Dr. East Phillips

Acupuncture and aromatherapy are two individual modalities that have been used for thousands of years to successfully treat a gamut of conditions and diseases. But what happens when they are combined together in one treatment? Is the treatment session more effective? Is there no difference at all? Does it merely increase patient satisfaction and comfort? I set out to answer these questions in 2011 while obtaining a doctoral degree in acupuncture and Oriental medicine. Here I will share with you what I discovered and suggest that yes, combining aromatherapy with acupuncture can make a treatment more effective. Let’s begin this discussion the same way I began my research – by asking the question: “What is something that nearly all patients complain about?” The answer is: Stress. Stress is something that affects every one of us in one way or another, especially our patients. Some may even take it further and suggest that stress is the underlying cause or root of the majority of conditions we treat. Many of us know from personal experience that we can effectively reduce stress with acupuncture treatments. In fact, this notion has been proven through multiple studies and a great deal of clinical research. But what if we add aromatherapy to an acupuncture treatment which is aimed at reducing stress levels? Will the addition of aromatherapy reduce stress even more? To determine this, I ran a clinical trial comparing the efficacy of reducing stress levels from acupuncture treatment alone to a treatment session where acupuncture was combined with aromatherapy. In the early days of gathering research for my clinical trial I was immediately surprised that I could not find a single published study or clinical trial on the combination of aromatherapy with acupuncture. Rather, I found three trials wherein acupressure was combined with aromatherapy but none where acupuncture was combined with aromatherapy. Here was an opportunity to enter uncharted territories. Selecting a study design for my trial was the next step and I chose to perform a randomized, double-blind, placebo-controlled pilot study. At the time I remember several people asking me: “How can you have a placebo when performing a trial on aromatherapy?” “You either smell something or you don’t, right?” Well, it turns out that many of the previously performed trials on aromatherapy which elected placebo controlled trial designs simply utilized spring water or alcohol as a placebo. In many of these studies saturated cotton balls were placed on the chest area near the study participant’s nose. The cotton ball either contained aromatherapy (the intervention) or spring water (the placebo). Therefore, I decided to adopt the same deliver method and water-based placebo for my trial. For the acupuncture portion of the trial, I created a point protocol that was made up of acupuncture points that had all been previously proven to reduce stress. The protocol included: Liver 3 Tai Chong, Large Intestine 4 He Gu, Stomach 36 Zu San Li and Yin Tang M-HN-3. This protocol provides a simple and effective stress reducing treatment. Next, I formulated an aromatherapy blend of essential oils, each of which had also been proven to reduce stress levels. The blend included: Ylang-ylang, rose, grapefruit, and lavender all-natural essential oils. From here I had to select study participants, preferably a demographic with inherently high stress levels. Fortunately, finding study participants was an easy task for me as I was, at the time, the off-site supervisor at an in-house drug and alcohol rehabilitation facility for women. Under my supervision, acupuncture students would provide treatments to the patients that resided at the center, many of which were court-ordered to be there, had their children taken away from them and/or were required to be there for up to 18 months. Believe me when I tell you these women had high stress levels. So, with approval from the center’s corporate headquarters, I recruited thirty (n=30) women to be study participants. I acted as the primary researcher/acupuncturist and a prior student of mine, who was subsequently waiting acupuncture licensing, was my amazing research assistant who administered the aromatherapy, conducted all the paperwork and helped me manage the trial. The thirty participants were randomly assigned to either Group A (n=15) or Group B (n=15). While all thirty participants began the six week trial and completed at least two treatments, by the end, only fourteen had completed the entire 6-week trial with Group A containing six (n=6) participants and Group B eight (n=8). High participant attrition was a reflection of participants having to appear in court or tend to sick children, thereby missing a treatment session. The trial had a strict policy that if a participant missed a single treatment session, they would be removed from the trial. Unfortunately, due to this policy and the demands on this particular participant population, we lost more participants that we had anticipated. In retrospect, perhaps a trial length of only four weeks or a study design that allowed for one missed treatment may have yielded higher outcomes. Nonetheless, we ended up having an adequate number of participants and sufficient data to provide results. Each week, for six consecutive weeks, participants came in for a 30-minute treatment session. All participants received the exact same acupuncture treatment from the same primary researcher/acupuncturist (me). Every acupuncture treatment protocol was exactly the same using these points: Liver 3 Tai Chong, Large Intestine 4 He Gu, Stomach 36 Zu San Li and Yin Tang M-HN-3. After needles were inserted, I left the room and the research assistant would come in and administer the aromatherapy by spraying the contents of either Bottle A for Group A or Bottle B for Group B on a cotton ball and placing the saturated cotton ball onto the participant’s chest near their nose. The cotton ball would remain on the participant’s chest as they rested during treatment. After 30 minutes the research assistant would return and remove the cotton ball from the patient’s chest and room before I would return and remove the needles. The rooms were aired

