Posts Tagged ‘acupuncture’

Controversy abounds in medicine, especially when it comes to alternative forms of treatment, but there is one thing that almost everyone agrees on: feeling calmer and more

relaxed is good for your health. There are many ways in which a person’s mental and emotional state can affect their allergies or other sensitivity reactions (see pp. 232-7),

and these help to explain the beneficial effects of relaxation.
There are several different types of approach that can help in the quest for a calmer state of mind and a more relaxed state of body:
• Straightforward relaxation techniques which you learn and then practise for yourself, either on a daily basis, or whenever you need them, or both. Examples include

relaxation exercises of various kinds, biofeedback, autogenic training and self-hypnosis.
• Relaxation techniques that are rooted in spiritual practice, such as meditation, yoga, t’ai chi or chi kung (ql gong). Some other martial arts, in addition to t’ai chi,

also have a strong element of spiritual practice.
• Treatment techniques such as massage, aromatherapy, reflexology and short courses of hypnotherapy, that are intended to help you feel more relaxed. Acupuncture (see p.

214) can also have this effect. Some therapists providing this type of treatment will also teach you simple relaxation exercises to use at home.
• Investigative approaches that look into the fundamental causes of tension, and attempt to deal with deep-seated emotional problems: psychotherapy (in its many different

forms), psychoanalysis, long-term hypnotherapy when this has psychotherapeutic aims, and biodynamic massage.
In the long run, approaches that make you dependent on another person (an aromatherapist or reflexologist, for example), in order to feel relaxed, are usually less helpful than

those that give you an active role. If you are learning and practising a technique, as with relaxation exercises or yoga, this puts you in charge of your state of mind.
The techniques that are rooted in spiritual practice, especially meditation and yoga, are particularly helpful because they invite you to take a very broad view of the problems

that face you, and the situations that cause you stress. Firstly, rather than focusing very narrowly on your own tense muscles and recurring difficulties, they look at the human

situation as a whole – at the basic causes of tension and unhappiness in human beings. Secondly, rather than trying to graft a relaxed viewpoint onto a horribly unrelaxed daily

existence (which is what most of us now endure) a regular meditation practice can result in a fundamental and long-lasting change in outlook, with a greater sense of wholeness,

direction and stability. This is something that happens naturally within the stillness of meditation practice, and it should be very much an individual process of change, not

something imposed from outside. At a purely practical level, a spiritual practice tends to improve relationships with other people, and since a great deal of our stress is

caused by the people around us, any improvement in our social interactions can reduce stress enormously.
Some kind of psychotherapeutic approach may be the best choice for those who have tried and failed with other techniques, or achieved only a temporary reduction in stress

levels. By tackling the problems at a deeper level, it is often possible to achieve a more profound and long-lasting solution.
Many people discover that, whenever they try to relax or to meditate, they feel even more agitated and anxious. Others begin to cry, or show other signs of distress. Not

surprisingly, people who react in this way quickly give up their attempts to unwind, because their responses are so disturbing. Underlying these reactions to relaxation

exercises there may be deep-seated problems, usually going back to childhood, that can only be held at arm’s length with the help of a tense and always-busy approach to life.
Constant mental activity is part of this defensive strategy, which is why relaxing or meditating is such a frightening experience. Although it is tempting to run away from the

problem, by plunging back into a life of frenetic activity, mental and physical, this is ultimately no solution. Some form of psychotherapy is usually needed to deal with these

long-standing problems.
Whatever you decide to try, make sure that the teacher or therapist seems a calm and relaxed person. You should also look for someone who is sympathetic and supportive about

your illness. Avoid like the plague those who attribute all allergies and other physical symptoms to mental or emotional problems. Such people can cause immense psychological

damage – if you don’t get 100% better it will, of course, be your fault.
Hypnotherapy
Hypnosis has a distinctly shady reputation, because of its use – or misuse – in stage and television performances. If hypnosis were not so valuable medically, it would probably

be rejected entirely by conventional medicine, on the strength of this reputation. The fact that hypnotherapy is used by some entirely mainstream doctors, as a legitimate

treatment for conditions such as atopic eczema, is a great testament to its effectiveness.
Hypnosis is certainly a mysterious phenomenon, and it is difficult to say exactly what happens when a person is hypnotised. Dr Ruth Lever, a qualified doctor who combines

hypnotherapy with conventional medical practice, describes the hypnotic state as ‘not a form of unconsciousness but rather an altered form of consciousness, in which the patient

is more open to suggestion than he would normally be, and in which a corridor is opened between the conscious and the subconscious mind’.
It is certainly not true that the hypnotised person is under the control of the hypnotist or hypnotherapist. Autonomy is retained, and no one under hypnosis can be forced to do

anything that is really against his or her will. While the person may experience a different state of mind, he or she remains aware of what is going on in the room and anything

that is said.
The exact change in mental state during hypnosis varies greatly from one person to another. Some people respond far more readily than others, and go into a deeper hypnotic

state. (These same people are more susceptible to placebo effect, a psychological response to drugs or other forms of treatment –see p. 233.)
At one time, it was thought that only adults could be hypnotised. Children seemed to be immune to hypnosis, but in fact they are just immune to the particular hypnotic

techniques used for adults. With the right techniques, children can also be hypnotised.
Hypnotherapy treatment can be quite brief, taking only a few sessions. This approach relies on suggestions from the therapist to achieve relaxation, a change in perceptions

