Hearing that my friends in the United Kingdom at www.thoughtfieldtherapy.co.uk were about to have a conference on Thought Field Therapy (TFT) was all the encouragement that I needed to write a few more words about TFT and some of the other tapping therapies. I made mention of two of them in a blog entry for February 28th 2006, and I have dedicated several sections to it in my book and CD series Healing Meaning and Purpose.

TFT was the creation of the psychologist Roger Callahan, who discovered that stimulating a number of acupuncture points while connecting with an negative emotion, thought, impulse or memory, could initiate a cascade of healthy neurological, chemical, emotional, cognitive and even physical effects. There is an interesting sidebar here. When I first came across his work, it seemed absurd. It looked like a collection of unproven techniques cobbled together into some sort of system. I worry about sick people being treated by ineffective therapies, so I was determined to debunk TFT. I was a little taken aback when I sent for some of the Callahan materials and saw a smoker permanently cured in about five minutes. Undeterred, I flew to California to expose what I thought might be another scam. Within two days, I discovered that it was no scam. Roger has indeed made an extraordinarily important discovery that supports the notion that the laws of healing are changing. As a simple example, I used one of Roger’s simplest treatments on inveterate smokers. The first 11 whom I treated all stopped smoking, and when I followed up almost one year later they still were not smoking. This could have been beginner’s luck or a placebo effect, but both are unlikely. We know a great deal about the duration of the effectiveness of placebos.

TFT is based on the concept that thought is a form of energy, structured by a field and that psychological problems are manifestations of distortions within “thought fields,” which Roger defines as “a complex of forces that serve as causative agents in human behavior.” He conceptualizes psychological problems as the consequence of “perturbations” in the thought field. These perturbations contain the information that triggers negative emotions, and they also have relationships with specific major acupuncture points on the body. Fixing these perturbations involves tapping specific points in a specific order, while doing a series of other small tasks.

An important aspect of TFT is the concept of psychological reversal. Roger calls this the energetic blockade of natural healing, caused by reversals in the flow of Qi through the acupuncture channels. It now seems that much of what has been described as therapeutic resistance, self-sabotage or lack of willpower is a result of psychological reversal. He has devised some deceptively simple treatments that have shown us that people’s difficulties were often not a matter of a lack of willpower at all, but were the result of reversed energy. Deal with that, and many problems can melt away.

Like Roger Callahan, I emphasize the importance of toxins, of extending our concept of them, so that we conceptualize them as units of rogue information. In recent years Roger has done pioneering work into how to track down and deal with them.

Not everyone will be helped with any single form of treatment, and even with the best therapists, TFT is not for everyone. However, when someone says that he or she has not been helped with TFT, it most often for one of these seven reasons:
1. The treatment has not been done quite correctly.
2. The problem has been only partially treated.
3. Psychological reversal has not been dealt with.
4. There are still some toxins lurking around.
5. There is more than one problem, and they haven’t both been treated. (Somebody who said that he felt silly doing TFT needed to treat that fear of appearing foolish and then getting on with the primary problem.)
6. The problem may need the help of someone trained in TFT.
7. The person may have needed a combination of therapies.

TFT is the original tapping therapy, but others have now sprung up, including Emotional Freedom Techniques, and I have just read a new book called the Tapping Cure that claims that tapping an array of points on the surface of the body, while at the same time doing a specific affirmation, can be just as effective.

I have tried all these techniques, with varying degrees of success. Not just for clinical problems, but also for sports and other types of performance. While I was recording the CD series Healing, Meaning and Purpose, I several times found places where I fluffed my lines. On each occasion, the problem was resolved by tapping the border of my hand, because I was developing psychological reversal.

Unfortunately, proponents of each of these – and there are others – tend to be competitive with proponents of other techniques. And some enthusiasts have made some pretty incredible claims about what they claim to be able to cure. The competing claims really need to be resolved through empirical research.

Until we have that, I strongly suggest exploring the tapping techniques as adjuncts to other forms of therapy.

Technorat tags: Alternative medicine Complementary medicine Integrated medicine Thought Field Therapy Emotional Freedom Techniques Qi Subtle Energy Biofield

The last year has seen a mass of new obesity research linking intestinal hormones and the brain.

Over the last 25 years, there has been increasing evidence that many people with significant weight problems have problems in a region of the brain called the hypothalamus that is involved in the control of appetite, feeding, temperature and a range of other bodily functions. On April 18th, I mentioned the intriguing possibility that viruses could be one previously unrecognized explanation for the obesity pandemic. It is hypothesized that these viruses might alter the normal functioning of the hypothalamus, causing an increase in feeding, and perhaps also of appetite and inactivity.

A study from Albert Einstein Medical College in New York, published in this month’s Journal of Clinical Investigation provides further evidence that there may be something wrong with the normal functioning of the hypothalamus.

