Aromatherapy

Aromatherapy uses extracts of essential oils from herbs and other aromatic plants to influence health and well-being. There are over 40 essential oil extracts that are believed to have medicinal or health benefits. Essential oils should never be taken internally because many are poisonous. Oils should only be used in small amounts either directly on the skin or placed close enough to smell the fragrance. You should test any essential oil to determine if you are allergic to it before using it on your skin.

Aromatherapy is used alone or in conjunction with massage. Each oil extract has its own use and benefit. Oils can be obtained from a naturopath, homeopath, or other CAM provider. They can also be purchased at health food stores or on the Internet.

No studies on the effects of aromatherapy have been conducted among people with hepatitis C. There is also no evidence that aromatherapy cures or prevents disease. However, studies have shown that aromatherapy can reduce anxiety, tension, depression, and pain. Citrus extracts seem to be particularly good at alleviating depression.⁶ Peppermint, ginger, and cardamom extracts appear to relieve nausea in cancer patients receiving therapy.⁷ Black pepper extract appears to reduce the craving for nicotine.⁸

Art, Music, and Dance Therapies

Art, music, and dance or movement therapies have been used in people with a variety of diseases. These therapies appear to reduce stress, anxiety, and depression. ⁹

Art therapy involves using artistic expression to explore what having a disease means to you. Music therapy involves listening to music or playing musical instruments. Music therapy may be especially helpful for reducing pain, controlling nausea, and lowering heart rate and blood pressure.^10,11 Many people who combine music therapy with movement or dance therapy find it helps calm the mind. Music therapy can promote the production of endorphins that help reduce depression.¹²

No scientific data are available to support the notion that these approaches help reduce the incidence of symptoms from diseases or treatment side effects. However, they may help you more clearly identify what is going on in your body and mind, and the potential for harm is extremely low.

Biofeedback

Biofeedback was first studied in the 1970's. Researchers found that with training, people could learn to do such things as raise the temperature of the hands or feet, raise or lower blood pressure and heart rate, and control specific muscles by focusing mental concentration on these activities.

Biofeedback trainers use equipment such as temperature gauges, blood pressure monitoring devices, and heart rate monitors. These tools provide immediate feedback to the person attempting to use this technique to produce a physical response.

Studies have shown biofeedback can be effective in reducing stress and muscle tension, relieving migraines and other types of headaches, and relieving anxiety.^13-15 No studies have been performed specifically among people with hepatitis C.

Chiropractic Therapy

Chiropractors provide treatment by manipulating the spine. Chiropractic theory states blockages in the spinal cord nerves that lead to all areas of the body can cause illness, pain, or other distress. Moving the spine in certain ways is intended to reduce or clear these blockages. Chiropractic therapy has been shown to be effective in reducing low back pain and other pain due to muscle or bone injury.^16-18

No studies involving the use of chiropractic therapy for patients with hepatitis C have been conducted. Chiropractic therapy is considered relatively safe. However, if you have a chronic condition such as cancer or heart disease, check with your health care provider to make sure there are no contraindications to this form of therapy.

Craniosacral Therapy

Craniosacral therapy is based on the theory that many people who have experienced the normal birthing process or have had head, neck, or back injuries retain residual stresses in the skull and lining of the brain. Therapists treat these stresses by applying gentle pressure to the skull, jaw, and areas in the mouth to produce movement of the bones of the head and neck. There are no known controlled studies of this therapy. However, therapists claim craniosacral therapy is effective in treating headaches, and neck and back pain. It is also used to treat TMJ (temporomandibular joint dysfunction), eye problems, mental disturbances such as attention deficit disorder, and to stimulate the immune system.¹⁹

As with chiropractic therapy, this method of treatment is considered low risk and may be helpful. However, if you have any medical condition, check with your health care provider to make sure there are no contraindications to this therapeutic approach.

Crystals

The use of healing crystals is quite popular in the United States. However there is no scientific proof of the effectiveness of crystals.²⁰ A variety of crystals are used to treat many conditions and diseases. Some believe that the light held by or passed through a crystal has healing powers. Crystals are generally placed on the parts of the body affected by a disease or condition, or are worn as a necklace or bracelet.

