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Asthma
Asthma is a growing problem in the developed world, with 20 million American adults and 9 million children suffering from its restriction of breathing through inflammation of the airways. A good deal of medical research shows that relaxation and guided imagery can help reduce asthma wheezing, airway obstruction, anxiety, medication usage and complications. Our Guided Imagery for Self-Healing book and 4 CD set will teach you all the fundamental skills of using guided imagery to help stimulate healing from within. The book will explain the process, review the science behind it, and coach you through the common questions that people have, while the CD set guides you through the 9 essential guided imagery skills taught in the book. If you prefer to listen rather than read, you may want to start with "Self-Healing with Guided Imagery", a 2 CD set featuring Dr. Andrew Weil. The first CD explains mind/body healing and guided imagery while the second teaches you three self-healing skills. Because anxiety is a frequent problem with asthma, our Anxiety Relief CD can be very useful as well.
RESEARCH
Guided Imagery for Asthma
November, 2005
Prevalence and Costs
According to the American Lung Association, asthma is a large, growing, and expensive health problem in all industrialized countries. As of 2003, the CDC estimated that 20.7 million Americans adults and 9.1 children have asthma; the condition generated 12.9 million office visits; in 2002, asthma occasioned 1.7 emergency room visits, and caused 4261 deaths in this country (CDC).
According to the Labor Occupational Safety & Health Administration, 15% of disabling asthma cases are work related. Occupational asthma is the most common type of occupational lung disease in the industrialized nations (Rabatin, 2001). Workers with asthma are twice as likely to retire early; they have higher rates of absenteeism, and they rate their ability to work and their general health as poorer than non-asthmatic workers (Sauni, Oksa, Vattulainen, Uitti, Palmroos, Roto, 2001). Baking, electronics, chemical and metal manufacturing, paints and plastics, farming, and house cleaning are the highest risk occupations (Rabatin; Sauni et al).
What is asthma?
Asthma has several causes, including genetic sensitivity, exposure to environmental irritants, and stress responses leading to “hyper-responsiveness” and bronchial inflammation. Both Inflammation and excess mucus production can close airways, thus making exhaling difficult. This cycle is difficult to stop once it is established.
Medical treatment
Customary treatment includes daily inhaled steroid medication, an as-needed bronchodilator for use during attacks, and education to avoid environmental asthma “triggers.” Sometimes, oral medications are prescribed. However, non-compliance is a major issue, particularly with inhalers. In some studies, 70% of patients (Rand, Wise, 1994) either failed to take inhalers as prescribed, or never filled the prescription (Piecoro, Potoski, Talbert, Doherty, 2001).
Non-pharmacologic treatment including imagery
According to researchers Bloomberg and Chen at St. Louis Children's Hospital, "The mind-body paradigm that links psychologic stress to disease is necessary when considering the global evaluation of childhood asthma." The mind-body connection is important in adult asthma, as well.
Mind-body techniques and behavioral modification can be used to control inflammation and spasms. In two studies, hypnosis reduced hyperresponsiveness and increased forced expiratory volume in highly hypnotizable subjects; results were maintained at one year follow up (Ewer, Stewart, 1986). In another study (n=250), 59% of those in the hypnosis group who received positive suggestion were “much better,” compared with 40% of a group who only received relaxation training (Maher-Loughna, Macdonald, Mason, Fry, 1962).
Like hypnosis, guided imagery uses both relaxation and affirmative suggestion. “Self-hypnosis,” “auto-hypnosis,” and "guided imagery" are used almost interchangeably in the literature (Olness, 1981). A meta-analysis of previous studies conducted in 2000 showed that hypnosis had definite, long-term effectiveness in asthma. This effectiveness was helped when patients used self-hypnosis (Hackman, Stern, Gershwin, 2000). In one pediatric study (n=303), some patient’s symptoms resolved after one hypnosis session, 80% had measurable improvement, and no children's symptoms worsened (Anbar, 2002). In another pediatric study of self-hypnosis positive results were recorded in 13 patients in follow-up (mean, 9 months) and two were asymptomatic and able to discontinue medication (Anbar, 2001). Pediatric compliance in taking peak flow measurements increased when the children received a combination of education and hypnosis (Lehrer, Feldman, Giardino, Song, Schmaling, 2002). Adult asthmatics who listened to imagery tapes had lower levels of depression and anxiety, and were able to reduce their medication (Report, 1997).
According to a 2005 review of the hypnosis literature conducted by Mayo Clinic physician James H. Steward, no fewer than five studies showed positive results for asthma patients using hypnosis; results included a large multicenter trial with hypnosis patients reporting a "significant decrease" in failed treatments and an even larger number deemed "much improved" (Hypnosis for asthma, 1968); in another study, 54% of patients who used hypnosis had "excellent" results and 21% became asymptomatic and were able to discontinue medication (Collison, 1975).
In the Freeman and Welton 2005 study, the results were contrary to the researchers' hypothesis when it was shown that biologically targeted imagery was more efficacious than critical thinking asthma management.
Team or combination approaches in asthma management can be beneficial, as with Stanford University School of Medicine's multicomponent program (Shames, Sharek, Mayer, Robinson, Hoyte, Gonzalez-Hensley, Bergman, Umetsu, 2004). Remarkable improvement occurred in Anbar and Hummell's multicomponent approach which incorporates hypnosis; 82% of their patients showed either improvement or resolution of their primary symptoms.
REFERENCES
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Centers for Disease Control, National Center for Health Statistics. Asthma. http://www.cdc.gov/nchs/fastats/asthma.htm Accessed November, 2005.
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Family Guide to Asthma and Allergies. (1997). American Lung Association Asthma Advisory Group with Norman Edelman, MD. Little, Brown.
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National Center for Health Statistics. http://www.cdc.gov/nchs/fastats/asthma.htm Accessed November, 2005.
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Shames RS, Sharek P, Mayer M, Robinson TN, Hoyte EG, Gonzalez-Hensley F, Bergman DA, Umetsu DT. Effectiveness of a multicomponent self-management program in at-risk, school-aged children with asthma. Ann Allergy Asthma Immunol. 2004 Jun;92(6):611-8.
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United States Department of Labor Department of Labor Occupational Safety & Health Administration. www.osha.gov/SLTC/occupationalasthma/index.html Accessed November, 2005.
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