(e.g. that the skin feels cool and smooth, for someone with atopic eczema) and a change in habits (e.g. stopping scratching).
Another approach is to use hypnosis as a means towards achieving personal insight into emotional problems by accessing suppressed memories. This is a long-term treatment, which

has much in common with psychotherapy. It should only be practised by those who have full psychotherapy training.
Scientific studies show that hypnotherapy can be of benefit in both asthma and atopic eczema. Make sure you get a really well-qualified hypnotherapist –preferably someone who

also has conventional medical training, or psychotherapy training, and plenty of experience.
You may be given exercises in self-hypnosis to do at home, or tapes, possibly music tapes to be played at bedtime for children with eczema. These can be very useful in

reinforcing the messages from the hypnotherapy sessions about sleeping deeply and not scratching,Relaxation exercises
Acquiring the knack of relaxing is a very personal thing – what works for one person will be useless for another. You may have to try several different techniques before you

find one that is right for you.
Guided imagery is often an effective method, and increasingly popular with the widespread availability of relaxation tapes. The tape will ask you to sit in an armchair, or lie

down, and picture the scenes described (’waves are lapping gently on the golden sand…’ etc.). If you are able to visualise the scene, this should induce a more relaxed state

of mind – rather like the relaxation you get from watching a good film.
There are also tapes of special music, or music combined with natural sounds (waves, seagulls etc.) that are intended to produce a relaxed state of mind. Much of this music is

incredibly banal, and it may irritate you more than relax you! However, there are also some excellent tapes available, so shop around.
One time-honoured method of relaxing is to sequentially contract, and then release, muscles in each part of the body, beginning with the hands or feet. This is known as

Jacobsonian systematic relaxation training or progressive muscle relaxation. A study of children suffering from asthma found that this training increased the peak flow by an

impressive 32% for some children, although others did not do quite so well.
Autogenic training
Based loosely on self-hypnosis, autogenic training is a very down-to-earth approach to relaxation which may be useful for anyone who is wary of things esoteric. You are taught

to concentrate on different parts of your body in turn and imagine them growing warm and heavy. Beginning with ‘my right arm is heavy and warm…’ (repeated three times, either

out loud or in your head) you work your way through the rest of the body: ‘my left arm…’ , ‘both my arms…’ , ‘my right leg…’ etc.
You could, in theory, teach autogenic training to yourself, using a book, but it is helpful to have to go to a class. The teacher can encourage you to persist when you feel

discouraged by your slow progress, and can help with any problems that arise.
Teachers of autogenic training often add more specific lines at the end of the exercise, such as ‘my breathing is calm and regular’ for asthmatics, or ‘my skin is soft and cool’

for someone with eczema. A study of asthmatics found that they performed better in basic lung-function tests after eight months of regular autogenic training.
Autogenic training can sometimes evoke strong reactions if there are long-standing problems or suppressed feelings and memories. In these situations, the training sessions may

need to incorporate some elements of psychotherapy. Teachers vary in the extent to which they can offer this.
Yoga
Yoga, in its original form, provides a complex religious philosophy of life. If followed with dedication, it affects the whole person –physical, mental, emotional and spiritual.

Those who have practised yoga seriously for many years achieve a great deal of mental focus and calmness, plus a surprising level of control over bodily functions such as blood

pressure and heart rate. These profound changes are achieved through a combination of breathing exercises (pranayama), yoga postures (asanas), meditation, cleansing practices

and careful attention to diet and way of life.
Yoga has now been practised in the West for over a century, and during that time it has been watered down and very thoroughly Westernised. There are now forms of ‘yoga’ that

consist of little more than stretching and relaxation.
For the greatest benefits from yoga, look for classes with a more rigorous approach. If the particular kind of yoga is specified, e.g. Hatha yoga or Kundallni yoga, the chances

are that you’ll be getting something more authentic,
lyengar yoga is the most common form taught in the West, but it is rather narrow, concentrating almost entirely on postures. A form of yoga that includes breathing exercises is

probably more useful, especially if you have asthma.
Before you sign up for a class, talk to the teacher and find out what it includes. If you are asthmatic, make sure the teacher is really experienced in working with asthmatics.

It is all too easy to get the yoga breathing exercises wrong, making the breaths too deep. This can turn into a form of hyperventilation (see p. 226).
Approaching the breathing exercises with a ‘got to get this right’ attitude is another pitfall for Westerners doing yoga. Most of us have the unfortunate habit – acquired in

early childhood – of tensing up and ‘really trying’ when we are taught anything. This is a major obstacle to doing yoga breathing correctly. Eastern attitudes are much more

easy-going and this helps asthmatics much more, because relaxing as you breathe is the key to it all.
Meditation
Basic meditation involves stilling the mind – either emptying it of all thoughts, or focusing it on one very simple object. This is fantastically difficult for most people at

first, but with time, and regular daily meditation, it gradually becomes easier.
Many different forms of meditation exist. Most are part of a spiritual tradition such as Hinduism, Sri Lankan Buddhism, Tibetan Buddhism, Zen Buddhism, or Taoism (Daoism).

Meditation also forms part of yoga, and it is a cornerstone of most martial arts, though this tends to be played down when these are taught in the West. In each case, meditation

takes a slightly different form and has different psychological effects.
A practice known as transcendental meditation (TM), is one of the most widely available – the teaching is arranged by a large international organisation, and can prove

expensive. It is cheaper, and probably better in the long run, to go to classes in a local Buddhist centre or consult one of the many books and tapes on this subject. ect.
Biofeedback
This is the most thoroughly scientific, rational and high-tech of alternative treatments. Biofeedback uses technology to measure the state of some part of your body – a part

that is usually under automatic control, such as the electrical activity in your brain –and relays this information back to you (hence bio-feedback) .
The feedback is shown by means of swinging needles on dials, flashing lights or bleeping sounds. The idea is that you gradually learn to influence the signal, by noticing that

it has changed very slightly in the desired direction, and then re-running (in your head) the thoughts or feelings which apparently led to that change.
In quite a short space of time, you can, with this method, alter bodily states that are beyond voluntary control in most people. Scientific studies show that biofeedback can

teach people to regulate their heartbeat, for example, or reduce the amount of acid produced by the stomach. Although yoga practitioners have long claimed to be able to

influence such bodily functions. it was only with the invention of biofeedback that scientists accepted this was possible.
Biofeedback can also teach asthmatics to relax tight airway muscles, something that has been demonstrated convincingly in scientific trials. Unfortunately, the specialised

equipment needed for this particular form of training is not generally available.
If you sign up for biofeedback, you will probably be trained with equipment that measures the electrical resistance of the skin (this varies with how tense you are) or the

electrical activity of the brain. This kind of equipment can help you learn to relax at will.
Massage and aromatherapy
There are many different varieties of massage, and most are relaxing to some extent. Regular massage treatments may improve your general sense of calmness and your ability to

cope with life’s stresses and problems. In the case of long-standing asthma,
massage may also help with tension in the muscles of the chest, back and neck, which frequently develop during asthma attacks.
Aromatherapy is really a form of massage, with the use of scented oils. Bear in mind that the strong smell of some oils can provoke asthma attacks (see p. 39), while other oils

can irritate the skin of people with atopic eczema or contact dermatitis.
Biodynamic massage involves a much more subtle touch than other forms of massage and it has different aims. The central objective is to identify bodily tensions that are a

result of repressed memories or blocked impulses, and to rebalance the energies of the body. Think of this more as psychotherapy than as massage. It can be very helpful.
Reflexology and zero balancing
Reflexology is based on the belief that specific zones on the soles of the feet correspond to particular parts of the body, and that stimulating those zones on the feet (by

gentle pressure) can induce a healing process at distant points in the body. It may or may not be true – certainly, having your feet massaged is immensely pleasurable and can

induce a profound relaxation.
Zero balancing is a sequence of static touch, gentle holding and light pressure, applied to specific parts of the body. It can induce a state of great well-being and calmness.
Psychotherapy
The basic tenet of psychotherapy is that it is much more painful and exhausting to keep on repressing bad memories than it is to bring them out into the open, in a safe

therapeutic situation, which allows you to process them and move on. Dealing with deep-seated problems lets you relax and live life more fully. In some cases it may help with

physical symptoms, such as allergies.
There is a bewildering choice here, with so many different varieties of therapy on offer. Fortunately, according to recent research, they a// work to about the same extent, as

long as you have a good rapport with the therapist. But if you don’t click, the therapy usually doesn’t work, however expert the therapist might be. So make sure you have an

introductory meeting before committing yourself to a course of therapy, and don’t be afraid to say ‘no’ and try someone else, if you don’t feel quite right with the therapist.
Counselling can also be valuable, and again you will do much better with someone you feel at home with, but who is not afraid to challenge you when necessary.

‘I get ill if I do a long coach journey - six or seven hours say. I usually feel sick by the end of the journey, and have a headache. The funny thing is, if I’m walking along

the street and I happen to see a coach of the kind that I do long trips on, I feel a bit sick then too, just for a short while. It seems crazy, but I get ill just from seeing

the coach.’
What Jake is observing is the powerful effect of the mind on the body, in the reaction known as conditioning. Some people are more susceptible to it than others, but no one is

completely immune.
The Russian scientist Ivan Petrovich Pavlov first demonstrated conditioning in 1889, with his famous dog-and-dinner-bell experiment. Pavlov rang a bell every time he fed the

dog, and eventually the dog would salivate each time it heard the bell, whether dinner was being served or not. Its stomach would also begin to secrete acid, in anticipation of

the meal, simply on hearing the bell.
Modern-day experiments have shown that conditioning works with immune reactions too. For example, rats can be conditioned by repeatedly giving them an immunosuppressive drug and

always adding saccharin to their drinking water on the day the drug is given. Subsequently, just the taste of saccharin in the water is enough to- suppress their immune

responses.
This surprising discovery is partially explained by the finding that there are nerves running to the lymph nodes – key areas where the immune responses are coordinated. In other

words, the immune system and the nervous system, once thought of as completely separate domains, are in conversation with each other. In fact this is a three-way discussion,

because the hormones are also involved. The study of these complex interactions,
which we are only just beginning to understand, is known as psychoneuroimmunology.
Even before Pavlov carried out his classic experiment, Dr John MacKenzie of Baltimore had discovered that an artificial rose, in the vase on his desk, would bring on an attack

of rhinitis and asthma in one of his patients who believed that she was allergic to roses. (In fact such an allergy is unlikely –see box on p. 127. It is usually the strong

scent that triggers symptoms, the allergy being to something else, often grass pollen, which is in the air when roses flower.)
Much more recently, something similar happened – this time unintentionally – when a boy with severe hayfever and pollen asthma was undergoing hypnosis aimed at helping him