Energy Manipulation

Many mind-body treatments are believed to shift energy patterns in the body. Some of the most common forms of energy manipulation are Reiki, therapeutic touch, tui-na, reflexology, and watsu. With all of these treatments, the therapist applies gentle touch to the body. Watsu is done with the patient floating in warm water. None of these therapies is likely to cause harm. They may be helpful for reducing stress, anxiety, tension, and pain.^21-24 No studies have been conducted specifically among people with hepatitis C.

Humor

Norman Cousins, former editor of The Saturday Review, has written about his use of humor to cure himself of a debilitating illness.²⁵ Several studies have been conducted evaluating the therapeutic use of humor. They indicate that laughter can cause a release of endorphins in the same way exercise does.²⁶ Endorphins can reduce depression and stress, sensitivity to pain, and produce feelings of well-being.^27-29 While no studies have specifically focused on hepatitis C, there is no reason to think laughter would not have the same effects on people living with hepatitis C as it has on other people.

There are many ways to bring humor into your life: movies, cartoons, books, jokes, and television shows are just a few. There are even Internet sites devoted to spreading humor.

Hypnosis, Self-Hypnosis, Hypnotherapy

Hypnotherapy has been effectively used to treat a variety of conditions including tobacco and other addictions, migraine headaches, sleep and eating disorders, pain, and nausea and vomiting. Hypnosis involves deep relaxation that can be induced by a trained therapist or self-induced. Hypnosis usually involves suggestions to be carried out by the person after the hypnosis session ends. Examples of such instructions are, "Remain calm in a stressful situation," or "Remember to take ten deep breaths before responding verbally." Hypnosis requires the mind to be relaxed, calm, and free from extraneous thoughts to be effective. Some studies have shown hypnosis may be helpful in stimulating the immune system.^30-33 Hypnosis produces a feeling of calm, reduces stress, and imparts a sense of well-being.

Hypnotherapy may be helpful for people living with hepatitis C. If you decide to try hypnotherapy, it is important to find a good therapist to work with you. You may want to ask your health care provider for a referral.

Massage

Massage involves rubbing and kneading the body's soft tissues and muscles. Massage has been used for centuries to ease muscle tension, reduce pain, provide relaxation, and reduce anxiety and depression. It is also used to increase alertness, relieve joint pain and stiffness, and to help heal injured muscles. It can reduce blood pressure and the frequency of migraine headaches. It can also help induce sleep, and increase the flow of blood and oxygen to body tissues.^34-36

There are many types of massage. With shiatsu, the therapist focuses the massage on acupressure points. Shiatsu is generally considered a gentle form of massage. Swedish massage is a deep tissue massage. Rolfing is a form of massage in which the therapist uses his or her elbows and knuckles to provide a very deep tissue massage that may be painful. Bowen massage focuses specifically on soft tissue manipulation to stimulate the lymphatic system.

It is likely that massage can be as beneficial to people with hepatitis C as it is to other people. However, there have been no studies to prove this assumption. The risk of harm from massage is low. However, check with your health care provider before beginning this form of therapy.

Meditation/Imagery/Visualization

Meditation, imagery, and visualization are mental techniques that can be self-taught with the aid of books or instructional videos, or can be learned from an experienced practitioner. Although some initial training is needed, once these techniques are learned, you will need no additional outside assistance.

There are many different forms of each of these techniques. However, all of them share in common a form of deep breathing called abdominal breathing or belly breathing. Abdominal breathing uses the diaphragm, one of the body's strongest muscles, along with the abdominal and pulmonary muscles to completely fill and empty the lungs. When you exhale using abdominal breathing, the diaphragm contracts and literally pushes the air from the lungs.

For many people, meditation is more of a spiritual practice than a therapeutic one. Some practice simple meditation by clearing the mind of all extraneous thoughts, and speaking, chanting, or thinking a single word or short phrase. You might choose a word like health, happiness, joy, or any other word or phrase that has personal meaning. Some people use the word ohm, a word used in traditional East Indian meditation. Meditation has been shown to be effective in reducing blood pressure, anxiety, and cholesterol levels, and for pain control. It is also an effective tool for treating substance abuse.^37,38 It may even be effective in preventing diseases such as cancer.^39-41 One researcher recently stated, "Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy."⁴²

Visualization or guided imagery involves allowing your thoughts to guide you, or to be guided with the assistance of a spoken message. Self-guided imagery is similar to self-hypnosis in that you plan what you want to think about ahead of time. Visualizing the image of a healthy you can be a very powerful tool.

