The New Zealand Herald newspaper has been running a great series of articles about the crisis in our mental health services: GREAT MINDS – The search for happiness
Despite numerous national inquiries into the failures of the mental health system and a huge increase in mental health funding, nothing seems to change. The stories from patients, shared in the GREAT MINDS series, portray a broken system.
The government is implementing a major reform of the NZ health system but, as before, the reform only addresses the funding and structure of the health system and is not actually reforming the care provided. This costly reform will damage the health system, yet again, without any improvement in patient care.
What to do?
I believe that we could begin to transform the effectiveness of mental health care within a year, without spending a dollar more on treatment.
I explain how in this letter to Alex Spence, the editor of the GREAT MINDS series. He has acknowledged my letter but, so far, there is no sign of my views being shared. I have decided to share my letter openly. Here is the text of my letter:
“Dear Alex
Thank you to the NZ Herald for the series of articles about the crisis in our mental health service and the lack of improvement, despite the Government investing huge sums of money. Hearing the different perspective from ‘the front line’ is valuable.
I work full time as a trauma therapist in my own clinic in Raglan. I have a unique perspective on the problems we face. I am a retired medical specialist, an author and speaker, and a former advisor to the NZ Government and the WHO on issues of patient safety, quality of care, and people-centred healthcare. I have campaigned in fifteen countries to bring more compassion and humanity to healthcare. I also have direct knowledge of the mental health services through the experiences of several close family members.
I feel frustrated that genuine innovations and breakthrough new treatments are being ignored or suppressed by the medical system and by those who fund mental health services. I’d like to share one innovative treatment with you and how the medical system of knowledge and power suppresses any genuine breakthrough. My purpose in writing to you is not to promote a particular therapy (although I would love more people to know about Havening). Rather, I want you to understand the structural problems that prevent real change occurring in mental health services.
In my clinic, I am seeing life-changing results in my clients every day using a therapy called Havening Techniques. This method has been developed over twenty years by a medical doctor and researcher in the USA, Dr Ronald Ruden. The method is based on a detailed scientific theory of the exact mechanisms by which traumatic events get hard-wired in the brain. Trauma is the underlying cause of almost all mental health problems and addictions. The science and physiology is well described but is not taught in the medical curriculum. As a medical specialist, I was completely unaware of this science until four years ago.
In Havening techniques, we do not aim to treat pathology, rather we stimulate an innate healing response that can completely erase the neural encoding of a traumatic event in a matter of minutes. Dr Ruden’s scientific paper fully describes the neural pathways and molecular mechanisms underlying both traumatic encoding and deletion of the memory. The healing reaction is stimulated with very precise forms of soothing touch, which are mediated by newly discovered nerves in the skin. The sense of profound safety created by the touch allows the client to erase the traumatic memory. I am a trainer in this technique and it requires about four or five hours of teaching to fully explain the science – it’s that detailed.
Severe traumas, such as sexual violence, abuse, abandonment, betrayal, injury or illness can be erased in a matter of minutes. Severe phobias can vanish. Having been an anaesthetic specialist for 30 years, I am a skilled observer of human physiology. The changes I witness in clients are astonishing.
For instance, I did a research series of thirty mothers with PTSD as a result of severe childbirth trauma (which is extremely common). These mothers are at serious risk of postnatal depression, failed bonding with their new babies, chronic anxiety, re-traumatization with subsequent births, and long-term mental health problems. 80% of these mothers were essentially cured of their PTSD with a single session of therapy and others were relieved after the second session. My research report is here.
I have given up a lucrative career as a medical specialist to do this work full time because it is the most rewarding and astonishing work I have ever done as a doctor.
This therapy is backed up by a detailed scientific theory (Ron Ruden Science Paper) and two randomised controlled trials (references below). These controversial papers are not getting published in mainstream medical journals and my medical colleagues immediately dismiss this therapy as being ‘woo woo’, ‘alternative’ or ‘not evidence-based’.
The traditional process to get a new medical treatment established is to conduct major scientific trials. Here are the barriers we face:
- Lack of research funding for truly innovative treatments (no track record)
- Strong opposition from Hospital Ethics Committees – “it’s unethical to try an unproven treatment in a vulnerable population”
- Extreme difficulty getting a researcher to invest years of work in an ‘unproven’ therapy
- When a study is completed, extreme difficulty in getting the finding published because of the criticism by Peer Reviewers who are deeply invested in their own expert knowledge.
The published scientific trials took years to complete and to get published, framed in rather academic and obscure terms which tend to conceal the true impact of the research. To sway medical opinion, we generally need four or five large randomised controlled trials published in mainstream medical journals. A realistic timeframe to achieve that is TEN years from now.
But when new medical science is proved, beyond doubt, the average time it takes for the new treatment to be systematically adopted in medical practice is SEVENTEEN years. We can’t afford to wait a quarter of a century to change mental health care.
