Hypnosis in ALS: For the patient and caregivers
ALS is a terrible disease that is gaining more and more notoriety. The Ice bucket challenge has already contributed much to research money for a solution to this disease. Because a person with ALS has less and less freedom of movement, it has a great impact on the quality of life. In addition, the disease is currently terminal, which is a depressing prospect for both the patient and his or her loved ones and caregivers.
Mindfulness and hypnosis can help reduce psychological symptoms despite illness. Therefore, in this article, I discuss what ALS is and how hypnosis and mindfulness can improve psychological factors.
What is ALS?
ALS, which stands for Amyotrophic Lateral Sclerosis, is a neurological disease. In some ways, the disease resembles MS because it affects the body’s motor functions. The motor nerves in the spinal cord and brainstem are adversely affected by it. As a result, you may first experience loss of strength and spastic movements, followed by paralysis. This can also impair articulation because the muscles important for speech become paralyzed as well.
In addition, there are other symptoms, such as pain, insomnia, emotional instability, and minor muscle tension.
Eventually, the muscles important for breathing also paralyze, causing the person with ALS to die. This prospect is very frightening for many people with ALS.
The chance of getting ALS is extremely small, only 1 to 3 people per 100,000 people per year get the disease. So the chance is much less than one percent, but if you do get the disease, the impact is great. Most people with ALS get the disease between the ages of 40 and 60.
Types of ALS
There are several types of ALS you can get, namely:
SALS: Sporadic ALS, then you have no genetic predisposition.
FALS: Familial ALS, then you do have genetic predisposition.
In 80 percent of ALS cases, there are no genetic causes and in 20 percent of cases, ALS runs in the family. So 1 in 5 people who get ALS have a genetic background in the cause, but in 4 out of 5 there is no clear genetic link.
There are also distinctions made by symptoms and when those symptoms begin. For example, in rare cases, people develop the first symptoms before the age of 20, in which case it is referred to as juvenile ALS.
In addition, there are sometimes combinations of ALS with other diseases. For example, ALS with Frontemporal Dementia or ALS with Parkinson's disease.
Who suffers from ALS?
ALS, of course, has a huge impact on the person facing this diagnosis. The realization that all muscles are becoming paralyzed is very distressing and can cause a great deal of anxiety and feelings of depression.
ALS is also a terrible disease for family and friends because the clock of life suddenly becomes a stopwatch with a timer that you don't know how long it is running, but you do know that it is suddenly winding down a lot faster than intended.
People with ALS have an average of 4 to 5 years to live. Only 5 percent of patients have 10 years left.
What treatments are available for ALS?
ALS is very difficult to treat, but there are several treatment methods to extend life with ALS.
Stem cell therapy has variable results, but can help well for some people.
The ketogenic diet is also attracting attention because it may protect the nerves. It is used, for example, to treat Alzheimer’s disease, but results vary in this case as well.
Because there is so little that can be done about ALS, and because in addition to prolonging the lifespan, this disease simply cannot be cured, there are many mental treatments that help people with ALS and those around them better cope with anxiety and depression.
Quality of life paradox
When someone learns they have ALS, they may experience a range of reactions, such as apathy, denial, hatred, hope, suicidal thoughts, anxiety, and depression. Studies show that 30% of people diagnosed with ALS experience anxiety and 40% experience symptoms of depression. Many people with ALS suffer from a combination of these symptoms.
Oddly enough, the quality of life is perceived as better by the person with ALS after each time there is more failure, also the spiritual connection with the caregiver improves as more paralysis occurs. This is also known as the dissability paradox.
Research also shows that the length of life is prolonged by the patient's mood. With a better experience of quality of life, ALS patients are more likely to live longer than patients who do not experience good quality of life.
In addition, the patient's environment is also affected, and family members and caregivers may also suffer from anxiety and depressive symptoms.
Hypnosis and ALS
Hypnotherapy can help people with ALS look at their disease from a different point of view, reducing depression and anxiety. Research conducted in 2015 ( 1) shows that the psychological improvement in ALS patients with hypnotherapy also has an indirect impact on the environment, which also brightens up when the patient with ALS brightens up.
This is particularly about reducing anxiety and depression.
Before undergoing hypnotherapy in this study, however, neurological studies were conducted for brain functioning. Before hypnotherapy, a conversation also took place about how the patient is coping with ALS and mentally defending against it at the time. This is necessary to determine treatment and to build rapport with the therapist.
The hypnotherapy session in this study consists of three phases. In the first phase, the hypnotic state is induced. Among other things, through relaxation techniques. This phase lasts 20 minutes.
You then get 30 to 45 minutes of core therapy. In this, therapeutic metaphors are given, guided visualizations and direct and indirect suggestions depending on the patient's needs.
The final phase anchors the suggestions that help apply self-hypnosis. Then the patient is gradually led back to a normal state of consciousness. This phase lasts about 10 minutes.
The study used 4 hypnotherapy sessions.
Safe space
In the first hypnotherapy session, a safe space is created where the patient can mentally recharge when things are not going so well for a while. This can be done, for example, by visualizing a nice place.
Awareness
In the second hypnotic session, patients are made aware of their thoughts, emotions and the body's physical response to them. This can also be used to improve mindfulness in daily life.
Life Chain
In the third therapeutic session, the goal is to let go of the focus on time and shift the focus to the family and the generations within that family.
Perception
The fourth and final session focuses on visualizations and beliefs associated with positive emotions and metaphors.
Results of this treatment in people with ALS
The results of this study show that anxiety and depression are reduced by this treatment in patients with ALS. In fact, anxiety remains lower for at least six months, but depressive symptoms may return after three months.
This study also found that the patient's psyche affects the disease course of ALS. In particular, secondary symptoms, such as insomnia and emotional instability were reduced. In addition, muscle failure was slowed, but unfortunately not stopped.
Results for family members and caregivers of ALS patients
The study also found that for family members and caregivers of ALS patients, anxiety and depressive symptoms were reduced and continued to be reduced six months later. Thus, unlike in patients themselves, depressive symptoms do not recur in family members and caregivers within six months.
Mindfulness and ALS
ALS is a terrible disease and hypnotherapy can improve psychological factors of this disease. In addition, that hypnotherapy in this research also improves mindfulness of the patient. As a result, he/she is increasingly better in the here and now with his/her attention than with thoughts in the future.
Mindfulness training was developed specifically for people with an incurable disease and therefore can also be a way for people with ALS to cope.
The disability paradox also by itself creates more mindfulness and also seeing life in a different perspective than normal. If this does not come naturally, it can be induced by mindfulness.
Would you like to learn more about the benefits of hypnosis and other mental health treatments? Then check out the training programs offered by the Hypnosis Institute of the Netherlands.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469765/