Bach flowers: medicine or magic

After taking a few years out from my Bach flower remedy practice due to illness in the family I am now available to see clients again, so it seems timely to revisit the topic on this blog.

The remedies are intended to restore emotional balance. Common presenting problems include anxiety, grief, relationship difficulties, lack of direction in life, and the hardships of physical disease. I am continually impressed with how well the system works: 80 of my first 100 clients reported an improvement, and this figure is in line with the experience of other practitioners. But it is not always easy to reconcile my background in orthodox medicine with my interest in holistic therapies like the Bach flowers. I have to acknowledge there is no accepted scientific explanation for their mode of action, and that when tested in the artificial context of clinical trials they usually perform no better than placebo.

Leaving aside the question of whether the remedies have direct effects, a consultation with a Bach practitioner can be therapeutic because it empowers the client – as the jargon goes – “to take responsibility for their own healing”.  The interview does not follow a set structure, and it is up to the client to decide what they want to talk about and how much detail to reveal. The practitioner listens, and asks questions for clarification, but does not probe for extra information or offer unsolicited advice. The selection of remedies is a cooperative process, with the practitioner making suggestions but the client helping to choose what flowers they need, and sometimes seeing their problems in a new light as a result. The combination of up to six flowers is tailored to the unique individual’s state of mind rather than a symptom or diagnosis.

This is very different from the assessment process used in orthodox medicine and psychiatry. Traditionally, in the orthodox system, the doctor is in charge while the patient takes a passive role. The consultation follows a standard format, with a series of questions followed by examination and investigations, aimed towards establishing a diagnosis. The drugs, surgery or radiation prescribed will usually have evidence-based benefit for the disease concerned, but inevitably carry some risk of side effects. The orthodox approach often works very well, especially for acute conditions and those that are clearly defined, and is sometimes life-saving (as was clearly brought home to me in 2015 when my husband required heart surgery, described in my short memoir Across a Sea of Troubles).

The orthodox approach with its armamentarium of marvellous medical and surgical technology, and the holistic approach which draws on the universal principles of healing and self-help, are truly complementary to each other and can be used together – I think of them as representing the “yin” and “yang” of healthcare. Unfortunately there is considerable antipathy and misunderstanding between practitioners of the two schools and the concept of integrative medicine, which combines the best of both, has not been widely accepted.

While Bach flowers can be used on their own for minor mental or physical imbalances, they are not sufficient as a sole treatment for anything more serious. I often advise clients to seek a medical assessment if they have not done so already because physical diseases, for example over- or under-activity of the thyroid gland which is common especially in women, can present with psychological symptoms.

Clients are attracted to therapies like the Bach flowers because they are natural and safe, treat them as a “whole person” rather than just a case of a particular disease, and provide them with a sense of choice and control.  More information about Bach flowers can be found on this page.

Complementary therapies in cancer care

This short overview is based on a talk I recently gave to the members of Sweet Louise, a New Zealand charity for the support of people with incurable breast cancer.

Complementary therapies can be loosely defined as those not included in orthodox medical training or practice, though this can change, for example acupuncture has been used in pain clinics for many years. Some therapies involve physically touching the body – examples include massage, reflexology, acupuncture. Others involve taking substances by mouth – herbal remedies, homeopathy, flower essences, special diets. Then the mind body therapies such as relaxation, meditation, yoga, visualisation and guided imagery, energy healing. And creative therapies with art, music, writing and dance. Several types can be combined.

They are often known as “natural” therapies, and the same ones may be called “complementary” when used alongside orthodox medical treatments, and “alternative” when used instead. The “integrative” approach combines them both but has been slow to get established, perhaps because of prejudice and misunderstanding on both sides. All these therapies are grounded in the “holistic” approach, which aims to balance the whole person in body, emotions, mind and spirit, and mobilise the potential for self-healing. This is in contrast to the approach of conventional medicine, which uses powerful drugs, surgery or radiation to suppress symptoms and destroy disease, and in which patients have a passive role. Both approaches have their place and can often be used alongside each other.

Surveys show that as many of two thirds of women with breast cancer are using one or more natural therapies, and there is good evidence that they can improve quality of life – helping to relieve physical symptoms such as pain and nausea, mental symptoms such as anxiety and depression, reducing the side-effects of radiotherapy and chemotherapy. They appeal because, in general, they are safe and natural and many of them are pleasant to receive. When I was practising with the Bach flower remedies, many of my clients told me they wanted a therapy that treated them as a unique person, rather than just one more case of a diseased body part.

While all the modalities have specific effects, their benefit is partly due to their positive influence on mind-body relationships. The self-help element, especially with therapies that require some active user participation, enhances a sense of choice and control. Spending time with an understanding therapist in a relaxed setting is comforting. Expectation of improvement can help to bring it about. Such general factors are important, and it is a mistake to devalue them as “just placebo”.

A key question is whether using these therapies can lead to a longer life expectancy or even to remission of the cancer. Many individual cases of remarkable recovery have been reported. But there are few formal research studies on this aspect, and it is a difficult thing to investigate for many reasons – for example treatments are used in individual combinations rather than standard protocols, and patients’ beliefs and motivation affect the outcome.

