The banana press

Reading a GP's Twitterings made me realise that we have very different ideas about what patients should expect from GPs. GPs expect patients to fit into the numbers game (alcohol consumption, weight, blood pressure, cholesterol). Patients expect GPs to treat them as individuals. I do see both sides of the desk, being married to Dr B (who is not a GP but who does work closely with a number of excellent GPs). And having spent several years at medical school myself, perhaps I am not the best patient.

I actually wanted to call this post 'Is your GP making you sick?' but I chickened out at the last minute, in case he reads it and thinks I'm being overly-critical. Recently, there was a new government campaign about not ignoring the signs of lung cancer. Many GPs were aghast at the sentiment of the campaign, that being that prolonged cough could be cancer. They were concerned that more patients (a deluge) would demand a referral for lung cancer screening. In fact, what most patients want is to be taken seriously, for the GP to take a thorough history, even if they think they know the patient, and then to refer (or not) as appropriate. 

I have also already said how cross I am that GPs are planning to take industrial action on Thursday. This upsets and unsettles patients.

When we were preparing for Mom's death, I looked around for a support group, of similarly terminally ill people, who didn't want to go to hospice. Well, as far as we know none exists locally. And I think I know why. General Practice is not equipped for the emotional side of dying at home. Yes, they are a talented team of people who rally round with bed baths and pain relief but there was no emotional support. We found a hypnotherapist who worked with Mom to help her come to terms with her prognosis, and for that we are eternally grateful; but this approach was not endorsed by the GP and caused a delay in Mom starting this treatment, even though we paid privately for it.

I have recently mentioned this again, in response to a blog post about an article written by a Journalist who has recovered from breast cancer. I am so pleased for her and for the many women who do survive breast cancer, but there are so many people who do not survive cancer, and there is precious little support for those who know the battle is lost. Mom decided that hospice was not for her, and that meant we were on our own. And the point is, Mom's story is painful, but beautiful. Mom's story is about dying with dignity. Mom's story needs to be told.

I have offered my services voluntarily through a GP to support the terminally ill in practical ways in our community. The response: the terminally ill should try this* group, they may not suit everyone as they are overtly Christian (or words to that effect). There could be a much better way. The District Nurses already provide a wonderful service to the community but they are stretched, short-staffed - could volunteers help in any way? Perhaps administrative, preparing information packs, ordering home equipment, filling in forms? That would free up the nurses for caring. Could volunteers be trained to talk to terminally ill people in their homes, helping them and their families through the maze of jargon and paperwork that comes with this label?

Mom's story is close to home, mistakes were made in her treatment but we triumphed in the end. It is a powerful tribute to Mom. And it could help others. I would like to help others.

And the bananas? Well, I'm very frustrated by the lack of support, and the lack of understanding about the need for support, for the terminally ill. Banana is a polite way of saying bo****ks.

*anonymised

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Mind-body interactions in chronic illness

Picture credit

Mind-body interactions include the techniques of relaxation, meditation, music therapy, hypnotherapy and other complementary therapies. Many of us have used some of these techniques to help with a single symptom such as anxiety, stress, or to quit smoking. In chronic illness such as cancer, patients often present with a complex pattern of symptoms, including anxiety, pain and sleep disturbance.

Hypnotherapy in particular, has proven benefits in smoking cessation, weight control and treating phobias. But it is also useful in maintaining a positive outlook on life, mainly by changing perceptions. Shortly after my mother died from lung cancer, her hypnotherapist and I wrote a short article on the benefits of hypnotherapy in chronic and terminal illness. This was first published in the newsletter of the Spirit Fitness Club, Guildford and can be read here. We felt that there was more to write, however, and I have been looking into recent research papers* to further substantiate our (largely) anecdotal evidence, and to show that there is good evidence for the use of complementary therapies in patients with chronic illness.

The Marie Curie Cancer Centre, Newcastle upon Tyne, published a small pilot study, looking at the role of hypnotherapy in the palliative care setting, by relieving stress and helping patients to cope with their illness and the prospect of dying. The audit established the demand for a hypnotherapy service, and the practicalities of providing such a service in a busy centre. It also identified the benefits of hypnotherapy, as perceived by patients and therapist. The study was conducted over 5 months, involving just eleven clients (seven staff and four patients), using questionnaires. The main findings were a unanimous positive coping and relaxation benefit, with 82% of clients reporting it had assisted in improving the presenting problem, and 91% felt it had been of benefit in general. Similar findings were published by Monti, Sufian and Peterson in 2008, where mind-body therapies, not just hypnotherapy, were found to improve cancer survivorship. Two studies carried out in Budapest by Jakubovits in 2010 and 2011 further suggest methods for hypnosis in complex oncology.

Cassileth and Keefe in 2010 published their findings looking at the role of integrative complementary therapies, including mind-body techniques, on specific cancer-related neuropathic pain, a complex physical and psychosocial pain; indeed in all types of chronic pain, hypnotherapy is shown to be effective on a variety of pain outcomes (Dillworth and Jensen, 2010).

Another aspect of cancer treatment is the sleep disturbance many patients experience. Hypnotherapy can effectively help manage the pain-sleep disturbance cycle in people with cancer, by helping with relaxation. A good night’s sleep is fundamental to well-being, for both patients and families. A report by Kwekkeboom et al (2010), found that further studies on mind-body interactions in the treatment of complex sleep disturbance could help patients with all aspects of the pain-fatigue-sleep disturbance cluster.

In a specific case of the management of leukaemia, Wesa and Cassileth in 2009 found that patients were looking for complementary therapies to be used in conjunction with traditional cancer treatments to reduce side-effects of the drugs, or as a coping mechanism during treatments. In this study mind-body interactions such as self-hypnosis, meditation and breath awareness such as is practised in yoga, massage and reflexology, acupuncture, and a healthy diet and exercise were analsyed and found to be useful for these patients. Just a word of caution here, botanical extracts and vitamin supplements may interfere with cancer treatment, so ask before using these.

And finally, in a randomized trial of mind-body interactions on a positive/negative effect during breast cancer radiotherapy, forty women were randomized to receive either cognitive-behavioural therapy and hypnosis or standard care, and their analysis showed a reduction in the negative effect and an increased positive effect, which was significantly more intense. Patients receiving this therapy also had significantly more positive days during their treatment, and the authors conclude that mind-body interaction therapies have the potential to significantly improve the experience of women breast cancer patients receiving radiotherapy (Schnur et al 2009).

It seems obvious to me that these complementary approaches together with traditional cancer treatment should be more widely offered to patients during treatment, both as outpatient chemotherapy and radiotherapy patients, but also as inpatients in hospital. Sometimes, as a cancer patient, despite all your best efforts, a hospital stay is necessary. That in itself is traumatic, but it shouldn’t have to be without complementary therapy too. By writing this blog, I am hoping to raise awareness of the possibilities, and to encourage patients and their families to ask for more help along the cancer journey. It can make life so much easier.

*You can search the Pubmed database for more topics.

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Local heroes

I've had a Twitter epiphany! A fellow blogger declares her weekly Twitter and blog awards, which I think is a very good idea. I think we can take this idea a bit further though, and would like to start my own Local Hero awards. I have been networked into a couple of local to Godalming networks, and I hope these networks will become stronger.

So, as a start to my Local Hero (Twitter) awards, and not to be confused with Community Heroes at Surrey Life magazine, I nominate the following :

@garlicwoodfarm for traditional breed beef because I believe in high quality locally sourced food

@Sandysviews for his thought-provoking blog and considered #FollowFriday's

@SurreyLife for a great magazine which promotes our wonderful county

@Puppy_Views for amusing cocker spaniel tweets and because today is #happyfursday

@HypnotherapySy because what he does is very important

@claz0r for her charity undertaking this year

Of course, there are Local Heroes not on Twitter or blogging, and we shouldn't forget them even though I can't name them here. I have chosen to post this here because it's part of moving on from bereavement. Believe or not, I have found some wonderful characters on Twitter, real people with genuine talent and kindness. They and others are a constant reminder that keeping people close to you is important. And just as important, is making new friends and developing new networks.

You might have your own Local Heroes, can you nominate someone from one of your networks? I'd love to hear your choices.

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Hypnotherapy to Stop Smoking

Guest post : Stephen Rigby has been a full time hypnotherapist and life coach since 2002. He has his main hypnotherapy practice in Guildford. Stephen is also the hypnotherapist for the Surrey Park Clinic (on the Research Park) and is BUPA recognised. You can find out more information on his service by accessing his website.


New Year’s resolutions are upon us and one popular resolution is to Stop Smoking. In a recent poll of nearly 2000 forum members at MoneySupermarket.com, 5.5% of them said that they would be making a New Years resolution to stop smoking. Unfortunately, 7.6% said they made a resolution in 2011 to stop and failed.

I have probably had over a thousand people seek my assistance to stop smoking using hypnotherapy and almost all of those had tried many times to stop smoking previously before they came to me for help.

Hypnotherapy can be an incredible tool in assisting a person to stop smoking and when a person is willing to make the necessary commitment, it is extremely effective. My clients have reported back to me that hypnotherapy made stopping smoking easy, eliminating things like cravings and weight gain.

For this article I have covered three aspects of smoking that may be of help to those who want to quit. When embarking on any journey it is always advisable to have the right information before you start, unfortunately, there is a lot of misinformation that will make the journey of a smoker to being a non-smoker much more difficult.
1. Willpower is not required

This does not mean that you do not have to make an effort but regard willpower as being the effort required to do something you do not want to do or not do something you do want to do. To stop smoking is a decision – the decision to never smoke again. If you cannot make that decision, there is something going on that you are not consciously aware of – something that hypnotherapy may help you to address.

The prime reason for someone to return to smoking is that they do not make the one simple decision of “I have stopped smoking and no matter what happens I will never smoke again!”