Like Chinese Medicine, aromatherapy has been around for thousands of years. Ancient cultures from all over the world have used various forms of aromatherapy ranging from the burning of incense to utilizing the extracted oils from various plants, herbs and flowers. These ancestors used aromatherapy because they understood the healing properties of essential oils and the aromas that come from them. This article aims to provide a general understanding of how aromatherapy works and ways in which you can incorporate aromatherapy into your practice. Since many of us are familiar with the term “aromatherapy” it is interesting to first explain where this term originated. Back in the late 1920’s, French chemist Rene-Maurice Gattefosse was severely burned in a laboratory experiment. It is said that he applied lavender oil on his burned flesh and discovered that not only did his pain and swelling reduce significantly, but the wound healed rapidly and almost miraculously. It was around this time that Gattefosse began a life-long exploration into this healing modality and coined the term “aromatherapie” (basically referring to the use of essential oils for treating the body, mind and spirit). Generally, aromatherapy can be applied in three ways: Direct application to the skin, inhalation and internal consumption. In all three scenarios the properties of the essential oils, which constitute “aromatherapy”, travel through the body and eventually go to the brain where they have both physiological and psychological effects. When applied to the skin, the essential oils are absorbed and enter into the lymphatic system, which then circulate into the blood stream, making their way into the brain. Similarly, when essential oils are inhaled or ingested, they are absorbed into the mucous membranes of the respiratory tract, lungs and/or gastrointestinal system, transferred into the blood stream, and make their way to the brain. Inhalation of essential oils also utilizes the body’s olfactory system which processes the smell, sending a signal to the limbic system of the brain. The limbic system is directly connected to the parts of the brain that control heart rate, blood pressure, breathing, memory, stress levels, the balancing of hormones and the processing of emotions and memories. For these reasons, it is evident that aromatherapy can have a very powerful effect, both emotionally and physiologically. We can also look at aromatherapy from a TCM point of view. Lavender (Lavandula Angustifolia) and Grapefruit (Citrus Paradisi), two very common essential oils used in aromatherapy, can serve as good examples. Lavender is spicy and sweet, has a cooling nature and affects the Lung, Liver and Pericardium. Two of the major functions of lavender are to promote the smooth flow of Liver qi and calm the shen. Grapefruit is spicy and bitter, has a slightly warming nature and affects the Lung, Stomach and Gallbladder. Major functions of grapefruit include regulating the flow of Liver qi and breaking up qi, food and phlegm stagnation. With their positive influence on qi, just using these two essential oils would be a good start to incorporating aromatherapy into your practice. So, now that we have a basic understanding of aromatherapy, healing mechanisms of same and two essential oils which we can start to use immediately, how can we specifically incorporate this powerful, ancient healing modality in our practice? Here are a few simple and extremely effective ways: DIFFUSERS Diffuse essential oils in your waiting/reception areas and/or treatment rooms. You can buy special plug-in diffusers designed to slowly release essential oils based on your desired strength (i.e. from light to heavy scent). You can also use a small tea-light oil/scented wax burner that does virtually the same thing without the need of electricity or batteries. ACUPUNCTURE POINTS You can place drops of essential oils onto acupuncture points prior to needling or in lieu of needling. If you chose this technique, it is extremely important that you dilute certain essential oils before doing so as some oils can burn the skin. Lavender is an example of an essential oil that is safe to place on the skin directly. SPACE SPRAY You can make an aromatherapy spray by placing drops of essential oils into a bottle (preferably dark colored glass) filled with spring water. Similar to making an herbal formula, you can chose one essential oil or create a blend based the individual make up of each essential oil and the desired therapeutic outcome. For a one ounce bottle, eight to ten drops of essential oils is sufficient. You can spray over the patient during treatment or between patients in the treatment room. EYE PILLOW Many eye pillows come infused with aromatherapy. However, if you do not possess one of these, you can easily make one by lightly spraying essential oils onto a folded Kleenex tissue and placing the Kleenex tissue onto the eyes of your patient. Instructions on making an aromatherapy spray are given above. COTTON BALL Place a few drops of an essential oil or essential oil blend onto a cotton ball and place it on the patient’s chest, near the face, during a face-up treatment. This way the patient is able to receive the aromatherapy while they are having an acupuncture treatment. If they are face down, place the cotton ball on a chair under their nose so they can receive the aroma. When the treatment is over, you can give them the patient the cotton ball to take with them, directing them to continue smelling it throughout the day. You can also give a cotton ball to patients that become extremely relaxed from a treatment and feel “out of it”. Saturate a cotton ball with a few drops of an uplifting essential oil like grapefruit and have them inhale a few times before leaving your office and have them take the cotton ball home with them so they are alert as they drive away and go about their day. MASSAGE Add drops of essential oils into your massage oil and apply to specific channels of the body or even to the UB channel where we find the

Over the course of 15+ years of private practice I have realized that there truly is an art to being a continuously successful and completely fulfilled practitioner. Sometimes we get burned out. Sometimes our patients get bored with the same treatment every time they come in. Sometimes we get a patient that our traditional treatments don’t seem to help effectively. So, what do we do? In this article I hope to offer you some ideas. While I have a steady stream of new patients I also have a solid base of returning patients – my “regulars”. They have been coming to see me every week or every two weeks for years. I have found that for these regular patients it is important to keep the treatments fresh, new and exciting. Luckily for us, practitioners of TCM and alternative medicine, we can be creative and add different things to our treatments to enhance the experience, maintain the transformation in our patients and keep them coming back to us. Whether you are a brand new practitioner or a “seasoned” one like me (so much better than saying “old”), it is absolutely vital to keep your practice fresh and keep your bag of tricks filled so you can approach all types of situations. By doing so you will not only increase patient satisfaction, you will also increase your own job satisfaction greatly. In this article I share 6 simple and effective things you can add to your treatments and/or practice to prevent burn out and/or stagnation, enhance the over-all treatment experience and increase patient satisfaction: Aromatherapy. I have always used aromatherapy in my practice and patients love it. The easiest way to incorporate this ancient healing technique is to simply add essential oils or aromatherapy sprays onto a cotton ball and place the cotton ball within your patient’s sniff zone while they are receiving a treatment (i.e. place the cotton ball on their chest or under the head rest if they are face down). Then, when the patient leaves after their treatment have them take the cotton ball with them, instructing them to smell the aromatherapy frequently to keep the treatment going through their body. Even though it is a cheap little cotton ball with aromatherapy on it patients will covet it like prized gold and look forward to their cotton balls with each treatment. I once walked a patient to her car and saw a line of cotton balls on her dashboard from prior treatments. For basic aromatherapy you can add lavender to cotton balls to help them relax or try a citrus oil like grapefruit or orange to move Qi and increase energy. It’s simple – we all have cotton balls. It’s effective – efficacy of aromatherapy has been proven over and over again in clinical trials. It is inexpensive – it costs you pennies and pays you back in spades when your patients want to come see you regularly. It has even been proven that adding aromatherapy to an acupuncture treatment increases its efficacy. Cards.  No, I don’t mean business cards.  I’m talking more about oracle cards or positive affirmation cards.  While thought leaders like Doreen Virtue and Denise Linn were some of the first people to come up with these cards, everyone seems to have their own deck and there are decks for all areas of life.  Louise Hay has positive affirmation cards, Deepak Chopra has several decks for spirituality, Doreen Virtue has dozens of decks and now Gabby Bernstein, one of our newest thought leaders in personal development, has her own positive card deck “Miracles Now”.  There are even little tiny angel notes that have positive affirmations on them that you can have placed in a bowl in your waiting room.  Patients can pull one while they are waiting and take it with them as a little positive pick me up.There are several ways you can use them with your treatments. You can have your patient pull a card before treatment as a way to get them to share what is going on inside them. Perhaps the chosen card reminds them of something they forgot to mention to you or the card really speaks to how they are feeling. So much is revealed in these discussions. You can also use them to provide encouragement. I’d like to share one particular experience I had with using these types of cards. I had a fertility patient who was finishing her third month of treatments as was becoming impatient as she wanted to get pregnant now and didn’t understand why it was taking so long. I asked her if she wanted to pull an angel card from Doreen Virtue’s Daily Guidance From Your Angels card deck. She agreed and after shuffling the cards a bit she pulled one from the middle and it was the “Child” card which reads: “ Your life purpose involves helping children – A child in Heaven is saying ‘I love you’ – Pregnancy or adoption might be part of your life”. She couldn’t believe it and started to cry (I couldn’t believe it either!). Then she said to me: “Hey, are they all Child cards?” inferring that I may have stacked the deck. I went to turn over all the cards and show her that there were 44 different types of cards in the deck and a card fell on the floor between us. I picked it up and we both looked at it. It was the “Have Confidence “card. We both laughed. She felt encouraged and left my office. She conceived 2 weeks later. True story!! Auricular To Go.  If you are not already using ear seeds I recommend adding them to your practice even if you just put a seed on Shen Men.  I do not provide ear seeds on every treatment or even on the first treatment.  I save it to add to future treatments.  It can also be something that you can suggest at the end of a treatment.  For example:  “While

