It is sensible to be mildly apprehensive about flying, just as it is to be mildly scared of heights. If the faculty of sensible fear is out of balance, then extreme reactions abound.However, with a problem such as this there are other possibilities which seem to us to go to the heart of the problem much more directly. Hypnotherapy or CBT (Cognitive Behavioural Therapy) are both well tried approaches for phobias, with the added advantage in the case of hypnotherapy of being able to do trial runs under the power of suggestion. There are a great many forms of hypnotherapy, all of which have their strengths, but those based around NLP and the work of hypnotherapist Milton Erickson seem to have the most well attested handle on treating phobias.There is no doubt that you would probably derive some benefit from acupuncture treatment in terms of a reduction in anxiety, as our factsheets show, and always the possibility that a skilled practitioner might look at your overall balance and get that feeling that there is something obvious to be done which may help. It is more probable, though, that they would do as this expert would, refer you to a trusted colleague who does hypnotherapy or CBT to ensure that your needs were skillfully and professionally met.Because traditional acupuncture treats the person, not necessarily the condition they have, there is a danger that this can be re-framed as 'acupuncture can treat anything', and occasionally incautious practitioners let patients' expectations run away with them. From a Chinese medicine perspective every aspect of the human being, every inappropriate mental, physical, emotional or spiritual state, is theoretically amenable to change by treating the person as a whole. However, our clinical experience is that there are many problems, such as terminal illnesses or serious psychotic states, where expectation of recovery is virtually nil, and it is highly risky to feed the desperate need of patients with statements which might lead them to have hope where there is none. Cases like yours, although not quite as serious, nonetheless can represent entrenched patterns of thought and behaviour which require specialist skills to unravel.We think that this still represents the best advice that we can give, especially given the timescales involved. If you are London based, and your friend is also London based this is probably the best place to be in terms of finding someone who could possibly help. Your friend may even be able to get CBT sessions through the NHS if she has a sympathetic GP who understands both the urgency and importance of the situation. If not it can be a bit of a minefield finding someone who is appropriately qualified and appropriately skilled. The challenge is finding someone who does what your friend needs.If you want to see what we mean you could do worse than look at this brief video presentation by Richard Bandler, who along with John Grinder first set down the principles and practice of Neuro-Linguistic Programming (NLP). http://www.nlplifetraining.com/Spider-phobia-Overcome-yours-with-NLP-and-Richard-Bandler

There are many hundreds of practitioners in and around London, as there are throughout the UK, who use the same techniques, and we would assume may be able to offer the same effective process. Of course, as practitioners we would always be interested to see how the energy of the person had been affected for such an inappropriate response take such a strong hold, and perhaps when she returns from a successful and wonderful trip she might choose to explore this. Howe ever, first things first, and with only three weeks to spare, what we have suggested is probably the most likely way to get her to Australia.

We were once asked a question about the fear of flying, which although it is not quite the same thing, can be answered in a similar way. We said:

Does acupuncture help with a fear of flying?

It was always said that if you wanted to get a straight answer from a doctor, you should ask them, 'would you be happy for your wife to have this treatment?' So, I suppose if you said to us, 'would you recommend acupuncture to overcome your fear of flying?', the answer would probably be 'no'. This is not to say that it might not work; over many years of practice we have heard of a number of almost incredible stories about changes which people have managed to make thanks to treatment, and quite often by the practitioner simply sticking to very basic traditional acupuncture. Extreme reactions of any kind are, from a traditional acupuncture perspective, indications that a part of the system is out of balance and generating inappropriate emotional or mental responses. It is sensible to be mildly apprehensive about flying, just as it is to be mildly scared of heights. If the faculty of sensible fear is out of balance, then extreme reactions abound.

However, with a problem such as this there are other possibilities which seem to us to go to the heart of the problem much more directly. Hynotherapy or CBT (Cognitive Behavioural Therapy) are both well tried approaches for phobias, with the added advantage in the case of hypnotherapy of being able to do trial runs under the power of suggestion. There are a great many forms of hynotherapy, all of which have their strengths, but those based around NLP and the work of hynotherapist Milton Erickson seem to have the most well attested handle on treating phobias.

