Doctor-to-Doctor (Part 1: Clinician-to-Clinician)

(Part 2: Researcher-to-Researcher Is seen on the AcuDestress Research Site


If you were to send me a patient to treat, you’d want to know what to expect.

I think what I’ve written here fits the bill. You may also read the web site further...

I’d like to begin by showing you my reference library, which I consult regularly ...


 
  
 
 
 
  


I’d like to thank the authors - psychoanalyst Norman Doidge for unearthing a major key to neuroplasticity - neuromodulation, neurologist David Perlmutter for introducing (or re-introducing) nutritional medicine to psychoeducational psychotherapy, mind researcher Stanislav Grof for his courageous explorations of the mind’s extraordinary life, Roberto Assagioli for showing how to work with patients in the midst of extra-ordinary times, & Martin Seligman for mastering program design in a results-oriented, evidence-based way.

 

For a downloadable printable copy of this               6 page article...Part 1
CLICK HEREDoctor-to-Doctor_files/The%20AcuDestress%20Training%20Course%20in%20Mindfulness%20and%20NeuroplasticityPart%201.pdf
 

The AcuDestress Training Course in Mindfulness and Neuroplasticity

An overview for referring clinicians


If a patient asks me what will happen in the course of mindfulness arising, my honest answer has been that I don’t know - but that past experience suggests that it acts potently and in one’s favour.  That’s my answer to you as her health care provider too! If that same patient asks me how acupuncture effects what will happen (as they all do, whether overtly or not,) I can answer better over time, once they are actually experiencing it. Answers do present themselves! The bigger challenge will be to answer these questions to someone on the sidelines (like yourself) who are not actually going through the experience yourself. 


I regularly expose curious patients to someone who has received the treatment themselves, just over half way through the 16 sessions, when they already have some experience under their belt. What they really want to know is whether it will work for them. By the halfway mark, they have the evidence themselves. 


Mindfulness has captured the imagination of therapists far and wide. Fully 41% of psychotherapists report using mindfulness as part of their methodology. Even blow-by-blow explanation during the sessions (which we do) has its challenges. But hands-on experience demonstrates to the recipient that acupuncture acts as a quick-action brain neuromodulator (catalyst) which brings the body/brain back into balance, initially at the subcortical (limbic) level (explained scientifically on Pages 7-10), while mindfulness addresses imbalance by allowing one to stand aside, objectively aware of both foibles and deeper, transcendent capacities.


Historically linked to meditation in its original presentation by Kabat-Zinn, other methods reach mindfulness even faster, like Dr. Jeffery Schwartz treatment of OCD, Dr. Dan Siegels child psychotherapy, and most poignantly, Dr Stanislav Grofs holotropic breathwork which offers quick entry into non-ordinary states of consciousness.




2.

Non-Ordinary States of Consciousness


As early as following their first ear acupuncture treatment, at least some patients begin to experience non-ordinary states of consciousness, momentary flashes at first of new competencies. These become the building blocks for new tools the patient will find useful later, so it requires that the subject comes to understand them right when they unfold, so that anticipating the next is not accompanied by undue anxiety. The process is one which toggles between mindful experience and understanding, understanding and experience, building momentum as it goes.


Early-on in AcuDestress, subjects are told that they will not have to do any hard work during those four weeks. Action on their part, if initiated too early, will follow the person’s usual habitual action patterns and experiences they've had before. This would work against the process we are trying to encourage - acting from a different perspective, in a different capacity - i.e. remaining aware of (i.e. present to) their experience. We suggest that it will be much easier to them to act in new ways - afterwords.


I speak of habitual action during the course as emanating from the personality - a mind structure determined by both genetics and environment. The 20th century personality theorist, Dr. Karen Horney saw that everyone, patients and others, has a personality structure that reacts to stress by either 1.) withdrawing from it, 2.) acting against it, or 3.) taking some action that involves other people - mounting defense mechanisms to prevent succumbing to the stress.


Until the notion of learning to be mindful was introduced by Kabat-Zinn in 1978, therapists had lacked short order ways to altering the personality abd its rigidity. It was seen to be a structure that had both a highly fixed awareness and understanding of what was going on, and a fixed way of acting. But when mindfulness was introduced, an awareness dawned that there was a new element which could alter how the personality functioned - The patient’s ability to be present objectively to what is going on - what mindfulness therapists speak of as “taking the position of the witness.”