relax. Part of the hypnotist’s standard technique was to describe an idyllic scene in an alpine meadow, and ask the subject to imagine being there. For this boy, it worked all

too well – the thought of the grass pollen in the meadow brought on a severe asthma attack. The hypnotist, with great presence of mind, asked him to imagine a helicopter

suddenly appearing in the sky and rescuing him from the meadow – and the asthma attack subsided. How allergies affect the mind
In studying the psychological aspects of allergy, researchers have discovered that some patients frequently have thoughts that catastrophise the situation. In the case of atopic

eczema, these thoughts might go along the lines of ‘this terrible itching will never end’ or ‘none of the treatment really makes much difference’.
Such thoughts may be just below the surface of the conscious mind most of the time, and it is only by developing the ability to notice what is going on internally that the

allergy sufferer can become aware of them.
Researchers have also found that, when negative thoughts such as these arise, eczema sufferers are far more likely to scratch their skin and so make the eczema worse. Thus the

thought becomes a reality – a self-fulfilling prophecy.
The tendency to catastrophise difficult situations is something that most people develop (or acquire from others) at a very young age, and it may take some effort to even become

aware of this mental habit, let alone change it. Yet it is possible to start thinking about illness, and about life in general, in a different way – for example, as a difficult

challenge but one that can usually be overcome.
Allergies are in no sense unique. Any long-term disease that causes intense discomfort, makes life unpredictable or limits your activities, is bound to have profound effects on

the personality. However strong a person you are, it affects your life, and influences you in a very deep way – shaping you as a thinking and feeling individual. This is

especially true if illness begins at an early age, becoming part of your formative interactions with your parents (see box on p. 233) or marking you out as different from other

children.
This shaping can have both positive and negative aspects, and it is important to recognise that there is a choice about which aspect you emphasise. It is never too late to try

to change the emphasis. Counselling or psychotherapy (see p. 225) may help with this, especially if the counter-productive attitudes to the illness are deeply rooted in family

experiences.
The role of the mind in asthma
The diagnosis of intrinsic asthma has long since been abandoned. This diagnosis, which was commonplace in the 1950s and 1960s, technically meant ‘asthma with no external cause’.

But the widespread assumption was that the cause was psychological. As older asthmatics will tell you, this made their lives particularly miserable, because they were held

responsible for their disease. Families were often ashamed of having an asthmatic child.
The injustice of this sweeping assumption is clear today. Modern research shows that an external stimulus which initiated the asthma, such as an allergen, can usually be found.

Among asthmatic children, an allergic cause exists in 80-90% of cases. Even where no specific stimulus can be found, there is still a clear-cut state of inflammation in the

airways. No one with any knowledge of asthma would now claim that it is an entirely psychosomatic disease, nor even that it is predominantly psychosomatic.
Nevertheless, once asthma has begun, the mind may play an important role in bringing on attacks, or making them worse, as many asthmatics know from their own experience. This is

entirely understandable when you think how closely breathing is tied up with our emotional lives – fear, sadness, excitement and anger all alter the usual breathing pattern in

different ways, and any of these reactions may trigger an asthma attack.
The interactions between the mind and the airways are complex in the extreme, and vary from one person to another. Anxiety and tension can make asthma a great deal worse for

some people, while others only suffer an asthma attack when the stress is over. A few people actually have less trouble with their asthma when under stress and, oddly enough,

this is the reaction that is easiest to explain. Stress activates the sympathetic nervous system (see box on p.235), which produces adrenaline, and the adrenaline opens up the

airways.
For stress to make asthma worse, as it frequently does, there must be some other reaction going on which overrides the effect of the adrenaline. Doctors don’t know exactly what

this is, but asthmatics who get worse when stressed could be hyperventilating (see p. 226) just a little – not enough for it to be obvious, but enough to make their airway

muscles contract.
Breathing through the mouth, rather than the nose, can also occur under intense stress, and this is bad for the airways because the air they receive tends to be drier, dustier

and possibly colder, for not having passed through the nose first. This raw air may irritate the sensitive airway linings of an asthmatic, and so make the airway muscles

tighten. Small local nerves, that run directly from the airway linings to the airway muscles, could cause this reaction.
Scientific tests, carried out in a laboratory, back up these casual observations. For example, many people who are allergic to grass pollen will suffer an asthma attack if the

experimenter says they are inhaling grass pollen through a mouthpiece – even though they are actually inhaling fresh air.
It can work the other way as well. Telling the same asthmatics that they are now inhaling a reliever drug will stop the attack, even though they are still breathing the same air

as before. This is the basis of placebo effect, the benefit that tends to occur with any treatment, even a dummy pill, as long as patients believe that the treatment will work.
Note that it is not necessarily the immune system producing all these reactions. There are also direct effects of the mind on the skin, in atopic eczema, on the airway muscles,

in the case of asthma, and on the nose, in rhinitis. Some of these are due to the autonomic nervous system (see box on p. 235) while others are much less well understood.
The findings described above should be reassuring for anyone who has noticed that their allergy or asthma symptoms are sometimes affected by their thoughts and feelings. There

is no need to feel bad about this, and it certainly doesn’t mean that your allergies are ‘all in the mind’. Conditioning, and other psychological responses, are an entirely

natural reaction to a very real illness.
However, if you suspect that psychological reactions are making a big contribution to your symptoms, you could try to address the problem directly. Hypnotherapy (see p. 223) can

be particularly useful in this regard, because those who are most susceptible to conditioning are also very responsive to hypnotic suggestion – which can counteract the

conditioning messages. Hypnotherapy can also help those asthmatics who
become psychologically dependent on their inhalers – something that happens quite often, especially in people with severe asthma. In the words of one asthmatic ‘If I found that