A rapid solution
At the moment, all health agencies that commission services (District Health Boards, Ministry of Health, Accident Compensation, etc.) insist that the therapy must be ‘evidence based’ within the traditional medical model. Often the ‘medical evidence’ bears little relationship to real-life outcomes for patients.
An alternative is to put in place a system of measuring real-life client or patient outcomes, and have that determine what services get funded. This is called ‘patient-oriented evidence’, which is generally resisted by the medical profession because it shows how ineffective many medical treatments are. Our lack of genuine progress is an issue of power and control.
An example is the data I collected in my research trial of mothers with PTSD caused by severe childbirth trauma. I used a scientifically-validated, patient-reported scale (Impact of Events – Revised), which measures the level of PTSD symptoms that cause so much fear, pain and distress to mothers. I also collected real-life stories from mothers about the amazing impact the therapy had on their lives (and their partners’ lives). The research shows about a 75% reduction in symptoms, with immediate effect.
In my view, the only person who is qualified to report on the effectiveness of mental health treatment is the patient or client. This is the only VALID EVIDENCE.
[Patients need to report:] Did this treatment cure my anxiety, fear or panic disorder? Has my phobia completely vanished? Am I now resilient and capable, rather than vulnerable and helpless? Is the profound depression and worthlessness caused by my sexual abuse now completely banished, such that I feel worthy, secure and happy? Has my chronic pain been abolished? (yes, lots of chronic pain is caused by encoded trauma and can be cured). Has my chronic physical illness resolved? (caused by inescapable stress). Can I anticipate my next childbirth, or next hospital treatment with calm and confidence? In the course of [mental health] treatment was I treated with loving kindness, deep compassion, respect and validation?
Ask these questions of many existing mental health treatments and the answer is sadly “No”.
Commissioning mental health services on the basis of client-defined outcomes is highly ethical, common sense, would be broadly popular and politically safe. Only the medical [and research] profession stands in the way. Their protests will be in vain.
The Government should mandate the use of patient-defined and patient-reported outcomes for all mental health services (and set up a national system to collect and analyse them.) Then we should fund and trial a broad range of mainstream, complementary and alternative therapies. Continued funding would be contingent on achieving real outcomes for clients and patients. Within a year, we could transform the approach to mental health.
Evidence from overseas shows that brief community-based interventions in trauma can prevent many cases of chronic mental illness, reduce the burden of acute mental health admissions, allow wards and hospitals to be closed, and invest ever more funding into services that really work.
If you want to see a 12 minute video demonstration of the power of Havening Techniques, see how I treat a 70 year old woman who had been haunted for twenty years by an armed hold-up in South Africa. She had frequent nightmares and fear responses in her daily life. You can see the transformation in the client. These effects are permanent.
You will sense my intense frustration and also my passion. I really hope that this essential issue can be brought to public and political attention.
If not, then perhaps we can raise charitable funds to do the patient measurements ourselves and generate the evidence needed to transform the system.
Kind regards, Robin”
References
Sumich, A., Heym, N., Sarkar, M., Burgess, T., French, J., Hatch, L., & Hunter, K. (2022, March 21). The Power of Touch: The Effects of Havening Touch on Subjective Distress, Mood, Brain Function, and Psychological Health. Psychology & Neuroscience.
Hodgson, K. L., Clayton, D. A., Carmi, M. A., Carmi, L. H., Ruden, R. A., Fraser, W. D., & Cameron, D. (2021). A psychophysiological examination of the mutability of type D personality in a therapeutic trial. Journal of Psychophysiology, 35(2), 116-128.
interesting ideas. they seem to fit well with
1. patient expertise, regarding both trauma detail and treatment outcomes
2. the notion of “inner healing intelligence”
But how well would it fit with the incoming tide of evidence regarding MDMA-assisted therapies? https://www.nature.com/articles/s41591-021-01336-3
I don’t care what therapies are used as long as they make a substantial positive difference to peoples’ lives. We need to use REAL evidence, not clinical trials dominated by pharmaceutical corporations.
Thank you Robin for that illuminating discussion. I would like to add another dimension, please. In Havening we don’t treat the diagnosis directly (although we do, on occasion, treat the emotional symptom arising from a traumatic event).
We treat the underlying root cause, encoded trauma and its consequences. It is thus difficult to outline protocols (as compared to psychopharmacotherapy (diagnosis/drug) as each patient has a different back story.
I so appreciate the idea of patient oriented experience (POE) as a valid marker for success especially since the mind/brain/body interactions are so complex. In fact POE should be the main thrust of any intervention. If many people are cured of their dysfunctional symptoms why would the medical system deny the opportunity for others to be helped? Havening has more neuroscience backing it then talk or drug therapy. It is time to think outside the double blind box.
Logically argued Robin. An approach that would work anywhere