Therapists have three entry points - the patients capacity to be present (which exists usually only as potential at the outset) and the patient’s awareness of her current state. and the patient’s ability to take action (which at the outset is the most resistant to change.)


By acupuncture activation of the first entry point, tantamount to turning on a whole new brain layer, the personality is seen to take on new complexity and a new social competency - all accounted for by mindfulness.



3.


Mindfulness-Based Diagnosis


Mindfulness arriving on the scene has resulted in a mindful approach to diagnosis, though this only gradually developed, and only now (2014) is becoming more clearly articulated by clinician-researchers like Ellen Langer at Harvard (The Power of Mindful Learning.) Suffice it to say that diagnosis from a mindfulness perspective includes the therapists’ own mindful shifting emphases to the place where the subject finds themself at any given moment. This allows us to know what to do next - so that they make the diagnosis, not us. After all, it’s they who will take it on the road.


Five-point ear acupuncture works (in part) by activating the brain's capacity for mindfulness, without a mediating vehicle like meditation. It switches on the parasympathetic nervous system, making it easier to get there. When Dr. Michael O. Smith suggested that some of us adapt his methodology (called AcuDetox) to stress management, he warned that he intentionally applied no verbal form of therapy with the acupuncture and taught no technique. This seemed strange but it was accurate - as acupuncture works, early-on, on subcortical limbic brain structures, not the cortex where words are generated. His patients sat quietly or chatted among themselves but there was no therapeutic intervention. Early on, my acupuncturist colleague treated each patient individually, as in regular acupuncture. Patients lay on the bed and received their treatment with no one else in the room and no conversation. Fully 60% of those treated early-on with 5-point ear acupuncture, with no therapeutic conversation at all, had remarkable relief from their stress, while the other 40% felt nothing. Those with results spontaneously became mindful (a state quite evident in their alert faces.)


I didn’t doubt that Dr. H.L.Wen, the method’s discoverer in the early 70’s had painstakingly researched how many treatments were needed so its effect reached everyone. He’d actually said that 15 treatments sufficed to have everyone feel the effect, so after while I thought we could be doing better. Not everyone was feeling it - after 10 years of doing it nonverbally.

The Colours (RESOURCES)

Our results were quite good but not as good as Smith's 85% relief from addiction - which was seen as the “gold standard” AcuDetox providers expected to achieve. One monumental thing we had note d at the outset was that when, being prior group therapists, we assembled our subjects
a month or so afterwards, they were exceedingly social, animated, curious and often brilliant mentally. Their lively stories were of life working. Of course, not all of them attended. Those who were not yet animated soon were, and our results improved 15%. What we were noticing were the “colours.” We soon saw that three unique conversations springing up spontaneously in the room. Each was exhibiting a freedom from the rigidity of one of Karen Horney’s personality styles. Those we (arbitrarily) called REDs were becoming newly compassionate, so we called compassion and empathy RED. BLUES were becoming spontaneous, decsiive and active, instead of withdrawn and resigned. GOLDS were becoming calm, flexible and insightful/intuitive instead of anxious, fearful and panicky.




4.

Metaphorical Understanding

They weren’t real colours  - but metaphorical (as often newly understood things are) - seen in people congregating excitedly with others with results similar to theirs. Mindful diagnosis, identifies newly-positive competency, not the usual unwanted negativity. This quite clearly worked, so we kept it.

As fundamental differences in temperament showed up, early after starting Smith’s ear acupuncture as Red-tinged, Blue-tinged or Gold-tinged phenomena, we introduced an understanding of how this originates (and where it is all headed) as it is portrayed by several researcher/authors (discussed in particular on Page 9) providing clients with a sense of what to expect in an aftermath of integrating what bubbles up in short order.


I start, showing (in the right column) the two brain functions which are “in play” during the mindfulness-neuroplasticity aspect of AcuDestress as metaphorically being held up by car jacks, showing the support they need as we begin. Stressed people have the ability to act, but success often eludes them. Ear acupuncture works (as will be shown show on Page 7. ) at the hypothalamus-amygdala axis of the brain’s subcortical organizing centre, scrambling the message systems which contain stress-creating patterns - essentially defanging addictions to certain lethal behaviours.