I’d left my Ventolin at home, that would sometimes start me off wheezing straight away. I was so afraid of being without it.’ Of course, it is important to carry your reliever

inhaler with you at all times, but this kind of excessive psychological dependence is distinctly unhealthy. At worst, it can lead you to over-use your reliever inhaler, which

can increase your risk of a life-threatening asthma attack (see pp. 153-4).
Sometimes the psychological effects involved in allergies and asthma are far more complex and deep-rooted than this, not just a matter of simple conditioning. It is not uncommon

for asthma attacks, in particular, to be provoked by family tensions and anxieties, or by suppressed memories from childhood. This can occur even though the asthma also has a

clear-cut physical cause, such as an allergy to house-dust mite. Some people find that their asthma always gets worse when they are in a certain place, with a certain person, or

in a particular situation. These problems are usually helped by psychotherapy (see p. 225).
While hypnotherapy and psychological treatments can sometimes be valuable, it is vital to remember that the mental factors in allergic reactions are always operating in

combination with purely physical responses – such as the triggering of mast cells by allergens (see box on p.12). Using psychological treatments alone is as much of a mistake as

ignoring the mental and emotional dimension of ill-health completely. The two aspects of treatment – physical and psychological – should always go hand in hand. Be very wary of

alternative therapists who overemphasise the psychological aspects (see p. 209).
Under the skin
To see a baby with severe eczema is heart-breaking for any parent – tormented by something it cannot understand, the child often experiences touch, not as a comforting and

pleasurable contact, but as a further irritation. According to some psychologists who have studied eczema in depth, suffering from severely itchy skin in the early years of life

may create long-lasting psychological problems. They believe that the discomfort associated with the skin, and especially with being touched, interferes with normal processes of

relating to the world and developing loving relationships with others. That is why it is so important to get the skin symptoms under control, with the proper use of steroid

creams, skin care, dietary changes if appropriate, and an anti-scratching programme (see p. 47).
Psychological symptoms from sensitivity reactions
‘People thought that because the hospital couldn’t find anything wrong with me, and because I wasn’t terminally ill, there was nothing wrong with me at all. No one could

understand how I was feeling, or even believed me. My friends and family lost patience with me. I overheard one member of my family saying they thought I was just

attention-seeking. This hurt me so much. I hated being ill all the time. I wanted to go out and enjoy myself and do the things I’d always done, but I couldn’t because I felt so

bad.’
Josey, who is now 27, was ill in this way for seven years, and her symptoms were so incapacitating that she had to give up work and abandon any sort of social life. Now, as she

puts it, ‘I have my life back again.’
The cause of her symptoms – dizziness, confusion, panic attacks, depression, shortness of breath, and a conviction that she was dying – turned out to be a sensitivity to

caffeine which was inducing hyperventilation (see p. 226). Giving up tea, coffee
and cola drinks restored her to normality very promptly, and she has not relapsed since, except on one occasion, when she unwittingly took a headache remedy that contained

caffeine.
What is clear from Josey’s story is how much the disbelief of those around her added to her problems. She felt trapped by her symptoms, which she could not overcome, while

everyone around her assumed that the whole problem was in her head, and that she could ’snap out of it’ if she chose to.
The suffering of patients like Josey could easily be avoided if more GPs knew how to recognise hyperventilation. This is one of those conditions that is well described in the

medical literature, but does not always get onto the curriculum in medical schools. As a result, many hyperventilating patients go through a lot of expensive and time-wasting

investigations, and may not get a proper diagnosis even then. This is especially sad when hyperventilation is so easy to diagnose and treat (see p. 228).
While the symptoms of hyperventilation are easy to spot, once you know what to look for, this is certainly not true of all
The autonomic nervous system
The autonomic nervous system is a kind of ‘auto-pilot’ – a set of controls that generally keeps you well adjusted to your external circumstances without you having to think

consciously about the situation at all.
The autonomic nervous system controls all the involuntary muscles – those in the heart, around the digestive system, and around the airways. It also controls the state of the

blood vessels, including those in the skin. The autonomic nervous system does its work by issuing two different sets of signals – one set that gears the body up for action and

one set that calms the body down.
Two completely separate nerve networks, the sympathetic nervous system and the parasympathetic nervous system, issue these different signals. The target organs – the airways,

heart, skin, and so on – all receive input from both networks.
The ‘get active’ signals are issued by the sympathetic nervous system, which comes into play at times of stress, excitement, fear or anger. When you can hear your heart pounding

or feel your pulse race, that is your sympathetic nervous system at work. It also makes your nasal passages and airways open up, because extra oxygen is needed for intense

physical activity, and it tightens the muscles around the blood vessels, which raises your blood pressure.
‘Chill out’ messages are delivered by the parasympathetic nervous system. This network comes on-stream when you know you can afford to relax. It slows down the heart, lowers the

blood pressure, encourages the digestive system to do its work, and makes the airways grow narrower because less air is needed when you are less active.
Adrenaline (epinephrine) is the messenger substance released by the sympathetic nervous system. Its action in tightening the muscles around the blood vessels allows adrenaline