We normally have a sensitive mechanism in the hypothalamus for sensing fats, which provide a strong signal to stop eating and also to start normalizing blood glucose. There are strains of obese rats, and in these little creatures the fat sensing mechanisms do not work properly. Not only do they keep eating, but also they cannot control their blood glucose properly. Those two things together conspire to produce yet more obesity. What was so interesting in this study, was that the researchers found that if they inhibited a single enzyme involved in fat metabolism, the levels of fatty acids rose in the hypothalamus, the animals were once again able to sense fat levels, and both their feeding and glucose levels normalized.

This is one of the first times that it has been possible to find a single enzyme that would normalize metabolism. The next question is to see whether this might constitute a viable treatment for obesity, or if the body would quickly work around the treatment and return to its old ways.

Technorati tags: weight control hypothalamus obesity

I recently had the great pleasure and privilege of speaking to a group of health care providers in Monteagle Tennessee, and an interesting question came up. The sick citizens of Tennessee are having a hard time now because of the problems with TennCare. This problem is not new, and is not only happening in Tennessee. There is no malice or lack of compassion involved, it is simply a matter of $$$.

And because we need to have a diagnosis in order to apply for reimbursement, the discussion soon turned to the matter of psychiatric diagnosis. It’s pretty well known that I have lectured on the subject of psychiatric diagnosis all over the world: it was actually one of the reasons that I was first invited to come to the United States. The problem is this. When we classify an illness, we can either think of it as a “category,” like strep throat or a heart attack: an illness that has clearly defined margins. Or we can think about it as a “dimension.” So instead of seeing illness as a separate entity, we think of health and illnesses as lying on a spectrum, running all the way from being healthy and well, through mild degrees of just not feeling “right,” to being severely ill. Reimbursement requires categorical diagnoses, even if they do not reflect clinical reality.

This second – dimensional - way of thinking is particularly useful when we are thinking about psychological problems. The world is full of people who are a little bit obsessive, or who get bad mood swings. But they are not bad enough to be called an “illness.” In fact, having some of these traits can be enormously beneficial: they have continued in the population because they have a survival advantage. If I need to have surgery, I sincerely hope that my surgeon will be mildly obsessive, rather than discovering a few weeks later that he had forgotten to do something he should have!

When I am teaching about schizophrenia and bipolar disorder, I discuss how they lie on a spectrum that passes through so-called schizoaffective disorder, cluster A personality disorders – schizoid, schizotypal and paranoid – to schizophrenia. (You may be interested in looking at the blog entry for May 24th here). I also make the point that I can make just about anyone psychotic. Come and live in my research center for a week, where you will not be allowed to eat or sleep; you will have to drink 30 cups of coffee a day and take up smoking. I can guarantee that most people will develop some symptoms. If you have a family history of mental illness it would not take a week, but perhaps 3-4 days. And if you have a personal history of mental illness, it could take no more than a day or two. The key is arousal. People experiencing high levels of arousal may well start to experience manic, depressive or psychotic phenomena. The types of symptoms that are experienced are determined by background, environment and genes. This sort of “reactive” psychosis is completely different from the other end of the spectrum, where, particularly in males, there are demonstrable abnormalities in the brain – shifts in laterality and progressive loss of grey matter in specific regions, with swelling in other – many of which are present before the onset of full-blown psychosis, and before exposure to medications. Though some of the older antipsychotic medicines may make the situation much worse.

In January of 2005, some of my colleagues in Edinburgh, Scotland, published an important paper after studying people at high risk of developing schizophrenia. Many of these high-risk people did not develop the illness, although some had transient and partial symptoms. We know that some family members – the carriers of the genes – may also suffer from some symptoms of the illness. This shows us how genes do not control everything: many people suffer from mild cases because their environment or personality helped protect them from developing a full-blown illness. In other words: biology is not destiny. These findings also give us important clues as to how we may be able to reduce the risk of an illness expressing itself.

Diagnoses are not always cut and dried. Medical professionals are sometimes unable to reach a definitive diagnosis, needing to wait and see how things develop. Having specialized in the diagnosis and treatment of tough cases, family members sometimes become very upset because their loved one does not have a clear diagnosis. Psychiatric diagnosis is still primarily clinical and often needs time to clarify. Although there are many demonstrable neurological disturbances in people with schizophrenia and bipolar disorder, even the most sophisticated brain scans are still not at the stage where we can make diagnoses.

If we think in terms of dimensional diagnoses that reflect clinical reality, it helps us to understand the range of symptoms that people can experience. It also speaks to the point that I have made time and again: symptoms are signs, and they are signs that can be generated in the body, in the mind, in relationships (not just because some might be stressful), and they may have subtle system or spiritual origins. Successful treatment needs us to identify the origins in an individual and to work with all the five main dimensions of the individual.

And by the way, we have succeeded in helping virtually all of our seriously mentally ill patients back to living the kind of lives that they want: jobs, relationships and so on. So this is not an academic discusssion, but instead something supremely practical

Technoratic tags:diagnosis category dimension bipolar disorder schizophrenia schizotypal personality disorder recovery spirituality

I have on many occasions discussed the problem of over-simplifying the mechanisms controlling our weight and appetite. They are complex and have multiple fail-safes and multiple levels of redundancy, which is why most weight loss programs only last for short periods of time. The body gets used to the diet, believes that it is starving, and immediately gets to work to conserve energy: our metabolism slows and our physical activity levels begin to fall.