At the outset of AcuDestress, I explain out-of-the-ordinary phenomena which will start to happen, demystifying the unusual, often inexplicable experiences, which nevertheless can/will make sense over time.


I compare
them to thinking of an old friend that one hadn't seen for years, and just as the thought is fresh in one’s mind, the phone rings and it’s the friend. Several such “phenomena” happen among group members, and are the premier topic of conversation in the group. While not everyone  has phenomena, everyone sleeps better and has more energy during the day, typical of the rebalancing which us happening at the subcortical level.


Phenomena aren’t unique. But people usually just enjoy such experiences, but extinguish them soon after, as there's no place for them in our lives. The phenomena that occur (and even if they don't) are precursors to the personality’s emerging ability to morph itself into a more mature form.


Recipients are asked not to take any action to support what’s happening, and I explain (again) that we don't want anyone to be acting based on their old way of functioning. They start to have inexplicable experiences of being able to be present to themselves, to be able to listen to classical music and tell where it registers in their own bodies. If nonplussed by this, they soon see that in what we call the Odd Man Out Exercise that they are able to, at least temporarily, neuroplastically rid themselves of of their most resistant patterns related to helplessness.




5


Seeing that they can choose presence over helplessness may not have a further effect right away (but it may, too) other than letting them know what “taking the position of the witness” is like in a hands-on way, and how, somehow, when they do so, their old defensive patterns melted away (usually) temporarily. It’s a good start - and maybe more.


Once they have had an experience of being present, in the midst of situations they could hardly tolerate before, an imbalance occurs between this capacity and their understanding of everything it implies. But repeating it under less than ideal conditions (which is not action as it doesn’t ask them to do anything that requires anyone else to join) can give new insight and understanding - which is needed to further the process and bring the two aspects they’re working on back into balance.


Note that in the diagrams to the right, at times at least, presence and awareness come into balance as a kind of epiphany. As that happens one experiences grace, dignity and beauty, which creates an opening to more.



Action is still kept waiting in the wings (till after the session) to be informed by the continuing/repeating, gradually established sequence of presence and awareness. As such they’re doing what they’re meant to be doing, or what is necessary to perpetuate presence.




6.


The End Game and The Matter of “Diagnosis”


Now well into the session, with participants already alternating between  presence and awareness, we present Colour Panels made up of people who’ve successfully weathered the integration stage, to give our subjects an idea of where they're headed and how to get there. It reminds me of an old joke, so I often tell it at the time...

An airplane flying from Toronto to Vancouver was caught up in some considerable turbulence. In time the captain came on to the intercom saying: “This is the captain speaking, we've been experiencing an adverse weather condition. I have some good news and some bad news. The bad news is that we have a problem. All of our navigation equipment has gone kablooey, and frankly we don't know where were headed. The good news is that we have a great tailwind, and are making great time.”

A conventional diagnosis is almost always bad news. And the conventional good news is usually something cooked up to counter the bad news (“Don't worry, we can treat it.” ) Here, we assist them to reorient themselves by their spontaneously seeing abd identifying with their RED, BLUE or GOLD colour (which represents the direction they’re heading and the ability which goes with it) while giving them the option to see the influences of their past on how they see their world as : Larger-Than-the-World, Must-Adapt-to-the-World or Smaller-Than-the-World. These discriminations pinpoint their early origins, the shaping conditions of their early family life. There is nothing pejorative about any of these - and we don’t want there to be.

As for their  metaphorical colour, it springs naturally from their getting a taste of their destination (i.e.maturation.) The  identification of their colour  invokes: “Hmmm, if I'm feeling clarity, focus and perspective where I came in feeling chaos, it must be that I'm meant to be heading in the GOLD direction. As I notice seeing myself in that way I feel more and more alive!”

This is all good news, but it’s admittedly “in house talk.” It's up to them to get a grasp of it, not their spouse, their friends, not even the clinician who sent them necessarily (unless he or she understands, or wants to understand what is in play here.) It is, by the end of the session, a call to action. It’s saying to themselves that they’ve experienced enough presence to be able to maintain it for some time, and enough awareness to claim a new maturity. We write it this way (coloured boxes below) on their chart, complete with a linked way to go to our web site and understand it better.

As this  way of working is new to the 15 clinicians at our Community Health Centre   we hold regular educational events and OTN broadcasts which allow the clinicians to make full sense of the work we do, and after a year and a half of continuous educational work, they’re catching on.


See: http://www. acudestress.ca/Why_Mindfulness-based_ Diagnosis.html













(Part 2: Researcher-to-Researcher Is seen HERE.)

 


Stanislav Grof is one of the original  pioneers of transpersonal psychology following on it’s originators, Dr. Abraham Maslow and Dr. Roberto Assagioli.

Transpersonal psychology is a sub-field or "school" of psychology that integrates the spiritual and transcendent aspects of the human experience with the framework of modern psychology.


The transpersonal is defined as "experiences in which the sense of identity or self extends beyond (trans) the individual or personal to encompass wider aspects of humankind, life, psyche or cosmos". It has also been defined as "development beyond conventional, personal or individual levels".


Elements of transpersonal psychology include spiritual self development, self beyond the ego, peak experiences, mystical experiences, systemic trance,  spiritual crises,  spiritual evolution, and other sublime and/or unusually expanded experiences of living. The discipline describes and integrates spiritual experience within modern psychological theory and to formulate new theory to encompass such experience. How transpersonal psychology became a part of AcuDestress is seen on Pages 9-10)


The AcuDestress entry point is “I’m not managing stress well!” voiced by people all the way from those in deep psychosis abd personality disorders to those operating beyond normal but who hit some snag keeping them from moving forward effectively. Most of our patients have tried several other approaches, including medication without success. The snags can be more physical, less psychological. Today we call these mind-body issues and treat them using skills from both disciplines


Like the therapist
esteemed by most North American psychotherapists of my age, Carl Rogers who most influenced my style, I see myself as a Rogerian (1% of therapists surveyed said they  practiced Rogerian therapy, yet 31% said they were most influenced by his style - versus  the 68%+ majority
who are (CBT) Cognitive Behavioural Therapists.  As his wrk influenced me as a program designer I was influenced most by the later CBT  version initiated by Martin E. Seligman. Seligman’s work with pessimistic 10-11 year olds which transformed them into optimists during only 12 hours of contact earned him Psychologist-of-the-Decade honours in the 90’s - and grabbed my attention. Much of my design incorporates his use of pleasant surprise. 


Rogers based his “client-centred” approach on three tenets I now use - "unconditional positive regard" (full acceptance of clients as they are); “empathic understanding of clients, clearly communicated to them; and "congruence," or being authentic, genuine, and transparently "real."


“While Rogers recognized our species' capacity for cruelty, destruction, immaturity, antisocial behavior, and all-round nastiness—he believed deeply that all human beings trend in "basically a positive direction," inherently "forward moving, constructive, realistic, trustworthy...


...Clients didn't need to have their words "interpreted" back to them. What they needed was the undemanding presence of a compassionate, deeply attuned listener, who didn't diagnose them, explain their problems to them, ask many specific questions, lead them in particular directions, or tell them what they should do.”          

                       Psychotherapy Networker

                            February-March 2007






Dr. Michael O. Smith launched his  psychiatric career at the Lincoln Hospital in the toughest area of New York City - young, creative, impetuous - like most of us early in our careers.

So in 1974, seeing neurosurgeon Dr. H.L. Wen report in the literature that addiction fell off in short order when ear acupuncture was used, he substituted it for methadone in the Lincoln Hospital’s 3 to 5 year treatment of heroin addiction.

Smith, experimented, finding that after 3 weeks of 5-point ear acupuncture (AcuDetox) his recipients were free of addiction. As often happens when a new and successful entity arrives, vested interests, afraid for their jobs, see nothing good about what’s new. Blind to it - they don’t see they are. It would be years before a  headlight-startled addiction community got on board. Now they are, getting there much as seen in this unrelated video  by being hands-on.

Dr. Smith soon realized that acceptance required a constituency without vested interests, one faced with addiction and having absolutely noway to address it. He thought of the judiciary who were seeing subjects on their way to prison who had committed minor recurring crimes largely associated with their addiction to drugs and alcohol.

