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Ask an expert - neuro and psycho logical - anxiety

18 questions

Q:  I was anxious about going on holiday and then when I got there I got sickness and chest pains and went into hospital. My heart is okay and since coming home I have been told my liver, pancreas are all okay and they have done an endoscopy and i do not have an hiatus hernia or ulcer. I am waiting for the results of the biopsy, but in the meantime I have got very anxious and can't keep food down. I feel sick from morning to night and even though I am taking anti sickness tablets as well as omeprazol I still get a lot or reflux? I am not sleeping well so I am taking quiet night (herbal tablets)which help a little but everything is going over and over in my mind. I am also losing a lot of weight 26lbs. Can you help me?


A: There are a number of aspects of what is going on in your health where we know that acupuncture may well benefit you. As our factsheets on nausea and anxiety show


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 there is a growing body of evidence which suggests that acupuncture treatment may be of benefit to you. Clearly not all of these trials mentioned use acupuncture in a traditional way - the nausea trials invariably use a single well-known acupuncture point in a way that no traditional practitioner would use over and over again - but even when it is used formulaically, it seems to work. The other problem you mention, acid reflux, has not been so well-researched, but is clearly described in several frequently encountered syndromes (specific collections of symptoms) in Chinese medicine which have been identified and treated for two thousand years. Syndromes are what enable acupuncturists to appear a little like magicians from time to time; if someone has two or three symptoms in different parts of the body a practitioner can often forecast with great accuracy two or three others which someone is very likely to have.
On balance, therefore, it is probable that treatment may help with some of the symptoms which are troubling you. However, we would be very concerned by the weight loss, and we are sure that you own doctor will be too. This is not to be alarmist; 26 lbs is a great deal of weight to lose without trying to, and shows that there is something going on which you will probably be tested for in many different ways until they establish the exact cause.
For this reason we would counsel caution if you do seek treatment from someone local to you and find that the symptoms do start to abate. Even if successful treatment eradicated all of the problems you currently have, the weight loss is a serious matter, and you need to get a very clear diagnosis of what is going on.
Our best advice is to visit a BAcC local to you and ask their opinion in a brief face to face interview where they can offer you a better assessment of the potential benefits of treatment than we can do from here sight unsee.  

Q: Has the acupuncture field treated globus hysterics (anxiety driven) aliment successfully?  Are there people who claim to be able to eliminate this?  If so what should my son know of this?


A:  Globus hystericus, or more properly globus pharyngeus, is the sensation of having a lump in the throat. While often associated with anxiety states, it is more recently thought to have a great deal to do with reflux, the rising of stomach acid into the oesophagus. Of course, this is often associated with anxiety states anyway, so the conjunction of all three - globus, nerves and stomach discomfort - is quite common.
Strangely enough, in Chinese medicine there are one or two symptoms which have colloquial descriptions, and one such is 'plum stone throat' or 'plum pit throat'. This is a feeling that there is a plum stone which hasn't been swallowed properly and which sits at the top of the back of the throat. People who experience this often have a tendency to cough or try to clear the throat, and often end up, as many globus pharyngeus sufferers do, having endoscopes, so real does the sensation of 'something being there' feel.
Again, and oddly for a system of medicine which is premised on the fact that symptoms are not usually reducible to a single cause, the sensation of plumstone throat is invariably associated with the stagnation of liver energy as understood by the Chinese, called Liver Qi Stagnation in the textbooks. This can often be brought on by stress, and often creates other symptoms such as acid reflux, headaches, and an unevenness of bowel function which the Chinese call 'alternating constipation and diarrhoea', not going for a few days and then the bowels being looser for a short period.
Whether this is treatable in your son's case is something which you could only establish by visiting a BAcC member local to you and asking their advice. Clearly the fact that it is a recognisable symptom pattern in Chinese medicine means that there are a number of protocols for treating it, but every person is unique and different and it would be unfair and unwise to say 'definitely yes'. Without any idea of his age, there are some stresses about which a practitioner can do very little - having to work long hours, being in unstable and unhappy relationships - and these can have a significant effect on how much can be achieved. If your son is quite young, there may be limits to what treatment may be possible.
Sight unseen it is difficult to say. The best course of action is always to discuss the issue face to face and obtain a more thorough assessment of whether acupuncture might help. Most BAcC members are happy to give up some time in order for a prospective patient to be sure that acupuncture is something they wish to pursue, and to understnd what happens and what the potential outcomes may be.

This is a very difficult question to answer. For a start, a practitioner would want to know what sorts of situations you feel unconfident in. Are these all to do with people, or to do with being able to perform tasks as well as you can, or to do with past experiences, or all of the above. Traditional acupuncture is certainly based on a theory of the interconnectedness of mind body and emotions, and a treatment strategy aimed at producing balancing in and between all three, so in theory the kinds of imbalances which make people feel unable to cope with certain kinds of situations would come within its range.
A key word in Chinese medicine is 'appropriate'. It is appropriate to experience all of the emotions at their right time, and to react appropriately to the sorts of joys and sorrows of life. If someone finds that they are stuck with a single emotional response to the world, or cannot find appropriate responses to sad, joyful, anger-inducing or frightening situations it would clearly be a pointer to an imbalance of sorts, and one which a practitioner might be able to influence by using the principles of Chinese medicine. Acupuncture has certainly developed a growing reputation for its use in treating anxiety and depression, as our factsheets show, and other areas like lack of confidence and self-esteem are part of the same overall pattern of disfunction.
Our only concern would be if your lack of confidence resulted from specific causes which required skills beyond the limits of confidence of the average practitioner. There is often an element of informal counselling enbedded in treatment simply because our members afford people a great deal of time to explore what is ailing them, and often they uncover complex issues. Sometimes, however, this requires specific skills inm therapy to avoid 'sorcerer's apprentice' situations where someone lifts the lid on a deep problem but lacks the skills to replace it safely until the next session.
We suggest that you contact a BAcC member local to you and see if they can spare you a half hour of their time without charge to see whether the sorts of issues which you want to address are within their scope. There is every chance that they will be but if they aren't we trust that they will refer you on to people they know and trust within their own network who have the skills which may benefit you better.   

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