The treatment of anxiety

Comment by Chad J. Dupuis, L.Ac.

First, out of all the treatments for anxiety disorders acupuncture and cognitive behavioral therapy appear to show the highest promise for results, so I'm glad you are familiar with both. Basically there are some things that are out of your control to some degree (brain chemistry, etc.) and acupuncture does an excellent job of balancing these functions and CBT does a good job of training you to not have the same reactions to common stimulus which re-creates the cycle of anxiety. Most of my patients resolve fairly completely, so I don't often refer to a CBT therapist, but I am aware of it's value and understand the mechanisms behind it.

Now, on to your question about acupuncture. First, you need to see a different practitioner - simply put. While there are certainly a number of different theories within acupuncture from treatment frequency to point selection, etc. the bottom line is that anxiety is a commonly treated condition that should respond very well to appropriate treatment.

Within the system that I use, we very, very rarely treat more than once a week. We usually treat once a week until the condition resolves to a reasonable degree (i.e. very noticeable changes from the patients perspective) and then we start branching out the treatments to 2 weeks, 3 weeks, etc. until the person is basically going a month between treatments, usually then they are fine. Sure they may come for some kind of infrequent maintenance, but the condition never regains the hold that it had on them to begin with.

While you are relaxing during the treatments, it sounds like you are getting essentially no response from them. You could relax doing almost anything, so I wouldn't account even that much to your treatments. You don't say how long you've gone, but within 7-10 treatments people should have a noticeable change. While full resolution will vary amongst cases based on their constitution, their involvement in their own healing, their life situations, diet, etc. it will resolve in the vast majority of cases.

As a student, I encourage you to try a number of practitioners and styles and don't get caught up too much in certain theories about point selection, treatment frequency, etc. There is a vast range of skill level amongst practitioners and you have to watch very carefully people's actual clinical outcomes when you are evaluating people to study with - not just how busy their practices are or their reputation. Also, in school you are learning the basics, either during that time or afterwards you should find someone you really trust to guide you further - probably the person who will give you your first truly effective treatments.

In my opinion daily, or even 2-3 times/week treatments are very unnecessary, a waste of money from the patients side and a waste of time from the practitioners side. Acupuncture is about guiding the body back into a state of balance, letting it make the right decisions and holding to them. Daily or too frequent acupuncture is a brute force approach that is similar in nature to taking a strong medication - you are not giving the body anytime to take up the changes you are recommending. I have never seen anyone respond any better to acupuncture given more frequently, but I have often seen the opposite effect - or at best no effect at all.

Generally brain chemistry takes 3-5 weeks, perhaps a little longer to change significantly, so weekly treatment over that time frame is a reasonable amount of time to get the changes started, then things improve fairly rapidly afterwards. I recommend you read my anxiety treatment article, and perhaps particularly the section on the tam healing system/tong ren therapy section within the depression treatment section which would be nearly the same points (the system that I primarily use).

Comment by Archived User

Thanks Chad for the decent response, much appreciated.

Its a funny one, I know what your saying seems right and yet in reality it was never the case for me, I went to several acupuncturists when I had anxiety or PTSD. It was like I was constantly fired up and I couldn't let go. Acupuncture, only had a brief effect and trust me I went to some of the best in the field in and around London.

You see, the problem lies in the programming, emotion that hasn't been processed the brain is stuck in the same time as the trauma happened, even though the rest of you moves on. When the programming is out of balance / flashing and not able to swith off, this imbalance is reflected in the energy system. Balancing the energy system ofcourse gives relief and has a soothing effect on the brain. BUT and its a big but that programming is still hard wired in. The only way to change that programming / rewire the programming is to do relaxed more than one does stressed. This means one needs to implement true relaxation. Trust me, when you have PTSD it is extremely hard to relax and switch off, even when one is doing something relaxed the brain still doesn't want to fully give in and believe me I tried it all! This is what I'm talking about. acupuncture works, but it only works briefly. If it was so successful then acupuncture would be the front line treatment, although its up there, its not, in all fareness there is no simple solve all treatment. I did acupuncture weekly for over a year and found it didn't do anyhthing more than take the edge off briefly, ofcourse my acupuncturest would tell me this and that were more inline but the feeling of anxiety didn't shift. Why, becasuse it wasn't enough, honestly, first hand experience, it just didn't do enough to flip the programming.

For me it meant having to re-programme through using CBT over a couple year period to get ontop of it. But throughout that whole process I had to conciously do it, it was me doing it and it was hard work! Acupuncture is easy! Why not, if it gives relief, use it more frequently. From my experience and from many other people who I know who have used acupuncture for anxiety including the acupuncturists themselves saying, look this is not the cure but it helps.

Okay, perhaps regular anxiety is more responsive but PTSD is pritty stubborn stuff. It doesn't seem right to me that, here is something than can really take the edge off and then to say, hey, only do it once a week though! Do you see what I'm saying, acupuncture is the only thing out there that can give these types of people the daily relief they need so they can then get on with their lives.