He approached the Miami
Drug Court in 1979 to offered his methodology. In an independent third party study, inmates were
freed of their addictions. The surprise was that they also lost a proclivity to criminality.
Recidivism fell
from 44% to 3% and stayed there.  See a reference to the use of  the 5-p0int ear acupuncture protocol at the Miami Drug Court  here. AcuDetox remains in use in the Miami Drug Court and other drug courts. AcuDetox has also become established at three University of Toronto affiliated hospitals with great success and global OHIP funding and has received legislative endorsement





Dr Smith talks about AcuDetox and the World Trade Center disaster (911)

in  2013 (Ontario Bill 50 Traditional Chinese Medicine Act.) Smith became well known for opening the doors of the Lincoln Hospital to an overwhelmed New York City the day after 911. He is now retired having spawned 1500-2000 AcuDetox clinics worldwide.





Action makes  the presence and awareness of AcuDestress part of us (i.e embodies it). If it’s just some technique they use on Saturday night to make their world better, it will soon peter out. What if, instead, it got progressively better? Here’s a metaphorical representation of where they were at the outset:





We’ve been telling t hem that there’s no need to take action, make an effort or use will power to change anything (during the session). This applies throughout. The RED line (above) represents their ability, at the outset, to act on their world in an effective way, needing outside support (e.g. medication) like a disabled car due to flat tires, it’s seen here resting on two car jacks. Then 5-point ear acupuncture arrives and the ability to be present rises a notch...





At the outset, they don’t know what is involved in phenomena - being able to be present - but we continue to talk about it, they bounce it off others, listen to others, and, in time, their awareness of what’s going on increases. Considerably!














Note that the ability to be present and the awareness and understanding come to a balance. Then more presence intervenes during or after the Odd Man Out Exercise throwing things into imbalance again...



There is some likelihood that further understanding and insight, even intuition occurs to restore the balance again by the end  of the session..



But now  awareness and the ability to be present have risen and are out of balance with the ability to take action, which had been suspended .





So, integration of ones new state of being, if it is to stay around, needs to be met by action which rebalances one’s approach to life - but at a higher, more complex level than previously...




This call to action is the leg of the journey upon which they are now embarking, and can well do mostly on their own. But we’ll help if needed...

_________________________


When it comes to diagnosis, mindfulness-based therapists want their now-mindful patients to be full participants in determining whatever descriptor they will be working with in the aftermath. They will be doing much of their own work in this day and age of increasingly-utilized “limited engagement” working arrangements. we are past the days when therapy that goes on indefinitely will be paid for by insurers. So, like Martin Seligman, who has influenced my other design projects, I want to send patients out with a positive and hopeful honnicker.


The RESOURCE which either has emerged or is on the verge of emerging, results in a note like the one on the right, depending on their own understabding of what is emergent in them. While they occasionally  see things differently over time this completes the patient’s discharge summary, after thorough discussion at out-take, with plans for expanding it over 6 months discussed as well.

 

_______is a Hornevian Withdrawing (BLUE)  See web page: http://www.acudestress.ca/Work/BLUE.html  whose early family environment has dealt her a Larger-Than-the-World viewpoint on life, meaning that she sees her life as not very sympathetic to her sometimes elevated views of what is possible. This task then, is to more realistically assess others and to temper her relationship with them with realistic expectations.

______is a Hornevian Compliant (GOLD)  See web page: http://www.acudestress.ca/Work/GOLD.html  whose early family environment has dealt him a Must-adapt-to-the-World viewpoint on life. He has spent his whole life around environments which have induced him to live in fear, and it is no surprise that he would develop a autoimmune disease in response to other probably very high cortisol levels. He will require something more than I can offer, we

agreed in unison.

________ is a Hornevian Aggressive (RED)  See web page: http://www.acudestress.ca/Work/RED.html  whose early family environment has dealt her a Larger-Than-the-World viewpoint on life. Parents and siblings gave her much praise/support so she has devoted her life to doing things to get acknowledgment. Her task at this point will be to be her own source of acknowledgment. Needs to be flexible and put things in perspective.