Some of the therapies carry risks, for example herbal remedies can have adverse interactions with prescribed drugs; massage and acupuncture occasionally cause physical injury. They can be expensive. The field is not tightly regulated and, while most therapists are skilled and honest, there are a few self-styled practitioners who cause more harm than good by making unrealistic promises of curing cancer while advising clients to refuse conventional treatment that would have been effective.

More detail about these topics, with case histories, can be found in some of my non-fiction books.

Update on introducing Bach flowers to medical doctors

My last post on this blog was about preparing a short talk on the Bach flower remedies for a group of doctors and medical scientists. Several readers asked me to report back, so here is a brief update following the event.

My talk seemed to be well received by the  audience, which represented a wide range of specialties: neurosurgery, rheumatology, oncology, paediatrics, general practice and others. Most of those present had never heard of the remedies before. There were plenty of questions, for example: are the same plants used for similar purposes in herbalism and pharmacology? how exactly did Dr Bach select his flowers? would just looking at the flowers have an effect? At least one person thought that the mode of action must be chemical, but another was familiar with the concept of vibrational healing, pointing out that plants have an energy field as demonstrated by Kirlian photography.

It was encouraging to receive so many positive and open-minded responses, and I was left wishing that there were more opportunities for orthodox clinicians and natural therapists to learn about each others’ work.

Introducing the Bach flowers to medical doctors

Later this week I’ll be giving a short talk about the Bach flower remedies to a group of senior doctors with connections to my old medical school in Oxford, UK. Many of them will probably never have heard of the remedies – even though Mount Vernon, the home of the Bach Foundation, is only a few miles away from Oxford city. Even fewer will have had personal experience of using them, or know how much they can help with the management of health problems whether mental or physical.     

I hope and expect that there will be a friendly informal atmosphere at this meeting, and that most people in the audience will be interested in the brief case histories and flower photos I plan to present. However, some orthodox clinicians are sceptical about the value of ‘natural therapies’ in general, and a few are quite hostile towards them, so I need to be prepared to answer criticisms such as the following:

Bach flowers are no more effective than placebo: several randomised controlled trials published in medical journals have reached this conclusion. The placebo effect, in which the beliefs and expectations of both patients and their clinicians work to bring about a self-healing response, is indeed a powerful force for good and if the Bach remedies can mobilise it effectively, so much the better. There is certainly a placebo element in this therapy, as in any other.

It is, however, difficult to believe that the excellent results achieved with the remedies are due to placebo alone – over 80% of clients treated by Bach practitioners respond well, and they include babies and animals. And the occurrence of ‘healing reactions’, in which a minority of clients experience an aggravation of symptoms before they get better, seems unlikely to be a placebo (or nocebo) effect.

The published trials have several limitations, for example they have usually given the same remedies to all participants although it is a key principle of this therapy that an individualised mixture should be chosen for each case.

The challenges of evaluating natural therapies and the ‘holistic approach’ are considered in more detail in my recent book Persons not Diseases (by the way the e-version on Smashwords is on promotion at just $1.50 USD this week, 2-8 March – here’s the link).

Their supposed mode of action is not scientifically credible: talk of ‘vibrational’ and ‘energy’ medicine does not go down well in orthodox circles, where mechanical and chemical approaches hold sway. It must be admitted that the mode of action of Bach flower remedies, like that of homeopathics, is not well understood. However, it is arrogant to assume that a therapy must be ineffective because current knowledge cannot explain why it should work. The phrase ‘the exact mechanism of action is unknown’ quite often appears in the product descriptions of widely-used pharmaceutic drugs!

The remedies give ‘false hope’ of cure, and patients may use them instead of effective medical treatments: It is true to say that Dr Edward Bach envisaged a world in which most diseases could be cured if patients themselves simply learned to recognise the emotional imbalance underlying them, and used the flower remedies to restore harmony to mind and spirit. Although subsequent advances in mind-body medicine would support Bach’s ideas, current claims for the remedies are more modest. They are not a panacea and, as made clear in training courses for Bach Foundation practitioners, they are intended for ‘complementary’ rather than ‘alternative’ use. They do not treat specific medical conditions, but are selected according to the personality and emotional state of each patient, with the aim of improving quality of life. They can safely be used alongside conventional treatments.

If any other points of interest arise from the meeting, I’ll write a follow-up post next week.

Persons not Diseases: the ebook

My new ebook Persons not Diseases was published on Smashwords yesterday. It’s a short practical guide to the ‘holistic healing approach’ written for patients, clinicians, and anyone else with an interest in natural healthcare.

It began as an update of my earlier book Focus on Healing and covers a similar range of topics, but soon took on a life of its own, with new case histories, and inclusion of some references to research in the field.

There is now plenty of evidence that changes in lifestyle and mindset, self-help practices such as meditation, and use of complementary therapies can assist with coping and recovery from almost any illness. Yet these simple natural approaches are often ignored or dismissed in orthodox medical settings. I am hoping that, if they are willing to look at this book, some of those sceptical clinicians whose hackles rise when they hear the word ‘holistic’ might change their views.

Some people still prefer to read from printed copies rather than electronic devices, and I plan to publish a print version of Persons not Diseases in the next few weeks. Meanwhile here again is the Smashwords link: