Behavioural medicine introduces rigour to two approaches to sickness. Sylvia Thompson reports
Approaching serious life-threatening illness by treating the physical symptoms alone is the cornerstone of modern medicine. In spite of the dominance of this orthodox approach, many ill people in the western world are also embracing the holistic healthcare model.
This model encourages individuals to look to the mental, emotional and indeed spiritual dimensions of their lives when searching for clues to causes and cures of illness.
Dr Sean Collins and Rhoda Draper are two Irish psychotherapists who are aware of the conflict (and potential risks) that can arise when patients are sometimes secretly following complementary treatments while receiving orthodox medical interventions. They have developed aapproach which enables patients to integrate both treatments.
Called integrative or behavioural medicine, the approach offers patients an eight-week intensive programme of yoga, walking, meditation, breath training, visualisation, nutrition and self-talking which runs alongside orthodox treatment - or as they would prefer - begins as soon after diagnosis as possible.
"The overall survival rate for most cancers remain stuck at about 55 per cent," says Dr Collins, acknowledging the widespread acceptance of how orthodox treatment approaches offer no guarantees to a cure. "The one remaining area for application is the influence of the mind and behaviour in cancer," he adds.
So, following on from his first self-published patient workbook, Tipping The Scales - how to fight back against serious illness (Ardagh Clinic, 1997), Dr Collins has teamed up with his colleague, Rhoda Draper, to write The Key Model - a new strategy for cancer recovery (Ardagh Clinic, 2004) published today. In the book, the authors guide patients on a personal journey in which they delve into their psychological selves - seeking ways to change unhelpful beliefs, attitudes, mindsets, negative self-talking, negative emotions and any deep dark secrets (which virtually everyone has) that may be preventing them from fighting their illness.
They also encourage people to engage a crisis counsellor or coach - either professional or a close friend/family member - with whom they will be able to share their worries and elicit support during and after treatment.
Although Collins and Draper are slow to criticise other complementary treatment approaches - and Collins is part of the working group on the regulation of complementary therapies set up by the Department of Health - they believe a faultline lies in how arbitrarily people choose their therapies.
He argues that many patients cherrypick complementary therapies and often don't stay with the treatment long enough to witness an effect.
The behavioural medicine programme is not for the fainthearted and those who take it on will need both determination and dedication to complete the programme. "Patients need to be able to give one to one and a half hours a day commitment to the programme for 90 days but, I usually say, that's less than a week in hospital and a lot more pleasant," Dr Collins says.
Dr Oliver Clinton, a medical consultant, did the behavioural medicine programme in 2001. "I found it an excellent programme in that I had surgery, chemotherapy and radiotherapy for a brain tumour and this was my psychotherapy and counselling. Working in the medical field, I thought I would know how to deal with and cope with illness but I found the programme helped me come to terms with my illness. It made me more thoughtful and more patient. Now, getting back to work, I am still realising the benefits of it years later."
While the approach is specifically geared towards cancer patients, the Ardagh Clinic in Stillorgan, Dublin, offers counselling and psychotherapy to patients facing other life-threatening and quality of life threatening conditions. "There was a time when the dominant approach was 'bring us in your body and we'll fix it' but now patients are interested in being more proactive. I would say up to 20 per cent of patients want to be proactive when they become ill.
"There is also an issue that patients want to do something while they are experiencing delays in receiving medical treatment. This can be a time when the immune system plummets so we believe by tutoring and training people and equipping them with skills (of visualisation, self-hypnosis, etc), they can have the ability to change their physiology and strengthen their immune systems."
In an attempt to provide evidence for the efficacy of the programme, Dr Collins carried out a research project on behavioural medicine in 1996. The results showed participants lost five years off their biological age (using a biological aging test derived by the Canadian Institute for Stress) following completion of the study. More specifically, the group showed a 10 per cent reduction in blood pressure, 5 per cent reduction in cholesterol levels and a 15 per cent improvement in psychological wellbeing.
The Ardagh Clinic is seeking public funding to carry out more research into the programme. "Science is committed to isolating fragments and exploring each of them individually. Sometimes, if you put everything together, it's the synergistic effect which makes a difference."
Dr Sean Collins is giving a stress reduction workshop at the Your Health Show on Sunday
(3 p.m.) and Monday (2 p.m.) - see www.wellness-recovery.com