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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).

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.
It is not unusual for people to experience a slight return of some earlier symptoms when they begin acupuncture treatment. This is more often the case with long standing chronic problems like migraine or skin disorders, and we always warn new patients that it is possible they may experience a slight return, sometimes quite extreme, of problems which they may have had many years before. Indeed, in some other similar professions this is known as the law of cure, a return of earlier disorders in reverse chronological order.

The energetic reasons for this are quite complex, and not all practitioners agree on the exact causation. Most take the view, though, especially with traumatic injury, that when it happens it allows some form of disruption to travel into the system and become dormant within the body, so that when the body starts to heal it is then expelled in a similar way to the way it was experienced when it happened. Chinese medicine abounds with expressions like 'releasing the interior' or 'expelling a pathogen' and such like, and they all carry a sense of kicking things out of the system.If this is the case for you, then it is a very heartening response, especially if the process also gets rid of any residual tendency to fibromyalgia at the same time. However, when people get these kinds of reactions we are always careful not to be blase and assume that it is a positive outcome. The key element of a 'good' return of symptoms is that they are usually short lived. If the symptoms return for an extended period of time, then they need to be looked at carefully, especially if they were associated with an accident less than a month ago. These may still be a response to what happened then, and it would be remiss of a practitioner not to point someone back to their GP if the problem persisted for a week or more.Hopefully by the time you read this the pains will have subsided and gone, but if they continue it would be worthwhile to contact your practitioner to discuss what to do and to arrange an appointment with your doctor as a precaution.
We have searched our own database and the databases of several other associations in the UK and we have found no trace of a Lian Chen, nor anyone with a name which is similar. Had the person belonged to a professional body you could rest assured that they had proper professional indemnity cover. In the BAcC, for example, professional indemnity insurance is automatically provided within the annual membership subscription, so when we say that all of our members are fully insured we know this for certain. Some other organisations check the insurance every year, although it is up to the individual practitioner to obtain the deal that they prefer.

The only other way to check whether a practitioner is insured is to contact the local authority under whom the practitioner has to be licensed or registered. There is a piece of legislation called Local Government Miscellaneous Provisions Act 1982 under which all acupuncture practitioners have to register. Many local authorities check whether an incoming practitioner has proper insurance in place. We suspect that South Gloucestershire Council is the relevant authority for BS34, and a call to its Licensing Department or Environmental Health Department will put you in touch with someone who can tell you whether the person is properly registered. The only people who are exempt from registration are doctors and dentists. We have checked the GMC register and there is no Lian Chen currently registered. This almost certainly means that the title Dr refers to Chinese Medicine and is not a sign of a conventional medicine qualification. If this person is not a doctor then they will have to be registered. We have take the liberty of looking at the address you gave us on google streetview, and we have to say that it doesn't look like an acupuncture practice. However, since there is no trace of the practitioner on the internet it may well be someone who is working from home. We hope that this helps you to get hold of the information you need.
We have repeated below a 'nested' response (two responses, one inside the other) which we gave some time ago;

We tend to be a little tentative in offering advice on conditions like Parkinsons which are often chronic and degenerative. A typical response that we have given in the past reads:
 From the perspective of research studies alone it would be difficult to give any firm recommendations for acupuncture as a treatment of Parkinson's Disease. There are a number of studies, some undertaken in the US but the vast majority in China, which show some positive signs, but not of sufficient change in a significant number of patients under study to draw any firm conclusions. You can see some of the studies if you google 'ncbi acupuncture parkinson's disease' - the National Centre for Biotechnical Information in the States is a convenient way to find many of the the more significant papers. There is also a Cochrane Review of a protocol for assessing the value of acupuncture, but as far as we are aware this has not been put into action yet.With all chronic degenerative conditions the extent to which acupuncture can help has to be carefully explained. It is often, as one rather ironic patient said, a case of 'getting worse slower', and this is extremely difficult to quantify in a condition like Parkinson's where the disease progression is neither smooth nor predictable. Anecdotally there are many accounts of patients finding that treatment helps with some of the manifestations of the disease, such as the periods of rigidity and freezing, and a general sense of well-being, but these are not documented sufficiently well to be able to claim any undisputed levels of efficacy.The best course of action is to see whether a BAcC member local to you will give you an honest assessment from an eastern perspective of what they might be able to achieve for your own unique patterns. There may be elements of how the condition manifests which they may feel that they can help.As you can see, we are very cautious in our choice of words. The shaking of the arm with Parkinsons has been tested in some small studies, as in this one there is some optimism in the write-up but it is a very small study.From a Chinese medicine perspective there are a number of syndromes which describe the shaking of the limbs, and which provide explanations of them in the terms which we use as practitioners. This can sometimes cause a little confusion because it gives an impression that a symptom which is treatable in Chinese medicine may mean that the same symptom might be easily treatable from a western perspective. Where there is a physical change in the brain, however, it would be unwise to get too excited about the possibilities.In any situation like this, though, we find that it does not help to be negative because there may be multiple reasons why someone's tremor might be quite bad, not least in the fact that stress itself can make the symptoms of Parkinsons more noticeable. We have found in clinical practice that reducing stress can sometimes make the frequency and severity of symptoms reduce, and it would certainly be worthwhile talking to a BAcC member local you you about what may be possible.We are not quite sure why we did not refer to our factsheet has some quite encouraging information under the 'evidence' button.We always add the observation that we often find that once someone has a 'headline' condition everything in their overall healthcare picture is assumed to be a secondary symptom of it. This expert has a patient with Parkinsons in whom several minor symptoms which have been declared to be a consequence of the disease have disappeared.  It may be that from a Chinese medicine perspective there are a number of your problems which are not directly related to the Parkinsons. We are not in the business of giving people false hope, simply recording what we have seen over the years.We also always check the current research, and since our factsheet was assembled there has been another very comprehensive systematic review while not conclusive certainly would encourage us to say that while we could not guarantee results the available evidence for amelioration of some of the symptoms is certainly stacking up.As always, a brief visit to a local BAcC member is worthwhile to discuss how acupuncture treatment might help your specific presentation.
The first thing we would ask in cases like this is what investigations you may have had already. There are a number of medical conditions like blocked tear ducts and the related dry eye syndrome which may be the cause of the swelling, and this can impact on the success for which one might hope. We answered a question on both a couple of years ago, and the answer is worth repeating for the wider context in which it places treatment. 

