THE POSITIVE IMPACT OF HYPNOTHERAPY FOR PEOPLE LIVING WITH DEMENTIA
Don’t we all enjoy the opportunity to slip off our shoes and simply kick back for some ‘me’ time? We know how much better we feel after we have had that time to simply relax – to withdraw into our own world where we can be at one with our thoughts.
For people living with dementia, and those supporting that journey, the ability to relax may become compromised due to high levels of anxiety, one of the Behavioral and Psychological Signs and Symptoms of Dementia (BPSD). There are ways of helping reduce anxiety without resorting to medication as a first line treatment, and this article aims to teach you ways in which this can be done.
In 2003, I led an empirical clinical research project in Liverpool testing whether hypnotherapy could be of benefit to people living in (a) a nursing home and (b) a residential home. Both services were for people who had various types of dementia. Our findings were so amazing, our research was publish in peer reviewed journals in both Europe and the US. So, what exactly were those positive outcomes?
Firstly, it is important to note that we had an active group who received one hour of hypnotherapy each week for 9 months, a control group who attended a weekly discussion group for 9 months and a treatment as usual group who received nothing different to their usual care for 9 months. Those involved in the project were a cross section of people needing nursing care and those needing only residential care. The journals are referenced below, but slide 1 demonstrates the outcomes we found in overall quality of life
We discovered improvements in 7 key areas: Concentration; Relaxation; Motivation; Activities of Daily Living; Immediate memory; Memory for significant events and socialization.
What was even more interesting is what we found during a longitudinal study 12 months post therapy. When you look at slide one, you see these results at long term. There are two possible reasons for these outcomes, hypothesis one and hypothesis 2. The first states that when a person is trying so hard to remember a particular thing, word, person or event, anxiety levels build and everything becomes worse. Negative thoughts, ideas and images develop, confusion increases and the process of dementia speeds up. By taking the person away from that negative thinking and taking them into a deep state of relaxation, the hypnotherapist is able to free up the negativity and replace it with positive suggestions directed at the subconscious. As a result, we see an improvement in cognition and a more relaxed individual, worrying less. The second one is more physiological. The neurochemical acetylcholine is deficient in people with Alzheimer’s disease. This chemical is released in large quantities during REM sleep. We know that people living with dementia have difficulty with sleeping and very rarely achieve REM. When a person enters the hypnogogic stage of hypnosis (this is when the person is going in to hypnosis) it is the same as REM. This presents us with the question ‘Does the brain get a massive hit of acetylcholine at the hypnogogic phase?’ These hypothesis have yet to be further investigated.
Case study from clinical practice:
Maria was 76 years old when she was referred to me by her GP. She had been resident in a nursing home for 9 months. Here anxiety levels had increased to such a degree that her quality of life, and that of her family, was rapidly declining. Her anxiety was based around the fear that her son, Alan, was going to be killed in a car accident. There was no family history of anyone being killed in this way, which meant she had underlying fears of other sorts that were being manifested in this way. Alan worked as a surgeon at the hospital which was a 20 minute drive away. Every evening he would call in to see his mum for an hour, but his visit was so full of anxiety and negativity that he was ready to stop visiting her. Over a period of 4 weeks, I worked with Maria to change those negative thoughts to positive ones. In hypnosis, I spoke with her subconscious mind and made suggestions that focused on Maria preparing a tea tray, baking a cake or making biscuits and getting herself ready for a visit from her son. Maria has recently celebrated her 77th birthday and her relationship with Alan is once again a happy one.
Positive use of cognitive resources
People living with dementia (and this may also be the case with relatives supporting them along the journey) can sometimes find it difficult to free up their cognitive resources in order to focus on a positive experience. For example, Helen might spend a great deal of time worrying about the fact she cannot remember certain things. This leads to negative thoughts and ultimately increased levels of both internal stress and anxiety, which may be expressed through agitation, frustration and sometimes unintended aggression. So, how can these cognitive resources be freed up so that thoughts become more positive? How can these unsafe levels of stress and anxiety be reduced?
As a trained, clinical Hypno-psychotherapist, I suggest that one of the easiest ways in which this challenge can be managed is through self-relaxation techniques.
What you should do
- Find a nice, quiet area – this could be in your chair, on the bed or even in the bath. Somewhere you know you will not be disturbed by noise
- Close your eyes and imagine being surrounded by a beautiful, warm, bright, light
- Begin by taking in a deep breath (if you have a heart problem or breathing difficulty, take in a gentle breath)
- As you exhale, allow the muscles in your body to relax – you may want to grip a squeeze ball in your dominant hand and gradually release your grip as you relax more and more
- Repeat this 5 times for deep breaths or 10 times for gentle breaths
- As you do this, try to imagine your favorite place on earth – your utopia.
- Allow your mind to drift to this place – if this is difficult, as someone to sit with you and describe this place for you as you relax
- do this for as long or as short as you wish
What you should NOT do
- Do not use an ‘off the shelf’ relaxation CD – Relaxation CD’s are a bit like prescription medicine in that it should be made specifically for you
- Do not force relaxation – allow it to happen naturally, and gradually
- Do not force an end to your ‘me time’ session – allow it to end at its own pace
When should I do it?
In my article I suggested that a bit of ‘me time’ will do you a world of good. You don’t have to wait until you begin to feel anxious or tense to do this. Also, the more times you do it, the more your body and mind will just go in to this state of natural relaxation when it feels it is needed. However, the moment you feel as though you are beginning to grow anxious – and for some people this happens as the sun begins to go down, hence the term ‘sundowner syndrome’ – it is a good idea to begin this relaxation exercise.
SUMMARY: Relaxation and ‘me time’ is good for all of us. However, for people living with dementia it can have that little extra, therapeutic benefit. The accompanying tool is to assist non trained hypno-psychotherapists in helping people to reach a state of therapeutic relaxation. To find a qualified therapist you can do so at Dementia Doctor in the UK
Duff S C & Nightingale D J, The efficacy of hypnosis in changing the quality of life in patients with dementia. A pilot-study evaluation, Journal of Clinical Hypnosis, 6 (2), 20 – 29, 2005
Duff S C & Nightingale D J, Long Term Outcomes of Hypnosis in Changing the Quality of life in Patients with Dementia, European Journal of Clinical Hypnosis, 7 (1), 2 – 8, 2006
Duff S C & Nightingale D J, Alternative approaches to supporting people with dementia: Enhancing quality of life through hypnosis, Alzheimer’s Care Today, 8 (4), 321 – 331, 2007 http://dementiadoctor.co.uk/dts-members/
Dr Daniel J Nightingale (affectionately known as Dr Dan) is a leading UK Clinical Dementia Specialist now based in the US. Dr. Dan is the recipient of the award for Outstanding Contribution to the Field of Dementia by Stirling University, one of the top schools in the world in dementia research.
He is also an author, writer and speaker, and a world leader in the use of hypnosis for people living with dementia. This follows his groundbreaking research with Dr. Simon Duff, which has led to the development of a training program for clinicians in this specialized therapy.
Clinical Dementia Specialist & Psychotherapist. New York & UK, CEO, Dementia Therapy Specialists LLC, Fellow of the Royal Society of Medicine, Fellow of the National Society for Hypnosis & Psychotherapy