This is why making a quit date can be so effective – it gives you time to reinforce your decision prior to making it.
2. There is no difference between a “Social Smoker” and a “Full Time Smoker”

People start smoking for a reason and generally they continue to smoke for the same reason. The “social smoker’s” reasons for smoking are just more isolated than those of the “full time” smoker.

One of the most revealing questions I can ask in a “Stop Smoking” session is “what did you get from smoking that was positive?” Usually the answer is “nothing”! If one engages in an activity from which one gets nothing, one does not continue doing it for very long! Smoking achieves something for every smoker. In most cases, there are as effective or more effective strategies to achieve the same thing but if one does not acknowledge there is a need one is unlikely to look for positive alternatives and ultimately return to smoking.

One of the effects of hypnotherapy is to strengthen ones self belief that there are more positive behaviours and life is still pleasurable and enjoyable without smoking.

Many of my clients tell me that life as a non-smoker is actually much more enjoyable and pleasurable.
3. Chemical addiction to nicotine is not a significant consideration

Many people believe that this is the major consideration because that is what they are told but nicotine does not behave in the same way as a substance that we regard as addictive.

There are many examples of this but possibly the most interesting is to observe what happens when a smoker goes to bed – irrespective of how many cigarettes they smoke during the day, whether six or 60 – they usually feel no desire to smoke until the next day! The same cannot be said for someone who has an addiction to something like heroin.

Contrast this with what the makers of Nicotine patches want you to believe. It was not that long ago that our TV’s were inundated with men dressed as cigarettes wandering round aimlessly during the night because of the introduction of a 24 hour nicotine patch!

The truth is that the impulse to smoke is mainly psychological and that is why hypnotherapy can be so effective in helping a person to stop and stay stopped!

My Stop Smoking sessions are carried out over one session. In certain circumstances this one session has to be augmented with an additional session to address a specific issue that only occurs in a small percentage of smokers. I give up to two free back up session in the first six months to address this circumstance.

Benefits of hypnotherapy in chronic illness

Published in Spirit Newsletter (Guildford club) November 2011
by Stephen Rigby
www.rigbys.net

Ask somebody how they feel about being hypnotised and you will get a wide range of responses – fear being one of them.  Yet, without knowing it, everyone reading this article is likely to utilise the hypnotic state every time they visit the gym – that music you hear may be just music but it helps you to get into “the zone” of heightened performance.  I am a hypnotherapist and I use hypnosis in conjunction with other therapeutic techniques to teach my clients how to utilise that high performance state to overcome habits, fears, weight issues, anxieties; it even helps with some medical problems (like Irritable Bowel Syndrome).

Not surprisingly hypnotherapy can also be useful for improving sports performance and over the years, I have been asked by professional and Olympic standard athletes to help them improve their game.

How Does Hypnosis Work?          

Maybe because of the misrepresentation of hypnosis on stage, screen and literature the most frequent question I am asked is “How does it work?”  The goal of all therapy is to create a new perspective; hypnotherapy achieves this by helping us build new mental pathways.  Hypnotherapy is far more effective than other forms of therapy because it is extremely efficient at achieving perspective changes.  Where people may attend other forms of therapy for months on end, I expect most people to get the change they want within four sessions using hypnotherapy.

In this first article, I am going to talk about how hypnotherapy helped one lovely lady change her perspective on life.  Vivienne, the lady in question, is the late mother of Lesley Beeton, one of the members at the Spirit.  Here is what Lesley says about how hypnotherapy helped Vivienne.

Lesley talks about how Hypnotherapy Helped

"Mom was extremely ill and there was no cure for her cancer. She was very afraid of her diagnosis, devastated by the prognosis, and felt unable to see any positives in her life. We knew that Mom needed to come to terms with her disease, to decide how to live the rest of her life, and to tell the clinical teams how she wanted to be treated.

I asked Stephen to work with Mom when conventional anti-depressant therapy was withdrawn and she was not offered any counselling. Stephen adopted a personalised approach to Mom’s needs. She was very fragile and cried a lot during the initial sessions, but she seemed much calmer to us almost from the beginning. Mom learnt to trust Stephen and enjoyed the one-to-one time, working hard to change her perspective as her disease progressed.

Although she never understood how hypnotherapy worked, she acknowledged that without it she would never have achieved the insight and focus to make informed choices about dying at home or plan her funeral. She was calm and at peace, happy to be alive each day, right up until the end. On the day she died, Mom declined all drug interventions and passed away quietly at home, pain-free and in her own time.”

Peace and Quiet

Most chronic illnesses, including cancer and heart disease, are complex - having more than one cause and often more than one treatment. The medical teams work very hard to treat the disease but often the patient gets trapped on a medical ‘treadmill’ without the peace and quiet they need to consider their own needs.  Patients suffering with these serious conditions also have all the small niggles that the rest of us do - headache, stomach upset, coughs and colds, dental pain, period pain etc, and it’s often these small things which can really bring a person down. So there is a real benefit in investing early on in diagnosis in a plan for managing ongoing symptoms, medical interventions and the emotional side effects of chronic illness - hypnotherapy can help with this.