There is no doubt that you would probably derive some benefit from acupuncture treatment in terms of a reduction in anxiety, as our factsheets show, and always the possibility that a skilled practitioner might look at your overall balance and get that feeling that there is something obvious to be done which may help. It is more probable, though, that they would do as this expert would, refer you to a trusted colleague who does hypnotherapy or CBT to ensure that your needs were skillfully and professionally met.

and we think that this probably represents the best advice we can give.

Because traditional acupuncture treats the person, not necessarily the condition they have, there is a danger that this can be re-framed as 'acupuncture can treat anything', and occasionally incautious practitioners let patients' expectations run away with them. From a Chinese medicine perspective every aspect of the human being, every inappropriate mental, physical, emotional or spiritual state, is theoretically amenable to change by treating the person as a whole. However, our clinical experience is that there are many problems, such as terminal illnesses or serious psychotic states, where expectation of recovery is virtually nil, and it is highly risky to feed the desperate need of patients with statements which might lead them to have hope where there is none. Cases like yours, although not quite as serious, nonetheless can represent entrenched patterns of thought and behaviour which require specialist skills to unravel.

We hope that you find someone who can help you. We are aware of how limiting this phobia can be.

Q:  I'm 67 years old now and it doesn't affect me so much now but 'shyness' has always been a problem for me. Can accupuncture help me in any way? Also, is there anything that can be done for 'erectile disfunction'?

A: We were asked a similar question about erectile disfunction a while ago, and our answer was:
 

 

I would like to find out if acupuncture will help me having a stonger erection

 

Q:  I am 69 years in good health, I would like to find out if acupuncture will help me havE a stonger erection

 

 A:  We are assuming that your question is about making good a slight loss of normal function (erectile dysfunction/ED) rather than whether acupuncture can be used as a sexual enhancement technique. There are a number of small studies, two of which you can find here 
 
http://www.ncbi.nlm.nih.gov/pubmed/14562135
 
http://www.ncbi.nlm.nih.gov/pubmed/10098953
 
which give some encouragement to the possibility that acupuncture in conjunction with conventional strategies can help men suffering from ED. However, the studies are small and far from conclusive, so we couldn't give a definite and positive recommendation.
 
As a general comment we would say that there are many reasons why men can begin to suffer from ED. These can range from the simple fact of ageing and the effects of conditions which become more apparent in older age, like mature onset diabetes, or to the problems associated with excessive drinking or smoking, through to the kinds of complex psychological issues which have arisen as a consequence of someone's life experience. Whether acupuncture can offer any help depends a great deal on the background against which the problem has arisen.
 
Traditional Chinese acupuncture is primarily concerned with the restoration of balance and flow in the energy of the body, and there are several distinct patterns of disease, or 'syndromes', in which poor flow or blockage of energy ('qi' as it is called in Chinese medicine) can cause erectile problems. If this were to be the case, and there were other confirming factors pointing to a specific syndrome in the overall diagnosis, there may be some possibility that acupuncture could provide some help. However, if the cause of the ED lies in a pathological condition which means that there has been some permanent loss or weakening of blood supply to the sexual organs, then acupuncture would be less likely to have any effect.
 
Our only advice to you can be to seek the view of a BAcC member local to you and discuss the matter face to face, perhaps offering them a little more background information on which they can give you a clearer assessment of whether they think acupuncture treatment may be of benefit.    
 

This advice still holds good.
 
As far as shyness is concerned, the theories of Chinese medicine address the whole person, body mind and spirit, and as such the classic texts do refer to conditions which would probably not be regarded as treatable in conventional medicine, or if so, belong to the field fo counselling or psychotherapy. We are not knocking these as options; many members refer patients on in a very responsible fashion if they believe that one of the talking therapies can be of real benefit to a patient.
 
