Alcoholism - Mind Body Therapies
The drive for alcohol experienced by those who are dependent upon it can be as strong as the need for food and water experienced by any other human being. The use of medical hypnotists dropped for a number of years when hypnosis began to be used in shows and for other forms of entertainment. However, in recent times there has been a cautious swing back towards using the techniques in medicine both for pain relief and for tackling deep-seated problems such as addictions.
Hypnotism usually works on alcoholic cravings in two possible ways, either the techniques can help access the patient’s unconscious mind and uncover the root cause of the addiction, so enabling better coping strategies to be developed and put in place, or, a hypnotist can employ covert sensitisation to alcohol which can be backed up by the patient through self-hypnosis. Covert sensitisation aims at linking the craving with a noxious stimulus which causes the patient to feel nauseous at the idea of drinking.
A study in 2009 on the positive and negative effects of hypnosis on drug and alcohol abusers found that the positive effects of the hypnotic dream and depth of the experience could be cross validated with other smaller studies. Mild negative effects such as headaches were reported by about 10% of participants. A longer study published in 2004 followed 18 alcoholics who were given and intense treatment of 20 daily sessions of hypnotism. The method showed a 77% success rate on the first year follow up.
A second 2004 study looked at the effectiveness of self-hypnosis in a study where 261 substance abusers were put into groups practicing self-hypnosis, trans theoretical cognitive-behavioural therapy, stress management and a control. Participants were assessed before, after and then 7 weeks after the trial. Relapse rates did not differ significantly across the groups and 87% reported abstinence. However, those in the self-hypnosis group who played the audio material at least 3 to 5 times a week reported the highest levels of self-esteem and serenity and the least amount of anger and compulsivity in comparison to minimal practice patients in the self-hypnosis group or all the other groups. Hypnotic susceptibility was a defining feature of who practiced the self-hypnosis audio material, but the results were sufficient to suggest that self-hypnosis can be helpful in chronic substance abuse for some individuals.
Yoga’s ability to help in cases of all types of addiction. In early 2014 the University of Exeter evaluated 14 studies into yoga’s use in treating addiction. Eight of the studies met the randomised clinical trials’ criteria and of these, seven suggested that various types of yoga including hatha yoga, lyengar yoga, nidra yoga, pranayama or CBT and vinyasa yoga, led to more favourable results in combatting addictions compared to various controls.
A separate 2006 study on the antidepressant and hormonal effects of Sudarshana Kriya Yoga (SKY) with 60 detoxifying alcohol dependent adults, found that in a two week study the group given alternate day SKY practice and specified breathing exercises enjoyed significant reductions in their Beck Depression Inventory and greater reductions in morning plasma cortisol and ACTH (stress hormone levels) than the control group. The results supported the conclusion that SKY has antidepressant effects and may have a biological mechanism which assists alcohol dependent subjects.
In a further study conducted in India, at a 90-day residential group pilot treatment program for substance abuse, psychological improvements were discovered through questionnaires which included the Behavior and Symptom Identification Scale and the Quality of Recovery Index. Participants participated in yoga, meditation, spiritual and mind-body techniques.
Massage benefits both physical and emotional parts of the body by stimulating blood flow to get rid of toxins and easing aching muscles from over stimulated nerves. By increasing the subject’s feel good factor it is said to help reduce cravings. A 2005 study looked at how massage therapy may improve the management of alcohol withdrawal syndrome. At a hospital-based alcohol and drug detoxification clinic, 50 patients were divided into a “rest”, or control, group and the others who received seated back, shoulder, head and neck massage for 4 days. Alcohol Withdrawal Scale, respiration, pulse rate and subjective patient evaluation were monitored. Scores for Alcohol Withdrawal Scale and respiration were markedly improved in the massage group, which lead to the conclusion that massage may be helpful in the early stages of detoxification.
In many instances the patient’s mind is at the heart of the spiral into alcohol dependence. A recent study looked at 109 alcohol dependent people who had suffered a serious relapse after being treated with anti-craving drugs. Half the group received medication and medical management whilst the other half received the same plus individual, disorder-specific cognitive-behavioural psychotherapy. The effectiveness was measured by the number of days until the first serious relapse. By the end of the study, the group that was also receiving psychotherapy was doing significantly better than the control, leading the researchers to recommend that psychotherapy be incorporated into alcoholic treatment programs at the earliest possible stage.
A 2008 study evaluated the supportive value of Interpersonal Psychotherapy (IP) versus Brief Supportive Psychotherapy (BSP) over a 16 week period in patients with serious alcohol abuse or dependence. They discovered that the depressive symptoms of alcohol abstinence were helped most by Interpersonal Psychotherapy, while those who received Brief Supportive Psychotherapy increased the percentage of days they remained abstinent.
Cognitive-behavioural therapy (CBT)
CBT is a talking therapy aimed at helping patients to manage their problems in a more positive way by studying how actions can affect thoughts and feelings. Talking can lead to changes in thought and consequent changes in behaviour which can make patients feel better about their lives. It has been shown to be a valuable part of an alcoholic’s recovery programme because it teaches subjects to recognise situations in which they are most likely to drink, and so avoid them. Treatment usually consists of two components: functional analysis – which looks at why a patient drinks and so helps avoid relapse; and skills training – which gives the patient better coping skills so that they have less need to resort to alcohol. CBT is usually undertake in 12 to 16 sessions during which the patient should unlearn bad habits and acquire healthier ones. It works best when combined with other recovery methods.
A large American study conducted a three year study to evaluate the effectiveness of pharmacotherapies and CBT. Splitting 1383 recently alcohol-abstinent patients into nine groups where members received 16 weeks of naltrexone (100mg/d) or acamprosate (3 g/d), both, and/or both placebos with or without CBT. The final group had only CBT with no pharmaceutical products or medical management. Patients were evaluated for abstinence for a year after treatment. Acamprosate had no significant effect over placebo. The groups that achieved longest abstinence were those taking naltrexone plus medical management, CBT plus placebos and medical management, and, naltrexone plus medical management and CBT. However, placebo pills plus medical management had a more positive effect above solely CBT treatment.
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