You’re driving down the road, and your check engine light comes on. “Hmm, that’s strange,” you might say to yourself. What do you do? If you’re like most of us, you probably just ignore it. Maybe it will go away, right? Then you start to hear some weird noises coming from your engine. Clonk, bonk, rattle, bump. “Hmm. So odd,” you ponder. Solution? Turn up the radio, of course. Then, a little further down the road, steam comes out from under the hood of your car, and you are forced to pull over because you can’t even drive with billowing smoke blocking your view. So how does that look for us, the practitioners, students, business owners, and educators of complementary and alternative medicine (CAM)? Well, just like your car, the warning signs start off soft and subtle and get louder and louder until you are forced to address the problem. It starts when you no longer look forward to treating people or going to work. You might hear yourself say things like: “Ugh, I have to go to work tomorrow,” instead of “I get to go to work tomorrow.” “I hope my patient(s) cancel tomorrow,” instead of “I hope more people schedule with me tomorrow.” You might start experiencing headaches, insomnia, or body aches and pains. Your burnout is getting worse when you find yourself complaining more frequently and making statements like these: “Oh, my Gosh! My patients are driving me crazy!” “I can’t stand working when so and so is in the office.” “I don’t even have time to think anymore.” “I’m getting so out of shape. I feel crappy.” “I don’t have enough money.” “I can’t remember the last time I got a treatment for myself.” “I’m so tired. I’m tired all the time.” “I hate these insurance companies and all the BS (bureaucratic stuff, of course) that goes along with the system.” “Does this medicine even work?” “Am I really making a difference?” “My students are driving me insane!” “These homework assignments are so stupid.” Here’s a final test to see if you are experiencing burnout. Which one best describes you lately? Question: When you drive to work or school, you: (a) Listen to music or inspiring e-books or podcasts; (b) Call friends or family to catch up; or (c) Yell at drivers to “Get the F out of my way, people!” When I was in Chinese medical school, I was a massage therapist. I worked for a chiropractor who booked me eight one-hour, back-to-back massages every Tuesday and Thursday. At first, I loved it. I had zero experience with bodywork or massage before Chinese medical school, so this was an excellent way for me to obtain practice in massage. After about six months of this, I really started to feel the toll of the excess one-on-contact with patients. I first noticed that after massaging eight people in a row I left work with headaches. Then I started having a hard time sleeping and began to become aware of many aches and pains in my neck, shoulders, and back. But I didn’t truly admit to myself that it was time to quit until… Red Flag#1: I purposely left my eighth massage patient of the day face down for an extra twenty minutes because I couldn’t stop crying while massaging her back and I didn’t want her to see my tear-stained face; and; Red Flag #2: One day before work, I was cutting fruits and vegetables for my lunch. The entire time I kept thinking to myself, “I honestly don’t know if I can do it today. This job is exhausting me.” That’s when I cut my finger so badly that I had to get stitches. And, since you cannot massage with stitches—guess what? No work for me. Does any of the above resonate with you? Has your check engine light turned on, yet you have chosen to ignore it? Most likely it has, given recent statistics that suggest that more than half of U.S. physicians are experiencing professional burnout[1]. If you suspect or know without a shadow of a doubt that you have burnout, please understand that it’s ok. In fact it’s not only normal—it may just be a blessing in disguise. Despite your fellow practitioner’s Facebook and Instagram profiles showing exuberant passion flowing in all directions, burnout is more common than you may think and not many people are willing to admit it. They are afraid people will think they are a bad practitioner, or that they are a bad person who doesn’t want to help people. Let me tell you something: I have two kids that I love more than anything in this world, but there are times when I fantasize about running away to live next door to Kate Hudson and Shakira in Ibiza. These feelings or thoughts don’t make me a bad mom or mean that I don’t love my kids. They are simply gauges telling me that my system needs attention—much like the gauges of your car. When my kids and the chaos they bring make me feel like running away, that’s when I know I need to make some shifts to get myself back in balanced and aligned with my true self otherwise I am not good to anyone. So, what do we do once we have determined that we are in a state of burnout? Well, what do you do when your car breaks down? You take it to a mechanic. Please consider me your practice mechanic. Having been in practice nearly 20 years and counseled hundreds of students and practitioners, I am an experienced, skilled and reputable mechanic that works from a space of integrity, and with your best interest in mind and at heart. I propose that it’s time to COPE with your burnout. In this sense, COPE is an acronym for Cause, Options, Pick/Plan, and Execute. It has been my experience that by following this 4-step process, you can transform your negative state of mind into one that re-aligns you with your passions, joys, and peak