Coping with physical illness; the role of Bach flower remedies

Bach flower remedies can help to relieve the emotional distress that often accompanies physical illness. They are intended as a complementary therapy to be used alongside medical, surgical and psychiatric treatments rather than instead of them.

The remedies are designed to promote a positive state of mind. This is highly relevant for patients in medical settings, up to one-third of whom will be experiencing significant anxiety, depression or other psychological problems. Negative mood states not only cause mental suffering but can worsen physical decline, due to the combination of poor self care with disordered physiology including a weakened immune system. Lightening and calming of mood, whether with Bach flowers or other therapies, may therefore improve physical as well as mental health.

Psychological problems can usually be understood as a response to the multiple stresses of having a physical illness: Bodily symptoms such as pain, nausea and breathlessness.  Having to wait for medical appointments, test results or starting treatment. The direct effects of the illness or its treatment on brain function. Receiving bad news about diagnosis or prognosis. Being unable to carry out former activities, or to provide for self and family. Practical difficulties with money, housing or transport. Changes in appearance. The prospect of deteriorating health. Existential questions about the cause of the illness, or what happens after death. Relatives and carers can be just as badly affected as patients themselves, though their plight is not always appreciated. Though some distress may be inevitable, it can often be minimised by apparently simple aspects of good clinical practice: clear communication, kindness, respect and practical support.

The burdens associated with physical illness are very real, and it is perhaps surprising that not all patients become seriously anxious or depressed, and that those who do can recover even if the physical illness continues to progress. Some even find the experience brings positive changes in their attitudes and lifestyle: Closer relationships. Less concern for material things and trivialities, and a sense of what is really important. Feeling able to follow their own path in life regardless of others’ opinions. Appreciation of the present day. Spiritual awareness. The Bach flowers can help to promote such benefits.

The remedies, being free of side effects or interactions, can be used alongside psychotherapies or prescribed drugs. The only possible caution is that brandy is used as a preservative during their preparation. This can be a contraindication for those who wish to avoid alcohol completely, although after the fluid has been diluted into a treatment bottle the concentration of brandy is minimal and most unlikely to have any biological effect.

Here are some examples, from the list of 38 remedies, of those flowers often relevant in cases of physical illness.

Mimulus (illustrated) for named fears, even if these seem justified.

Star of Bethlehem for shock, loss and grief.

Gentian for disappointment after a setback.

Gorse for feelings of hopelessness.

Olive for mental and physical exhaustion.

Crab Apple for feelings of uncleanliness or impaired body image.

White Chestnut for worrying thoughts.

Red chestnut for anxiety about other people, even when this is understandable.

Holly, Honeysuckle and/or Willow for those who harbour resentments about the past; there is evidence that chronic anger and hatred are risk factors for disease, whereas the practice of forgiveness has benefits for both physical and mental health.

Rescue remedy (Crisis formula) for any acute emotional distress.

Simplicity is the key to using Bach flowers. There is no need to get bogged down in the complexity of mind-body relationships, and unanswerable questions such as “Which came first – the anxiety or the heart attack?” or “Is the loss of energy due to cancer or to depression?” Remedies should be chosen according to the person’s current emotional state. There are no specific remedies for particular physical symptoms or diseases.

More detail on this topic can be found in my free ebook Bach Flowers for Mind-Body Healing. Bach flowers also play a small part in my Three Novellas, available from various online stores including Amazon.com, Amazon.co.uk and Smashwords.com.

mimulus

 

Book reviews: the good, the bad and the ugly

I depend almost entirely on reviews for discovering books that sound interesting and enjoyable to read. The best reviews, I think, provide a balance between a factual description of the book and the personal opinions of the reviewer. They usually include a summary of the content, though in the case of a novel it is infuriating when they reveal too much of the plot. There is also a discussion of the context, perhaps citing similar books and filling in the historical or cultural background, acknowledgement of the book’s good points and constructive criticism of its flaws. Writing a review, as I was sometimes asked to do during my former academic career, is quite an art. It takes a lot of time to read through the book and take notes, perhaps do some research about its subject-matter, and then compose a piece that is fair to the author and will hopefully prove interesting and informative for potential readers.

The detailed reviews in quality publications such the Listener, Spectator and Literary Review are often worth reading as essays in their own right, even when the books in question do not appeal. Many of the shorter reviews on public platforms such as Amazon and Goodreads are also well written and thought out, but a few of them represent individual opinions of an extreme kind, ranging from lavish praise to abusive condemnation. Some of the good ones have been paid for by the authors; some of the bad ones say more about the prejudices of the reviewer than about the book itself.

Many books never get reviewed at all, so from the authors’ perspective perhaps any review is better than none for publicity purposes. However, all but the most stoical authors feel a certain trepidation before looking at their reviews. Some have been so badly angered or upset by reading them that they no longer do so. While most of my own books have received positive reviews, and these are highly gratifying, it is the occasional negative one that can stick in the mind and feel soul-destroying. And it is baffling when there are completely different verdicts on the same book. Having recently been devastated by a 1-star rating of my Three Novellas on one site, I was comforted to find on its Amazon UK page a 5-star rating with the comment “Jennifer brings together all her experiences from previous work to produce a superb trilogy finishing with an interesting twist.”

I would encourage reviewers to be kind as well as honest, remembering that all books have both good and bad points, and that those they hate might be loved by someone else and vice versa. Personally I no longer post ratings or write reviews for books I dislike, but prefer to give up reading them and move on to something else.

 

 

The placebo element in Bach flower therapy

A review of seven published studies (Ernst 2010) states that “the most reliable clinical trials do not show any differences between flower remedies and placebos”. The validity of these results could be questioned, because clinical trial design inevitably distorts the way the Bach system is used, for example by giving all subjects a standard mixture instead of letting them take part in selecting their own combination of remedies. But in any case, considering that the remedies do help a majority of the clients seen in real life practice, does it really matter if they are “just placebo”?

Maybe it is time to replace the term “placebo” because of its negative connotations. At worst, it conjures up an image of dishonest charlatans charging fat fees for giving sugar pills to neurotic women with imaginary ills. But research has shown that a placebo element is involved in every intervention, including orthodox medical and surgical treatments as well as complementary and alternative therapies, and for “real” diseases as well as functional symptoms. By stimulating the body’s own self-healing capacity, with no risk of side effects, the placebo effect can be a powerful force for good.

Bach flower treatment could mobilise the placebo effect in several ways:

  • Through deciding to explore a new therapy that is natural, gentle and pleasant to use, clients experience positive expectations and a sense of choice and control.
  • Talking in a relaxed setting with a practitioner who is empathic and non-judgmental is therapeutic.
  • Analysing specific negative emotions and attitudes according to the Bach system offers a new way of understanding problems.
  • Taking the remedies four times daily provides a reminder of the positive feelings they are designed to instill.

Image: White Chestnut, a remedy for worrying thoughts.

whiteche

 

Two churches

This morning I attended 11 a.m. Mass at St Patrick’s Cathedral in Auckland, as I have done almost every Sunday morning for seventeen years. Being a member of the choir, I watch the proceedings from up in the organ loft.

cathedral mass

Services at St Patrick’s are traditional, based on the same format that has been used for centuries in Catholic churches all over the world. In the choir we mostly sing classical four-part motets, in either English or Latin; today’s programme included Call to Remembrance (Farrant), O Lord Increase my Faith (Gibbons) and Ave Verum Corpus (Elgar). Singing such pieces requires concentration, but there is also time to appreciate the beauty of the liturgy and the music, and the prayerful atmosphere of the setting.

After a brief lunch break I walked up the road to St Matthews in the City for a very different experience at the annual Blessing of the Animals service organised by the SPCA. The church was packed with people and animals, mostly dogs, some of them extremely active and vocal. The programme of hymns, songs from a school choir, poems and talks was mainly cheerful, though some aspects – lighting a candle for pets who have died, and prayers for animals who suffer abuse – were quite emotional.

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It is said there are many spiritual paths, all equally valid. Today’s two services could hardly have been more different, but both were uplifting.

 

Bach flower remedies and orthodox psychiatry: a comparison

After working as a psychiatrist in England, I became a Bach flower practitioner in New Zealand. The Bach flower remedies are a long-established complementary therapy intended to improve emotional balance. While not an adequate treatment for serious forms of mental illness, they can be used for the same sort of problems – anxiety and phobias, mild to moderate depression, responses to loss or stress, adjustment reactions, relationship difficulties – that often present in mental healthcare settings. Without a clinical trial, it would be impossible to say whether Bach flower therapy, orthodox psychiatric treatment or a combination of both works best. There are several points of contrast between the two approaches, as outlined below.

The style of interview: The traditional psychiatric interview and mental state examination involves asking patients a great many questions, covering not only the detail of their present complaints, but also their life history and social circumstances. This elicits a great deal of information, some of which may be highly relevant for future management, but some patients may find it intrusive or feel it does not allow them enough time to express their real concerns. A Bach consultation, in contrast, is more exclusively focused on current emotional state, and it is up to the clients to reveal as much or as little as they wish. Practitioners may ask for clarification, but do not probe too deeply – a key word is Simplicity. I believe this is more relaxing and therapeutic for those on the receiving end, however it may mean that important material – for example symptoms of a medical disorder, or suicidal ideation – is missed.

The diagnostic assessment: Psychiatrists assign their cases to a diagnostic category from the official classification systems, ICD or DSM. These categorisations are valuable in enabling research into the causes and treatments for different conditions. Bach practitioners, in contrast, make little or no use of diagnostic groups but aim to understand exactly what negative emotions the individual is currently experiencing; for example the same client might be feeling fear for no apparent reason, combined with regrets about the past and lack of confidence to apply for a new job.

