The Daily Mail reported recently on a randomised clinical trial involving 140 women in which Cognitive Behavioural Therapy (CBT) was evaluated as a treatment for menopausal hot flushes and night sweats (http://www.dailymail.co.uk/health/article-2103946/The-doctors-think-conquering-hot-flushes-mind.html). The results were impressive showing significant improvements in how these women rated the severity of their symptoms compared to a control group. Additionally, they experienced further benefits to their mood, sleep and quality of life. The hot flushes and night sweats associated with the menopause are believed to be due to falling levels of oestrogen and changes in the part of the brain which regulates body temperature. An unequivocally physical process. So how can psychological therapy help? As professor Myra Hunter, the lead researcher on the project says “women’s perceptions of the menopause affect how they experience the symptoms”. But she also stressed that “the research does not suggest that the menopause is all in the mind.” Yet, unhelpfully, the Daily Mail headed their article “The doctors who think conquering hot flushes may be all in the mind”. While the Daily Mail headline doesn’t say ‘menopausal symptoms are all in the mind’ the subtlety of their headline could easily be misunderstood to be claiming precisely this.
However, there is a much bigger point than misleading headlines at stake here and that is the muddled thinking about the ‘mind’ and the ‘body’ that has pervaded Western thought for centuries. Muddled thinking that still stigmatises and ghettoises mental health problems. The truth is that the mind and body are totally and utterly inseparable. One of the guiding principles of Neuro-linguistic Programming (NLP) is “The Mind and Body are part of the same cybernetic system”. What this means in plain English is that the mind and body are two aspects of the same integrated system. Crucially, these two aspects communicate with each other and influence each other profoundly. In reality there is no such thing as a purely physical or purely mental disease state. Even something as clearly physical as a broken leg will involve mental (i.e. cognitive and emotional) processes. Let’s take as an example a footballer who suffers a broken leg caused directly by a vicious tackle. Later, lying in hospital, our unfortunate player is not only in pain due to the fracture, but seething with anger at their assailant. The anger is a very normal, and I would say, healthy, initial reaction to the event. But, what happens if the anger does not subside and transform into acceptance? What happens if that person lies in bed imagining all sorts of violent revenge scenarios, all the while strengthening their conviction that their assailant really did mean to cause this much damage? Their anger is likely to fester into resentment and ultimately could become a deep-seated hostility, which could in time impair all that person’s relationships. Contrast this with another footballer who suffers exactly the same injury but sees it as an unfortunate consequence of playing a contact sport. Which person do you think is likely to suffer the most pain, and who is likely to heal, in the broad sense, faster? [Importantly, the key word here is ‘likely’. Just because someone harbours strong vengeful emotions does not necessarily mean that their healing will be compromised – simply that the likelihood is higher.] On the other side of the coin let’s take a closer look at a seemingly clear-cut mental health issue such as depression. Many depressive episodes can be considered to be largely, if not exclusively, the result of ‘disordered’ thinking (such as dark visions of the future, reliving past hurts and disappointments over and over etc). Yet, there is increasing evidence that depression affects the immune response leading potentially to a number of physical disease processes. Equally, there is a growing body of evidence that shows a disordered immune response can trigger depression in some people (see e.g. Brown, P. A mind under siege, New Scientist, 16th June 2001). As Professor Mark Williams and Dr. Danny Penman say in their splendid book (Mindfulness: A practical guide to finding peace in a frantic world, 2012, Piatkus) “the body does not just react to what the mind is thinking – it also feeds back emotional information into the brain which can then end up enhancing fears, worries and general overall angst and unhappiness”.
No disease process or life challenge, whatever the direct causative agent (be it accident, infection, genetics, lifestyle, emotional trauma, life events etc), exists as an independent entity. Menopausal hot flushes, depression, phobias, anxiety, tinnitus to name but a few always manifest within the lived experience of a unique human being. Good hypnotherapists have long known this. Which is why good hypnotherapy treats each person as the unique individual they are, and tailors therapy to each person’s unique strengths and aptitudes. Good hypnotherapy is an integrated way of working – using the very best approaches from all the major therapeutic orientations (psychodynamic, humanistic and cognitive/behavioural). Sadly some hypnotherapy trainings fall far short of the ideal. On the other hand Hypno-psychotherapists who qualify to join the UK Council for Psychotherapy (UKCP) undergo a minimum of 4 years postgraduate training and are thus proficient in all of the traditional hypnotherapy skills as well as contemporary developments. Hypno-psychotherapy is a truly person-centred mind-body approach with an impressive, and ever-increasing, evidence base (the subject of a later blog).
© David Corr April 2012
David is a UKCP registered hypno-psychotherapist who has also trained to Master Practitioner level in NLP offers integrated psychotherapy and hypnotherapy at Waterloo Therapy Rooms, The Waterloo Body Station and The Aston Clinic. For more information please contact David via his website: www.corehypnosis.co.uk