to be employed as a drug, which saves the lives of people affected by anaphylaxis (see p. 150). During anaphylaxis, there is a massive fall in blood pressure produced by

histamine (see box on p. 12), but an injection of adrenaline can reverse this.
Both adrenaline and its derivatives, the beta-2 relievers such as Ventolin (see p. 152), also help in asthma attacks. They do this by making the muscles around the airways

relax.
The messenger substance of the parasympathetic nervous system is acetylcholine. Drugs which oppose its action – the
anti-cholinergics – can also help relieve an asthma attack (see p. 156) by blocking the airway-narrowing action of the parasympathetic.
One of the ways in which acupuncture appears to work is by adjusting the activity of the autonomic nervous system. When
acupuncture is used to deal with the immediate symptoms of an asthma attack, this is probably how it makes the airways open up.
sensitivity reactions. Food sensitivity can occasionally cause some unexpected psychological symptoms, such as bouts of hysterical crying (see p. 80) that no conventional doctor

would ever associate with food.
Inevitably, patients with sensitivity problems such as these will initially be diagnosed as having a psychological illness rather than a physical one. It may be a very long time

before the correct diagnosis is established.
Even if the patient works out the link between eating the food and experiencing the psychological response, the doctor may well remain unconvinced. What complicates matters for

doctors is that quite a few people with genuine psychological problems would prefer to think that these have a non-psychological cause, such as a sensitivity to food. (In the

opinion of most doctors, patients of this kind are far more common than patients with psychological problems that are genuinely caused by food or chemical intolerance.) For such

patients, accepting that their problems have a psychological cause means thinking about what that cause might be – and it is often something deeply distressing which the person

would rather forget.
Unfortunately, for people who get into this situation, the phoney explanation doesn’t actually help at all, though it can provide a temporary distraction. Ignoring unpleasant

hidden memories is not the answer – the problem does not go away, it just festers. Facing up to the real underlying problem is the only way to get rid of the distress (see p.

225).
If you have psychological symptoms of any kind, bear in mind that psychological causes are by far the most likely. Such causes can include difficult life circumstances, damaging

experiences during childhood, loss of close relationships, or extremely traumatic incidents in the more recent past. Where there are longstanding problems, neurological factors

(damage to the nerves or brain) or metabolic factors (something affecting the balance of chemicals in the brain), might also play a part, or sometimes be the sole cause.
For a busy doctor, without much time to spare, it is immensely difficult to distinguish patients who really do have psychological symptoms due to food or chemical intolerance,

from patients with psychological problems that they have mistakenly attributed to an intolerance reaction.
What adds to the difficulty is that, with time, psychological causes can sometimes be grafted onto a straightforward intolerance problem. This occurs because illness of any kind

can produce some psychological problems of its own, especially if the person affected cannot lead a normal life. The psychological effects of the illness invariably get worse if

the person concerned has been treated with disbelief by doctors, family or friends – as
is frequently the case when a person has indefinite long-term symptoms that are due to food or chemical intolerance. Separating the secondary psychological reactions to the

illness (or to the scepticism of others) from the primary psychological symptoms that are genuinely produced by the intolerance reactions is far from easy.
Hyperventilation and chemical intolerance
Hyperventilation (see pp. 226-9) and chemical intolerance (see p. 84) often go hand in hand. A person who is sensitive to airborne items which they cannot avoid inhaling, such

as perfume or petrol fumes, may well feel apprehensive when they catch a whiff of these, and unconsciously alter their breathing in response. They may hyperventilate.
If they do, this can both aggravate the sensitivity symptoms, and increase their anxious feelings – because one key symptom of hyperventilation is anxiety (see p. 227). In this

way the problem begins to feed upon itself, and can spiral out of control.
Hyperventilation, pure and simple, may also masquerade as chemical intolerance. In these cases, a deep underlying anxiety probably exists in the person concerned, and one way in

which this expresses itself is as a fear of synthetic chemicals. The person’s fear triggers hyperventilation, which is the initial cause of symptoms. That is not how the person

interprets those symptoms however – because the person was anticipating a reaction to synthetic chemicals, the symptoms seem to confirm that a reaction has occurred. Again, a

vicious circle has been started which is hard to break.
Another possible scenario is that someone with a few sensitivity reactions – for example, a reaction to perfume and cigarette smoke – starts to feel concerned about other

chemical sub-
‘ and to suspect that these might also cause problems. If an anxious reaction to the presence of these substances develops into hyperventilation, symptoms will ensue from the

hyperventilation. These symptoms will appear to confirm the person’s fears about yet more sensitivity reactions. In this way, people with relatively mild chemical intolerance

can begin to believe that their chemical intolerance reactions are far more extensive and disabling than they actually are.
Where the symptoms of hyperventilation are all tangled up with symptoms due to genuine chemical intolerance, opinions tend to split. Some doctors will interpret all the symptoms

as psychological, while other doctors will attribute them all to the intolerance. Both are over-simplifying the problem, and missing a crucial ingredient – hyperventilation.