Moxibustion and Cupping

Moxibustion and cupping are sometimes used as companion treatments to acupuncture. Professionals trained in Chinese or Ayurvedic medicine sometimes use both techniques.

Moxibustion involves placing an ignited cone of mugwort or wormwood leaves over an acupuncture point where an energy blockage is believed to exist. The cone is left in place just long enough for the skin under the cone to feel warm. Moxibustion has been shown to be helpful in a number of conditions including asthma and ulcerative colitis. It can also help control diarrhea.⁴³

Cupping involves the placement of a glass cup on the skin over an acupuncture point. The air in the cup is heated so that a vacuum is created when the cup is placed on the skin. The cup is left in place or moved gently over the area for a few minutes. This procedure is done to help realign the energy or qi.

Many Chinese studies have evaluated the use of moxibustion and cupping. However, no studies of these techniques have been conducted in the west.

Prayer

Prayer is part of almost every culture. Prayer is perceived as communication, either silent or spoken, with a spiritual force. This force is called by many names depending on the culture, religion, and belief system of the person praying. God, the Great Spirit, and Yahweh are a few examples. Prayer involves an external focus as opposed to the internal focus that practices such as tai chi or yoga involve.

Many studies have evaluated the effects of spirituality and prayer. Analysis of several studies showed that in over 90% of these studies, participants derived positive mental health benefits from their spiritual practices.⁴⁴ Studies focused on prayer have been done among people with heart disease, cancer, and other diseases.^45-48 These studies included people praying for themselves and people who were prayed for by others. The overwhelming majority of these studies showed benefits including reduced incidence of disease, and improved quality of life for those living with disease. No studies have been done specifically among people with hepatitis C.

Several accounts of people with life-threatening illnesses spontaneously recovering have been reported. The question often asked is whether these are cases of spiritual healing or merely happy coincidences. More studies on the use of prayer and spiritual healing are reported every year in an effort to answer this question. However, even if prayer has not been clinically proven to cure disease, you may find its benefits significant if it suits your lifestyle and belief system.

Support Groups and Personal Support

One of the early studies in mind-body medicine conducted during the 1980's focused on psychosocial support. The study involved women with late-stage breast cancer. Half of the study participants attended a weekly support group in addition to receiving their usual treatment. The other participants received their usual treatment, but no psychosocial support. The women who received support survived significantly longer than the women who did not receive support.⁴⁹

Another study examined immune cell function in cancer patients who received psychosocial support compared to those who received no support. Those receiving support had significantly greater immune function up to one year after the support ended compared to those who received no support.⁵⁰

Support groups or group therapy can be formal or informal. In formal groups, a trained professional usually leads the group. However, support groups are also formed by people who share a common concern such as hepatitis C. Many of these groups are participant directed.

No published studies exist on the effects of psychosocial support among people living with hepatitis C. However, group support has been shown to be effective in helping people with other chronic, and/or life-threatening diseases such as cancer and heart disease.

The skill of a group leader can influence the support group experience. Facilitators who place blame on the participants are not helpful and should be avoided. If you find a certain group or facilitator is not providing the help you seek, try another group.

Psychotherapy

There are many forms of psychotherapy and many types of practitioners who provide these services. Psychiatrists are medical doctors and are the only providers who can provide both psychotherapy and prescription drugs such as antidepressants and anti-anxiety medication. Psychologists, social workers, chaplains, and other religious professionals also provide psychotherapy.

Psychotherapy involves regularly scheduled appointments. Therapy often focuses on helping people make the most of the healthy coping strategies they have, and limiting the use of coping strategies that can cause problems. Psychotherapy is often useful for people who are dealing with alcoholism and/or drug abuse. Studies have shown it is also effective in helping people deal with crisis situations such as being diagnosed with a life-threatening disease.⁵¹ No studies have been done specifically among people with hepatitis C.