Chinese medicine is based on an entirely different theoretical basis from conventional medicine, what is often called a different paradigm. The essence of Chinese medicine is a belief that the body, mind, emotions and spirit are all manifestations of an energy called 'qi' whose proper flow and balance means that everything functions the way it is supposed to. If this flow becomes blocked or disturbed in any way, then functional disturbances appear, often affecting all 'levels' of the system and for which needles are used by the practitioner to restore flow.

When someone reports blockages it makes one question immediately whether the energy of that area is flowing as well as it might, and a skilled and experienced practitioner could determine quite quickly whether, from the Chinese medicine perspective, there was something which might be done. Even if there were no immediately obvious signs in the area itself, the principles of Chinese medicine are founded on a notion of overall balance which means that symptoms are less critical, being indicators of a wider imbalance in the system rather than the necessary focus of attention. It would be worth your while to visit a BAcC practitioner local to you for an informal assessment of whether they believe that acupuncture treatment may be of benefit to you.

That said, we have to say that the research evidence for the treatment of both conditions with acupuncture is a little bit thin. There are a few studies, but one of the key factors in undertaking research from a conventional perspective is trying to reduce the variables, and this means being able to define clearly what the problem is. Blocked tear ducts  have several possible causes, and this means that comparing like with like becomes more difficult, and the results less reliable. What research we have identified is of relatively poor quality, and if we were making recommendations based solely on that we would have to say that it would not be worth pursuing. However, our clinical experience is that where there are clear energetic blockages treatment can sometimes have a very direct effect, and it would certainly be worth seeking advice from a BAcC member local to you.  There are, in fact, some quite useful studies of related problems like dry eye syndrome, and although it is rather technical this paper both realistic and encouraging.This expert has to admit that it has not been the most successful area of his practice. While few patients have come specifically for this as a problem several have had it as a secondary problem, and even where the main problems have responded well this hasn't. That said, in the minority of cases where there has been a positive change the result has been welcomed with great joy.

Acupuncture treatment is always worth a try. There is very little chance of an adverse effect, and there are enough reports of treatment working for this problem to suggest that it is worth a go. The only issue for cases where there is less evidence is to make sure that a patient doesn't get tied into a long and potentially expensive course of treatment without any tangible benefit. In another context, Dr Johnson once described something as 'the triumph of hope over experience', and we always ask our members not to succumb to joining patients in a desperate hope for good outcomes. If there is nothing happening after four or five sessions it may well mean that nothing will happen.
If, however, the bags under the eyes are a result of loss of muscle tone, then we enter the area of facial or cosmetic acupuncture which has been in vogue for the last few years. There is no doubt that there is some basis for this work, as studies like this one There may also be reasons to do with straightforward blockage where treatment may have an effect. Our belief, though, is that treatment of local blockages really needs to be done in the context of a wider diagnosis of a person's balance, and only by doing this can the results be maintained.The last decade has seen a proliferation in people training to do 'facial acupuncture' or 'cosmetic acupuncture', many of whom have no background in acupuncture at all. We are not being protectionist in saying that in the courses which people do, many of which are of one or two day's duration, we do not think that anyone can learn properly skills which form a part of a three year training programme. If you do decide to seek the help of someone offering facial or cosmetic acupuncture we would fully recommend that you make sure it is someone who is also properly trained as a professional acupuncture practitioner.

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