Experimental treatment in reflexology
with severe chronich post-traumatic stress disorder

By Meir Teichman* and Shmuel Zaidel

*Meir Teichman: PhD, clinical psychologist, professor of psychology and Head of the Tel-Aviv University Bob Shapell School of Social Work.

Abstract

This article deals with the attempt to relieve the Yom-Kippur war (1973) chronic post-traumatic stress disorder veterans through application of reflexology treatment. An experimental project was done on a group of men diagnosed with this disorder and who are under psychological and pharmacological treatments.

16 patients participated in two cosecutive series of reflexology treatments. The first series: 26.5.97 – 25.8.97 and the second one: 9.3.98 – 24.7.98. The sessions took place once a week about 50 – 60 minutes each. “Senior” reflexologists, graduates of the Institute of Human Ecology, treated the patients.

One of the patients left immediately after the first session's first series. The rest of the patients experienced temporary improvement for 1-3 days after each treatment session, in general feeling, calmness and even reduction of calming and sleeping medicines dosage.

Following the first series of treatments, a second treatment series took place. Each of the participants in the first series volunteered to the second one. One patient left during the second series due to personal reasons.

Introduction

Post-traumatic Stress Disorder (PTSD) is one of many familiar phenomenon known as anxiety responses to stressed situations and trauma . This disorder develops following exposure to an event or events that are perceived as a health or a physical threatening that might cause injury or death. The person's immediate response to the traumatic event is usually characterized with acute sensations of fear, panic, and helplessness. As a result of the above, family relationships, working and social functioning are affected and reactions of anxiety, nightmares, anger, lack of control and some times even violence might come into sight (see, DSM-IV, 1994, pages 424-429).

Chronic PTSD might develop following different events of the individual's life with no relation to age, education, origin or family situation. Researchers evaluate that as strong and threatening, as the individual perceives the event's intensity, the more likely it is that the Acute Stress Disorder will develop into a chronic state. This is how, for instance, the post-traumatic stress disorder might develop with rape casualties, victims of family violence, accident and work injuries etc.

A variety of treating approaches have been implemented with the post traumatic stress disorder injured people beginning with pharmacological treatments to the implementation of various psychotheraputic methods such as: exposure, cognitive-behavioral treatment, personal, family and group treatments etc.

According to a holistic approach the individual, conscious or unconscious, is responsible to his problems and diseases as well as his health condition. This approach determines that the soul is hidden in body organs in various forms. The question is whether the soul layer dimension hidden in the body organs might lead us to more understanding of the weak points and the breaking points, which disturb the soul.

Following the holistic approach to diagnosis numerous diagnostic possibilities to each revealed sign in the foot are available. Therefore, the whole range of phenomena and information presented by the patient should be joined together in order to translate them diagnostically.

Special indicators in the foot such as crystals, hardening of the skin or pain appearing similarly in a specific spot in number of people's feet suffering from the same problem will receive an identical diagnostic significance. For instance, within a homogenous group of men suffering from PTSD (chronic posttraumatic stress disorder), the interpretation to the phenomenon revealed in the feet, receive diagnostic alignment, which characterizes the group's problem.

Dry hard heels and skin hardening:

according to the holistic approach, the heel reflects the past, where we come from, the basis of habits, traces of life processes, the mental blocks within these processes of change and sometimes they reflect the fixation, restrictedness and the difficulty to progress. One of this group's outstanding characterizations was a hard heel. This finding points out the possibility that one of the traumatic experience's expressions would be skin hardening and hard heels. At this point it is important to emphasize that hard skin is an indicator of chronic dimension.

Digestion problems:

the main area of the digestive system reflected in the foot is in the plantar side between the front foothold cushion and the heel – it is also called bridge and reflects the abdomen. The body-soul connections related to the digestive system may be explained through holistic thinking: this system, destined to digest food in order to build and maintain the body, is used as “digestion source” to the spiritual contents nourishing the soul. The diagnostic findings in the feet of all of the project's patients showed sensitivity in the digestive system's reflection areas. All the participants reported of various recurring digestive problems. It is possible that this phenomenon is associated also with the mental problem and with their body's tendency to accumulate waste, which the body-soul drainage and cleaning techniques do not clear properly.

Depression:

All participants suffer from depressive moods; most of them are treated with anti-depression medicines. Diagnostic findings in their feet showed sensitivity in main chest organs: the lungs, the bronchus, the heart and the diaphragm. It is possible that depressive state of the PTSD patients is related to the condition of the physiological respiratory system and the condition of the soul dimension is associated to the same reflected area in the feet.

Depression and hard skin in the nose's reflecting point:

An outstanding finding in this group is formation of hard skin in the point of nose-reflection in the feet. It is therefore possible that chronic PTSD state is also related to the soul and spirit's energy opened to the nose, and to the mental condition of the soul, which is associated with the area of the spinal cord and the organs in the midst. The formation of hard skin in the feet's nose reflecting point is common among the group of shell-shocked injured and therefore highly important in diagnosis.

Instructions to the therapists

Through the whole series of treatments, the patients' feet have gone through a detailed examination in order to locate unique reflecting points, which characterize this group of patients.

The instructions given to the therapists were:

1. To identify sensitive spots in the feet, assuming that these are the patient's weak points, and to focus on each weak point as “focus treatment”.

2. To identify the health reflecting points in order to scatter through them and to increase the treatment's positive energy.