Qi gong

Qi gong (chi gong) is an ancient eastern mind-body practice that involves exercises done standing, sitting, or lying down. Qi gong should initially be learned from a trained practitioner. However, once the practice is learned, it can be performed alone or as part of a group. There are several types of qi gong. The gentle form promotes and preserves health. Specific routines are used to help reduce blood pressure and cleanse the liver, kidneys, and lungs.

Qi gong has been studied in clinical trials, though not among people with hepatitis C. Studies have shown that qi gong can reduce pain, improve the immune system, increase appetite, reduce the frequency of diarrhea, and help maintain normal body weight.^52,53 Caution should be taken when practicing qi gong to prevent any discomfort in the muscles and joints.

Spiritual Healing

Almost every culture has its own form of spiritual healing with its own unique rituals. However, many rituals are common to all forms of spiritual healing, such as the use of prayer.

The basic premise of spiritual healing is that the practitioner has the power to heal and cure those who seek their services. Healers typically train for many years. Healers are known by different names in different cultures. Indian cultures call their healers shamans. Western Hispanic cultures refer to healers as curanderos. Many Native American tribes refer to their healers as medicine men or women.

Western medicine generally uses treatments that have been tested in scientific studies to prove their benefit. Spiritual healers use remedies that have been passed down from generation to generation. The proof of benefit of these remedies comes from history and experience rather than science. Interestingly, many of the drugs prescribed today by western doctors were originally used by healers of other cultures.

Spontaneous cures associated with spiritual healing have been reported, just as they have been in western medicine. There have been no studies to determine if spontaneous cure rates increase if spiritual medicine is used either instead of or combined with western medicine.

Spiritual healers often use herbs or other substances. They are ingested, inhaled, rubbed on the skin, or used another way. Treatments can involve participation in healing rituals such as the Native American sweat lodge. Healing rituals and herbs have been shown in clinical trials to reduce stress and relieve symptoms such as nausea and fatigue.⁵⁴ A clinical trial involving people with asthma, diabetes, depression, cancer, chronic pain, and other conditions found Native American healing benefited more than 80% of participants.⁵⁵ To date, no studies on spiritual healing have been done specifically among people with hepatitis C.

Tai Chi

Tai chi is an ancient eastern mind-body practice. It is a series of specific movements performed in a standing position. Tai chi is best learned from an experienced practitioner. Once learned tai chi can be done alone, with the aid of a videotape or CD, or in a group. Each movement in tai chi is slow, specific, and meditative. The goal of tai chi is to move the good energy (qi) into and through the body while getting rid of the bad or depleted energy that may be trapped in the body.

Clinical studies have shown that tai chi is especially helpful for older adults and people with chronic illnesses such as arthritis, chronic obstructive pulmonary disease (COPD), osteoporosis, and heart disease.^56-58 Tai chi can improve balance and flexibility, increase muscle mass, and reduce blood pressure and pulse rate. ^59-61 A recent study tested the effects of 12 tai chi classes among people with fibromyalgia. Those who completed at least 10 of the 12 classes showed statistically significant improvement in both symptom management and health-related qualify of life.⁶² No studies specifically involving people with hepatitis C have been performed to date.

Yoga

Yoga uses controlled breathing, mental focus, and specific body positions to induce inner calm. There are many different forms of yoga. Some are very gentle, others are more strenuous. Yoga positions stretch and strengthen the muscles of the body. The positions should be maintained only as long as is comfortable for you. The practice of yoga should never produce pain. Though yoga practice can provide cardiovascular exercise and improve fitness, yoga originated as a mind-body practice, not an exercise program.

You can gain strength, flexibility, and endurance from practicing yoga. Yoga has been shown in several studies to be effective in helping control blood pressure, heart rate, body temperature, metabolism, brain waves, and many other body functions.⁶³ It is particularly helpful in the treatment of musculoskeletal problems such as arthritis and carpal tunnel symdrome.^64-65 Yoga can also help reduce disease symptoms and treatment side effects.⁶⁶

Yoga is best learned from a skilled instructor, but can also be learned from instructional videotapes or CDs. Once learned, yoga can be practiced either alone or in a group.