However, a key word underlying all Chinese medicine is 'appropriate', and all of the responses of the mind and emotions which can make life difficult are often a normal response gone a little too far. Fear is a very useful emotion, but too much fear paralyses someone. Anger can be necessary and appropriate, but not if it becomes a smouldering resentment which takes over a life. If there are energetic reasons, i.e. patterns of imbalance which relate directly to what you describe as shyness, there may be something which Chinese medicine in the form of acupuncture treatment may be able to offer. We have certainly dealt with similar cases, although we have to honest and say that most often these derive from events many many years earlier, and the more deeply ingrained patterns often need one of the talking therapies as the main key to change.
 
There is certainly no harm in asking a BAcC member local to you what, based on a short face to face assessment, they believe they may be able to do for you.
 

It was always said that if you wanted to get a straight answer from a doctor, you should ask them, 'would you be happy for your daughter to have this treatment?' So, I suppose if you said to us, 'would you recommend acupuncture to overcome your mother's fear of flying?', the answer would probably be 'no'. This is not to say that it might not work; over many years of practice we have heard of a number of almost incredible stories about changes which people have managed to make thanks to treatment, and quite often by the practitioner simply sticking to very basic traditional acupuncture. Extreme reactions of any kind are, from a traditional acupuncture perspective, indications that a part of the system is out of balance and generating inappropriate emotional or mental responses. It is sensible to be mildly apprehensive about flying, just as it is to be mildly scared of heights. If the faculty of sensible fear is out of balance, then extreme reactions abound.
 
However, with a problem such as this there are other possibilities which seem to us to go to the heart of the problem much more directly. Hynotherapy or CBT (Cognitive Behavioural Therapy) are both well tried approaches for phobias, with the added advantage in the case of hypnotherapy of being able to do trial runs under the power of suggestion. There are a great many forms of hynotherapy, all of which have their strengths, but those based around NLP and the work of hynotherapist Milton Erickson seem to have the most well attested handle on treating phobias.
 
There is no doubt that you would probably derive some benefit from acupuncture treatment in terms of a reduction in anxiety, as our factsheets show, and always the possibility that a skilled practitioner might look at your overall balance and get that feeling that there is something obvious to be done which may help. It is more probable, though, that they would do as this expert would, refer you to a trusted colleague who does hypnotherapy or CBT to ensure that your needs were skillfully and professionally met.
 
 

This is a difficult question to answer. Little or no research exists which could provide evidence in support of any recommendation. Such research as mentions noise phobia, or phonophobia as it is technically called, is usually in the context of treating migraine, where extreme sounds, smells and light can be a concomitant of an attack. There may well be studies from China, where research is conducted into anything and everything, but unfortunately very little of this is translated into English.
 
The key questions which a traditional acupuncturist would want to ask you would be the specific sorts of triggers which caused the greatest problem and the specific physical reactions you have to intrusive noise. The word 'appropriate' is heavily used in Chinese medicine, and many reactions which are extreme usually have a more benign and useful correlate. The 'startle' reflex to loud noises is an important one; without it we would all be at risk a great deal of the time. Where someone has no 'startle' reaction, or conversely a very extreme one, however, this may be a sign that the balance of the system has been compromised, and a practitioner may be able to make sense of what happens within the conceptual framework of Chinese medicine. Within Chinese medicine body mind and spirit are seen as inter-related, and so imbalances can manifest as physical, mental or emotional problems, and often a mixture of all three. If a part of the system is malfunctioning such that you have become noise phobic there is a very strong chances that ther will be other disturbances which might confirm a practitioner's suspicions.
 
There is no substitute in this case, however, for visiting a BAcC member local to you and seeking face to face advice on whether acupuncture may be beneficlal. If they feel it would not be there are certain to be other options they might recommend. We are aware of people using hypnotherapy conditions such as this, but there is a wide range of practitioners offering services in this feel, and a personal recommendation would be the best option if acupuncture might not be suitable. 

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