Ruth (www.ruthhull.com) trained as a homoeopathic doctor and complementary therapist, has published four books including Anatomy, Physiology & Pathology for Therapists & Healthcare Professionals, and has a special interest in working with people struggling with chronic fatigue, burnout or insomnia. Ruth also runs online post-graduate courses for complementary therapists, helping them develop not only their knowledge base, but also their confidence, in working with clients.
We’re all taught to ask our client’s medical history as part of their first consultation with us. Do you ever wonder what the point of this exercise is? Do your clients sometimes think you are wasting time and just wish you would get on with their treatment? When I first started practising therapies, I didn’t think a timeline was that important, but over the years I have come to realise it is vital, not just for my own documentation, but also for the healing process of my patient.
A few weeks ago a woman in her late fifties came to see me because she felt utterly exhausted all the time. Her doctor had run many tests and could find no reason for her fatigue. She took a handful of nutritional supplements every day and ate a healthy, balanced diet. She did not exercise much because she just didn’t have the energy to get out and about. Apart from low blood pressure, she had no other physical symptoms. She was just tired.
We sat down together and I asked her about her medical history. Nothing really stood out for me as a red flag. So, I asked her what was going on in her life a couple of months before she first started feeling tired. At first she said, “Not much was going on. My sister was ill with cancer and I had to nurse her.” I asked her how she coped with her sister’s illness and she said she was okay with it because she had counselling and support. I asked her if anything else was going on at that time, something other than her sister’s illness. She went quiet for a moment and then I could see she had suddenly remembered something. She started to tell me of an argument she had had with someone at that time and the more she spoke of the argument the more she went into her own memories until suddenly she was crying. That is when the healing started (and I hadn’t even begun any therapy). Amidst her tears she actually started laughing and said, “I never realized that argument bothered me so much. I had forgotten all about it.” She phoned me the next day to say she felt so much better after her cry and I realized how important it is to gently encourage our clients to look at, and connect with, things that have happened in their past.
I think a lot of us can get stuck in a stress response. We experience a stressful event and then because we don’t have time to process that event, we carry on with our daily lives unaware that we are still physiologically responding to that event. Our bodies have beautifully designed physiological reactions to cope with whatever stressors life throws at us, be it a lion chasing us or the loss of a loved one. However, these reactions should be only quick and short-lived and unfortunately many of us experience high levels of stress on an on-going basis.
When we are put under short-term stress, such as being physically threatened, we respond with the fight-or-flight response. This is meant to be a quick response in which our autonomic nervous system causes rapid changes in the body that result in higher levels of oxygen and glucose in the blood and faster circulation of blood to the lungs, brain, muscles and heart. At the same time, bodily functions that are not essential to fighting or fleeing, for example digestion or reproduction, slow down. Unfortunately, some people who have had a big fright or trauma in their lives get ‘stuck’ in this fight-or-flight response, sometimes even for years, and they end up with health problems such as high blood pressure, high blood sugars, irritable bowel syndrome and fertility problems.
When we are under chronic stress, our bodies respond with what is called the resistance response. This involves a cascade of hormones that act mainly on the adrenal glands, liver and thyroid. The adrenal glands are stimulated to secrete glucocorticoid hormones such as cortisol. Cortisol increases the availability of glucose, fatty acids and amino acids necessary for energy production and tissue repair, and it also depresses our inflammatory and immune responses. The liver is stimulated to produce growth factors that also increase the availability of glucose and fatty acids for energy and the thyroid gland is stimulated to release hormones which result in the increased use of glucose for energy production. Together, these hormones enable us to produce enough energy to cope with stress but, if this goes on for too long, we end up with a suppressed immune system, wasting away of muscles, high blood sugars, high blood pressure and liver and thyroid disorders.
Finally, in addition to the above-mentioned stress responses, the body also releases a variety of substances such as growth factors, neurotransmitters and cytokines that help mediate stress. These stress mediators generally stimulate the immune system and inflammatory response. However, if this response continues for too long, we can develop allergies, sensitivities, intolerances, and even autoimmune conditions.
So the next time you have a new client, instead of rushing through the past medical history, give your client some time to really explore their own timeline and begin their healing journey. Through gentle questions from a non-judgmental therapist, clients can become aware of how and when they became ‘stuck’ in their stress response. Sometimes, this awareness is enough to help them heal. Other times you may need to refer them to a counsellor or therapist to help them.