Medication: A great advantage of Bach flower remedies over psychotropic drugs is their lack of side effects or interactions. They can also be more accurately tailored to the individual case, as up to six of the 38 flowers can be mixed together, giving rise to multiple possible combinations; suitable remedies for the fictional client described above would be Aspen, Honeysuckle and Larch. The key question is whether they work? Many authorities are sceptical, given that their mode of action is obscure and that most  published trials have shown no significant advantage over placebo. However most of the trials have not used the remedies correctly, having given all subjects the same mixture rather than individual prescriptions chosen at interview. The lack of scientific validation stands in contrast to the worldwide popularity of the therapy, still continuing 90 years since it was first developed by Dr Edward Bach. I have found that about 80% of clients respond well, a success rate comparable to that seen with psychotropic drugs. I have not been able to find any randomised trials comparing Bach flowers with antidepressants or anxiolytics, and would be pleased to hear of any that I have missed.

Relationship with patients/clients: While doctor-patient relationships are no longer so authoritarian as in the past, the doctor (or other orthodox clinician) is in charge, the patient has a passive role, and there are firm professional boundaries. With Bach flower treatment there is a more informal and egalitarian relationship, with clients being encouraged to take part in choosing the remedies they need. I have never found this familiarity abused, having had many friends as clients, and clients who have become friends. It is stated in the Bach Foundation code of practice that clients remain responsible for their own well-being, and I believe this self-responsibility contributes to the success of the treatment – though it would not be appropriate for cases of severe psychiatric illness, which should not be treated solely by Bach flowers in any case.

Psychological treatments: In mental health settings, a range of psychotherapeutic techniques may be used either alongside or instead of drugs. Formal psychotherapy is not part of Bach flower treatment, although all practitioners need basic counselling skills, and some are qualified to use other methods that can successfully be combined with the flowers – I have used my life coaching training in this way.

Professional support: Clinicians working in a public health service are obliged to interact with colleagues, fulfil requirements for audit and continuing education, and attend meetings. All this helps with maintaining standards and keeping up-to-date, though can divert time and energy from direct patient care. In contrast, Bach flower practitioners often work in isolation and are not strictly regulated. They have more time and energy for their clients, and are very unlikely to cause them direct harm, but there is some risk they may fail to recognise a serious mental or physical disorder that needs prompt medical assessment.

A few psychiatrists around the world already use Bach flowers in their practice, and there seems no reason why these remedies could not be more widely integrated with orthodox treatments.

 

 

Walking for the animals

Following on from Zumba Gold and cold water swimming, my exercise challenge for today was a brisk walk in the Auckland suburb of Hobsonville. I did this partly for health benefits but more importantly to raise awareness for my favourite charity, the Society for Prevention of Cruelty to Animals or SPCA. A group of supporters, many with their dogs, gathered at the site where a new centre serving the North Shore area is to be built next year. Brian came too.

Although there are plenty of animal lovers in New Zealand, there are also many cases of cruelty and neglect. I know from my years of volunteering with the SPCA that the organisation does wonderful work in rescuing, rehabilitating and rehoming animals, educating school children about animal welfare, running low-cost desexing programs to prevent litters of unwanted kittens, seeking justice in cases of animal abuse, and more.

Until now the SPCA has operated from the Animal Village in Mangere in South Auckland, close to the airport. As the city’s population has grown, not only are these premises too small, but traffic congestion is making it very difficult to service the area efficiently. The new centre in Hobsonville will make it possible to help many more animals such as my own beautiful Magic (pictured), who was brought into the SPCA as the only survivor of a litter of kittens left to die under a hedge. More funds are still needed to build the centre and donations can be made through https://www.spcaauckland.org.nz.

Magic on cyclamen bed

 

 

 

Style after 70

With spring on the way, this feels like a good time to sort out my wardrobe. Despite my policy of giving away one garment whenever I get a new one, I have too many clothes and some of them no longer seem suitable.

Circumstances, priorities and bodies change with advancing age, often calling for adaptations in dress style. Some older women become more adventurous and frivolous, following the latest fashion trends or putting purple highlights in their hair. Some stick to a safe formula such as wearing only black, white or navy blue. Some have clearly lost all interest in their appearance, and opt for the comfort and convenience of old tracksuits. Personally I have become rather more conservative, aspiring to a simple practical and classic look, and hoping to avoid any impression of “mutton dressed as lamb”. So all my shorts and jeans, and anything too brightly coloured, will be going to the charity shop.

But other superfluous garments are hard to part with. Some have sentimental value because they were given to me by someone I care about, or bring back memories of a special occasion. Some that were quite expensive to buy have become faded and out of date, having languished too long in the cupboard being “saved for best” and hardly ever worn. Some are old favourites that I still wear a lot, but probably shouldn’t because they look awful if I happen to see them in a photo of myself. Others simply “might come in”. I suppose it is an exercise in letting go of the past and I could apply Marie Kondo’s advice to “keep only clothes that bring you joy”, as described in her book The Life-Changing Magic of Tidying Up.

My long-held ideal is having a wardrobe planned according to a logical system: a certain number of clothes of each type for each season, all colour-coordinated of course. Despite many attempts over the years I have never quite managed to achieve this. Fashion – and life – is always changing, and can never be perfect.

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