Recognising and treating hyperventilation (see p. 228) can help a great deal to alleviate the illness.
The psychologisation of illness
‘From the moment Joanna was born, she was never hungry’ Sandra recalls. ‘It took all day to force an ounce of milk down, and she seemed to have terrible stomach pains. At six

months old, after countless trips to the doctor, she was admitted to hospital. The hospital doctors couldn’t work out what was wrong, and in the end they said that she was just

very independent and that she wouldn’t eat until she could feed herself. I couldn’t believe my ears – what a thing to say about a six-month-old baby!’ But as far as the doctors

were concerned, that was that.
As Joanna got older, the symptoms got worse. She developed severe constipation, opening her bowels only once every four weeks. Because her over-full bowel put so much pressure

on her bladder, she wet herself several times a day.
‘She hated school, because the other children teased her, saying she smelled. And she had such awful stomach pains that she couldn’t bend down to tie her shoelaces. When she was

six she was admitted to hospital for a second time.
‘Again they said there was nothing physically wrong with her and it was all in her head, and this time they decided that it must be because something traumatic had happened at

home. They wanted her to see a psychiatrist. It was terrible. I knew nothing like that had happened to her at home, but it was impossible to convince them.’ There was talk of

Joanna being taken away from her parents, because of suspicions about child abuse.
Two weeks before seeing the psychiatrist, something happened to change Joanna’s life. Sandra saw an item on television about a book on food allergies. She bought the book and,

remembering how fiercely Joanna had rejected milk as a baby, she hazarded a guess that milk was the problem. She immediately took all dairy products out of Joanna’s diet.
The effect was astonishing. ‘Within 12 hours her tummy ache had gone, and after six weeks she began opening her bowels almost every day. She stopped wetting herself, and was so

much happier and healthier.’ In fact, all of Joanna’s symptoms went away. and she has remained well on a milk-free diet.
Psychologisation is most frequently encountered by patients %vith medical problems that are unrecognised by conventional medicine – Joanna is a typical example of such a

patient. Occasionally, however, those with true allergies find themselves in the same situation. Take, for example, someone who has collapsed after being stung by a wasp but

gives a negative skin-test result to wasp venom. In the case of insect-sting allergy, skin-tests are supposed to give very few false negatives – so the doctor may be sceptical

about the patient’s observation of what happened. A PAST test (see p. 92) may be ordered, but sometimes this too gives a false negative.
Doctors are – not unreasonably – more inclined to believe that the patient is an unreliable witness (there was never any insect involved), or that the patient has a

psychological problem that has led to this consultation, than that both these tests gave a false-negative result. A patient in this position may need to be quite persistent to

get proper treatment. The same goes for anyone else with unusual allergic reactions that are initially labelled ‘psychological’ by their doctor. In such cases, good

communication is everything.
Good communication with your doctor
Given the intense pressure under which they work, doctors often react badly to symptoms that don’t fit into a neat diagnostic pigeonhole, or don’t respond to standard treatment.

They simply do not have the time for unravelling complex problems and there is a common tendency to ‘psychologise’ such symptoms automatically. This often does great damage to

the patients concerned, boxing them into a corner from which it is impossible to escape – the more they try to convince the doctor their symptoms are genuine, and request

further tests or treatment, the more the doctor views them as difficult, demanding patients with psychological problems. Unfortunately, it is part of the dogma about

psychosomatic illness that patients affected by it will object vehemently to such a diagnosis. So the more you insist that the symptoms are not psychological, the more this

confirms the diagnosis as far as many doctors are concerned.
The psychologisation of illness becomes a real nightmare where the patient is a child, and parents are accused of actually causing the symptoms in some way (see Joanna’s story,

left). This has happened more than once to children with unusual sensitivity reactions.
Good communication skills may stop you from sliding into this situation with your doctor. Firstly, whatever else you do, stay very very calm. Getting emotional, agitated or

angry always causes doctors to suspect a psychological cause for your symptoms.
Secondly, be very open with the doctor, and don’t conceal anything. Be clear about describing symptoms, and accurate about times, the intensity of the reaction and any other

details. Never, ever exaggerate. If you are given to describing things quite colourfully in everyday life, tone it down as much as possible for your doctor’s benefit.
Thirdly, don’t make your own diagnosis – doctors are taught to believe that patients who diagnose themselves may well be suffering from hypochondria. Present any medical

knowledge you have acquired from books or the Internet as tactfully as possible. Finally, it will probably help a lot to use the appropriate words to describe your illness when

talking with the doctor.

Acupuncture
Acupuncture shot to fame in the West in 1972, when James Reston, a correspondent for the New York Times, fell ill with appendicitis while covering President Nixon’s historic

trip to China. Following the removal of his appendix, he received acupuncture treatment for pain, and was highly impressed with its effects.
His Chinese doctor invited Reston to witness the use of acupuncture in anaesthesia, and he reported the remarkable fact that patients undergoing surgery could be free from pain

with just a few tiny needles inserted into carefully chosen points on the body. They remained alert and talkative throughout the operation.
Traditional Chinese medicine has enjoyed a good reputation in the West ever since, but what few people realise is that acupuncture anaesthesia is a very new invention. Surgery

was not traditionally practised in China and it was only in the 1950s, after Chairman Mao had urged Chinese doctors to unify Western and Chinese medicine, that the anaesthetic

potential of acupuncture was discovered.
The remarkable effects of acupuncture anaesthesia made a huge impression on doctors in the West – a high-profile success that has had both good and bad results. On the positive

side, conventional medicine has been prepared to take acupuncture seriously, and to undertake some research into its effects. On the negative side, most
of that research has concerned pain control – the effects of acupuncture on the endorphins. These are natural painkilling compounds produced by the body (their effects are

mimicked by opiate drugs such as morphine and heroin).
Western researchers have paid little attention to how acupuncture affects most other aspects of health, including the immune system and allergic diseases. One exception to this