The treatment project

Altogether there were 2 cycles of treatments, 14 treatment sessions in each cycle. There were also briefing meetings for the therapists, which included a lecture about PTSD and acquaintance meeting of each therapist with his patient, which included anamnesis and diagnosis of the feet. After each treatment session, group supervision took place.

Each therapist was assigned to one patient. The treatments were given once a week on a regular time, each session lasted 50-60 minutes. The group of therapists and the group of patients were each divided into two. In the first hour, one group of patients was treated by a group of therapists while the therapists of the second group observed a patient and therapist of the first group. In the second hour the second group of patients were treated and the therapists of the first group observed. The third hour was assigned for supervision, discussing issues and problems that arise during the session, instructions or a lecture.

Theraputic map - 1

Connections between the heals (representing the pelvis) and the bridge (representing the abdomen)

Recomended combinations:

Sigmoid + Spleen
Descending colon + Sigmoid
Ascending colon + Ilio cecal valve
Rectum + Diaphragm
Gluteus + Spleen
Transverse + Rectum
Urinary bladder + Stomach
Prostate + Pancreas
Cardiac orifice + Ilio cecal valve
Small inrestine + Uterus

Key:

• Black areas - abdomen

• Striped areas - pelvis

Note: treat transition lines (heal - bridge ; bridge - ball of foot)

Theraputic map - 2

Connections between the ball of the foot (representing the thorax) and the medial longitude bridge of the foot (representing the middle of the body)

Recomended combinations:

Thyroid + Lungs
Pancreas + Lungs
Cisterna chyle + Trachea
Heart + stomach
Cardiac orifice + Pulmunary hilus
Heart + Pancreas
Nose + Lungs
Nose + Heart
Upper thorax vertebrae + Lungs
Upper thorax vertebrae + Heart
Ilio psoas + houlder muscels

Key:

• Black areas - thorax

• Striped areas - middle line

Note: direction of lower leg treatment - from inside out.

Results

First cycle 26.5.97-25.8.97

There are several ways to evaluate the intervention's effects upon the participants. One is by checking their presence in treatment and how they kept the program's frame. The second way is through the participants self report. The third way is by checking the reflexological parameters as the therapists reported them during the treatments. In this short paper we will not relate to the reflexological evaluation because the observed changes of this treatment intervention are very slow and occur throughout a long period. The reflexological picture shown here is the diagnosis one. We will report about the treatment diligence and number of behavioral variables as the patients themselves reported them.

The diligence in the treatment was very high and in case one of the patients had to be absent he coordinated an alternative treatment hour with his therapist. The request to the supplementary treatment was always the patient's initiative. In other words, what was tested here was the patient's motivation to receive the treatment. At the end of the treatment cycles when they were asked whether they would like to continue with reflexology, all the participants answered positively.

Table No. 1 presents the response-average of the 15 patients who completed the first treatment cycle. Scores are from 0 – no change to 5 – very positive change. In this cycle, patients were interviewed at the end of all the treatments.

Second cycle 24.7.98 – 9.3.98

The same group of PTSD veterans participated in the second cycle of intervention. The diligence in the treatment's second phase was also very high and in case one of the patients had to be absent he coordinated an alternative treatment hour with his therapist. The request to the supplementary treatment, similar to the first cycle, was always the patient's initiative. In this stage, only one alternative meeting could be fixed in order to avoid disruption of the evaluation. In this stage of the program the patients, at the beginning of each treatment, were asked to grade what they went through during the week. The tested variables were similar to the ones in the first cycle.

Table No. 2 presents the response-averages of the 14 patients who finished the second treatment cycle.
In this cycle, patients were interviewed during the series of treatments.

All the changes point out similarly – the reflexology treatments relaxing influence fade out, partially, after three days.

Summary

According to the personal report, it seems that the patients felt outstandingly improved during the first two days following the treatment. Comparing their feeling at the beginning of the treatment cycles, their subjective feeling was improved. From reflexology point of view, at the end of each treatment cycle, we found less sensitivity in the reflection points of the digestive and respiratory systems in most of the patient's feet. A less apparent reduction of sensitivity was found in the head reflection areas.

Considering the partial findings of this experiment, it is best that the reflexology treatment of trauma injured will focus on:

a. Treating the area of the bridge reflecting the abdomen, that is, the present dimension.

b. Treating the area of the heel and ankle joint, that is, the past dimension.

c. Treating the foothold cushion reflecting the chest area, that is, the future dimension (in Hebrew the root of the word for chest is similar to the words: foresee, front, forecast, prophecy and vision).

d. Treating the medial lines of the leg (below the knee)

e. Treating the separation line between the heel and the bridge, as reflector of the passage between past times and beginning of present processes.

f. Treating the separation line between the bridge and the chest – diaphragm line, as the reflection of the passage between the end of present processes towards their fulfillment.

Also, the possibility of two-three treatments a week should be considered. Specific variables such as: sleeping quality, concentration level, level of muscles tension, number of outbursts, degree of depression, general feeling and the amount of claming medicines, should also be checked out. The general intention of the treatment is to bring “domestic peace” between the big body areas through their reflection points in the feet: the pelvis, abdomen and chest as the areas supporting the clarity of thoughts and the concentration ability, which is characterized in the area of the head reflection.

We thank all the therapists as well as all the patients who took part in the treatment project, since without patients there are no therapists and without therapists there are no patients and they are both bound with each other.