We can tinker with leptin, cortisol or insulin to our hearts’ content, and each will probably help for a while. But if we ignore the body’s starvation-protection mechanisms, to say nothing of the psychological, social and subtle aspects of weight, our efforts will usually be fairly short-lived. Most of us now understand that food intake is only part of the equation; we also need to maximize our metabolic rate and increase our level of physical activity. One of the problems has been how to help someone exercise whose body wants to go into starvation mode.

Steve Bloom’s group at Imperial College and the Hammersmith Hospital in London has published another valuable report helping to elucidate some of the complex mechanisms involved in appetite, weight and metabolism. Steve has been working in this area since the early 1970s, and is one of the most highly cited scientists in the world. In a field that constantly sees new discoveries replacing the old, he is unusual in that that virtually all of his work has stood the test of time.

This report concerns the intestinal hormone oxyntomodulin, which has a dual action, increasing energy expenditure as well as reducing food intake. It appears that oxyntomodulin may let the brain know it has an adequate energy supply and that it can afford to do productive things rather than just concentrating on food seeking behaviors or energy conservation. The hormone signals the brain that it can increase exercise by letting it know that the energy is available to do so.

At the moment oxyntomodulin has to be given by injection, and, given the complexity of the weight maintenance systems it is unlikely to be the whole answer.

Technorati tags: weight control obesity oxyntomodulin energy expenditure weight management

The very first attempts to take pictures of the living brain go back to the 1930s, but it is only in the last 20 years that MRI, SPECT and PET studies of the brain have really moved the field forward. After thousands upon thousands of imaging studies, we are beginning to approach the time when we can start harvesting the data collected over these years.

We are on the cusp of an extraordinary advance in our understanding of the brain and how it can go wrong in a large number of neurological and psychiatric illnesses. But that is only a side show: being able to identify the neurological correspondences of, say a psychiatric illness, does not mean that we reduce the illness to the firing of a group of neurons. But it does mean that we are gong to be much closer to providing suitable treatment for the neurological component aspect of the illness.

There has been a dramatic demonstration of this with the publication of a new brain map of people living with a rare but important illness called William’s syndrome.

One of the biggest puzzles for those of us who look at brain scans, is why there is so much variability in the structure of the brain. In the rest of the body, veins and arteries can turn up all over the place, but nerves tend to be in pretty much the same position in everybody. This is not the case in the brain. I’ve looked at many thousands of MRI scans of the brain, and I’ve never found any two alike. It’s one of the reasons that I’m a little doubtful about some of the claims of imagers who say that they can diagnose someone by looking at a brain scan. Most of the time there’s just too much normal variation.

All over the world, there have practitioners who have claimed to derive all sorts of information from brain images. Most experts remain a bit skeptical: hundreds of experts and hundreds of millions of dollars have only enabled us to speak in generalities. Some private practitioners even perform scans for diagnosis.

Some time ago I met a psychiatrist who had an unusual theory about the causes of mental illness. He wanted us to do two MRI scans on a patient to prove his theory. When I told him that we were not yet able to do that in individuals, he was indignant, “But you’ve published all those studies showing abnormal brain structure in schizophrenia.” I explained that all the brain imaging studies have told us quite a lot about groups of people with mental illness, but little about individuals. I do not know of any academic psychiatrists anywhere in the world who think that we can yet use PET, SPECT, fMRI or MRI scans for diagnosis of mental illness. Maybe we’re just being a bit slow. Or perhaps the brain scan diagnosers haven’t got all the pieces of the puzzle just yet. Research is expensive and takes a great deal of time. Busy clinicians are eager to exploit new investigative tools for the benefit of their patients, and usually do not publish their results in peer reviewed journals. With this new research we are going to be able to see if these individual practitioners are correct.

Not only are there many inter-individual differences, but also the current state of the person can have a big impact on some types of imaging. I was recently asked to review a paper for a scientific journal in which the authors had enthusiastically explained the way in which they could now diagnose a certain illness by doing a brain scan. Sad to say, they had not asked a couple of basic questions, like the person’s mood when they were scanned. Depression reduces the flow of blood in regions of the brain, the patients turned out to be depressed, and the results were invalidated. It was a real shame, but it is so important that patients don’t get misled by investigations that cannot help them.

So the moral of the story is this. If someone wants to do any kind of investigation for diagnostic purposes, ask them first whether there is any published evidence that the test actually works: what are the sensitivity and specificity of the findings generated by the test? And who else is doing it?

“If the brain were so simple we could understand it, we would be so simple we couldn’t.”
–Lyall Watson (South African Biologist and Writer, 1939-)

Technorati tags: brain structure williams syndrome bipolar disorder PET scan