Remember I said ideal situation, not practical situation, to me daily seems ok. Especially when you consider acupressure which is allegidly supposed to do the same as acupuncture can be used as much as one likes, why is this??

Alex

Comment by Chad J. Dupuis, L.Ac.

There are certainly a host of theories and skill levels in the field, so I'm sorry you haven't had a good response from the acupuncture. While I certainly understand what you are saying, it's fairly clear from my response that I strongly disagree with the aspects of treatment duration and the level of healing possible with these conditions. My experience as a practitioner, my teachers, and a host of my close colleagues all get very good results with these conditions, so what I am saying is not theory, but our clinical reality. I'll leave it at that, however, as I know well that each person has their own process involved in healing and while acupuncture is a very effective modality I see the possibility that for some people it may not be the modality they need at a given time.

I would like to comment on the acupressure vs. acupuncture being "the same" comment as they are most definitely not. The most obvious differences is that you can't hold all the points at the same time nor can you hold them for the same duration. Acupuncture is simply not a point to point modality. As you will find in your studies, or may already know, certain points will be stronger when used together than individually, certain points will have strong immediate effects, others need to be left in for a longer duration, etc., etc. These things cannot be accomplished with acupressure. It's great for a self-help remedy, but can in no way compare to clinical treatment by a professional with acupuncture.

Comment by Archived User

Chad, again thank you for taking the time to respond to me, I love a good debate and I respect what you say. What you say coinsides with what my teacher thinks and my acupuncturist. I think your right that for many more acute conditions once a week is sufficient and I'm sure that you have made great success with once a week for more chronic conditions such as anxiety and more serious PTSD anxiety conditions, although as you know I believe daily treatment for some, more stubborn conditions is the only way to make a full recovery in a sesnible period of time.

I was happy with our discussion but then I found a very interesting article last night that was very much inline with our discussion, obviously after I put up the first post and after I posted my second message. I felt it would be interesting to let you have a read and see what you think. Check it out http://www.itmonline.org/arts/restructure.htm. The article strongly supports where I'm coming from, it argues that in China treatments were always and still are based on 1o day blocks of daily treatment with a possible 1 to 3 day cooling period and then possibly another block, then, if neccessary, work up from there. They are making much faster recoveries that Western acupuncture. The article is a proposal for restructuring the American acupuncture practices by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon.

Regards

Alex

Comment by Archived User

I am also just a student of acupuncture but a long time martial arts practitioner which also based on the same principle: solve the problem by wroking on the opposite.

From your comments I see you have tried long enough to solve your problem one way, it is now time to turn to the opposite: change your environment. Your clock is not out of balance within yourself but rather compared to your environment. Not recognizing this creates most of your frustrations that lead to your PTSD. Get out of where you are and discover where you belong to; and most importantly make that a part of your world. You're in London? Leave the city every weekend and discover nature. Make it not just a trip once or twice but a permanent lifestyle change. Don't stop taking acupuncture if you still need to but your real solution is in changing your environment and your lifestyle.

Learn to unlearn and you'll heal faster than you think you could.

Blade~

Comment by Archived User

First food, then acupuncture :)

Could your patient benefit from dietary therapy? Perhaps the food she is eating (and lifestyle, etc.) is working against your acupuncture...

Also, sometimes what we think is a bad symptom that we need to get rid of (i.e., the anxiety) is actually a good thing, i.e., a signal that the body is doing its job and trying to help. I am thinking of a personal issue as an example. At one job I had before I went to school for acupuncture, I suddenly started to experience inexplicable panic every morning as I drove near to my workplace. I took formula, acupuncture, all to no avail. Eventually the anxiety called to my attention something I had been ignoring, that I worked in a stressful setting interacting with some meanspirited people. Then I changed jobs, immediately, no more panic attacks, no insomnia. My old friend and nemesis LV qi stagnation doing its job, right? :)

Also if you are treating e.g., HT blood and the root is somewhere else ( say, LV stag brewing heat-> damage blood) then symptoms will keep coming back. So say I from my vast experience of practicing for 6 months :) But I just had to join this discussion, I find it quite interesting.

Comment by Archived User

Exactly what I am trying to say. I am too speaking from experience, matter of fact my last job was like yours. I had anxiety and just generally not feeling my best, and this went on for over a year. I also had treatments and they did help but just didn't seem to 'solve' the problem. Finally came to a realization that it was the job where I just didn't feel fit in - people getting promoted for 'sucking up' instead of accomlishing actual work. I too changed jobs and the symptoms disappeard without having any further treatments. The internal pressure was slowly relieved and I was back to my old self.

Acupuncture is only one tool that can help you but it's not a magic pill for everything - what lately I found with too many people seeking for life's solutions. If you have exhausted your possibilities - which I would say she did - it is time to look for the direction that actually permanently solves the problem and most likely in this case it is: changing the environmental factors! Don't get stuck with one way, remember the saying 'Insanity is doing the same thing over and arriving at the same result every time'.

Hope my advice will be a good solution to your problem.

Blade~