is asthma, where certain nerves do play a large part in producing the symptoms (see box on p. 235).
Treating the person
Diagnosis and treatment are far more orientated towards the individual patient-, in traditional Chinese medicine, and diagnostic labels such as ‘allergy’ or `hayfever’ are less

important than the particular character of a person’s Qi (see box on p. 215), as detected by the acupuncturist. A traditional Chinese acupuncturist pays great attention to the

quality of the different pulses and takes them at the start of every appointment, and at intervals during treatment, to check how the Qi flow has changed. Each treatment session

is unique and tailored to the individual’s condition at that particular moment.
This makes it very difficult to carry out conventional scientific research into traditional acupuncture.
In an effort to make acupuncture accessible to research, a more Westernised and formulaic approach has been developed, using orthodox medical diagnosis and needling a set of

acupuncture points that are prescribed for that medical condition. Experts in traditional acupuncture feel that this approach – first name the disease, then apply a standard

remedy – will often fail, and is missing the whole point of acupuncture.
That is not the only problem with Westernised acupuncture, as Dr David Eisenberg of Harvard University, a leading expert on acupuncture, points out. He describes a typical

acupuncture session in China: ‘Each time the acupuncturist inserts a needle, he or she asks the patient, “Do you have it or not?” referring to the patient’s “obtaining the Qi”

(de Qi). The question asks whether the patient has felt a sensation of fullness, distension, pins and needles, or the like, from the insertion of the needle in the spot being

used… Most Chinese have experienced acupuncture and they understand the phenomenon of de Qi… By contrast, most Western patients seeking acupuncture therapy know nothing of

the phenomenon of de Qi. Not knowing what sensations they should anticipate, they cannot tell the acupuncturist whether a needle is in the right place. When both therapist and

patient know little about de Qi, as frequently occurs in Western acupuncture clinics, the result is bound to be disappointing.’ Fortunately it is possible to find acupuncturists

who have been properly trained, and the sensation of ‘obtaining the Qi’ is perfectly detectable, even to a sceptical Westerner, so look for someone who pays attention to this.
There can be emotional and psychological reactions to acupuncture, so make sure that you also feel relaxed with your acupuncturist and that there is a certain empathy between

you.
Does acupuncture work for allergies?
According to Chinese theories, acupuncture can have some benefits in any illness – if you are ill, your flow of Qi must be disturbed, and it will help to put that right. Indeed,

most people do feel a sense of well-being after an acupuncture session.
To look at this from a Western scientific perspective, acupuncture can stimulate your body to increase its production of endorphins (see p. 214). This gives you a mild high,

similar to that you’d get from running for a couple of hours. Feeling relaxed and confident helps most people to cope better, and gives them a new perspective on life’s

problems. Since the mind plays some part in almost all illness (if only to aggravate the effects of an underlying physical problem), inducing a more positive state of mind can

be of benefit.
As regards more specific effects, several studies show that acupuncture can have a small, short-term effect in opening up the airways of asthmatics. This is not surprising

because acupuncture affects the autonomic nervous system, the ‘auto-pilot’ section of the nervous system (see box on p. 235) which can tighten or relax the muscles around the

airways. A short-term effect is just that – it doesn’t treat the real problem. What matters more in asthma is the long-term impact of any treatment on the underlying

inflammation of the airways (see p. 36). Although some studies of acupuncture treatment have found a reduction in inflammation, other studies have not. However, only one study

to date used an individualised approach to acupuncture, as opposed to a same-for-everyone formula. It is interesting that this study did find good long-term effects on airway

inflammation.
The larger picture
Acupuncture is just one element of Chinese medicine, which has several other techniques available. In China (and in some Chinese clinics in the West) these techniques are used

together, as different ways of tackling the same problem. No traditional Chinese doctor would dream of trying to treat every patient with acupuncture alone and, in the case of a

patient with allergies, herbal remedies would usually be a central part of the treatment.
A recent and very careful scientific study from Germany took this combined approach with hayfever, and showed some benefit. The patients were treated with both acupuncture and

herbal treatment, using a standardised regime but with additional acupuncture points and herbs chosen to suit the individual. Those treated reported a substantial improvement in

how they felt generally –but not in the specific symptoms of hayfever.
The flow of energy
Acupuncture is rooted in ancient Chinese ideas of the human body. which are radically different from those of Western medicine:
•    Vital energy. called Oi or Chi (and always pronounced ‘thee’). is what distinguishes living bodies from dead ones. It should flow easily and harmoniously thrOLIC11011i

the body nourishing and protecting the organs. When the flow of Qi is blocked, or becomes unbalanced. then illness develops. - Channels called meridians are the conduits for Qi

in the body. They mostly run vertically (i.e. from head to toe) and the points where acupuncture needles are inserted all lie on these meridians.
•    The flow of Qi can be measured by carefully taking pulses — not just one pulse as in Western medicine, but several different kinds of pulse.
•    By detecting disturbances in the flow of Qi, and correcting them, existing illness can be cured, and incipient illness prevented, before there are any obvious symptoms.
The nature of the meridians and the acupuncture points remains a mystery to Western doctors. Some parts of the meridians run roughly along the lines of certain nerves or blood

vessels, but they do not follow them exactly. The acupuncture points have no anatomical reality — there is nothing to see either on the surface or under the skin. However, many

are located near major nerve endings or over deep pressure receptors.