Placebo Effect - Talking to Clients with the Brain in Mind

The Placebo Effect

Placebo controlled massage therapy and manual therapy studies show a similar difficulty in teasing out where the improvement comes from. The placebo effect is defined as "the beneficial effect in a patient following a particular treatment that arises from the patient's expectations concerning the treatment rather than from the treatment itself." (Dictionary, 2005). Answer.com Dictionary. Retrieved Sept 5, 2005, [Full Text] www.answers.com/topic/placebo-effect

"In this small study, TT was no better than placebo in influencing median motor nerve distal latencies, pain scores, and relaxation scores. The changes in the outcome variables from baseline in both groups suggest a possible physiologic basis for the placebo effect." (Blankfield, 2001). Blankfield, R. P., Sulzmann, C., Fradley, L. G., Tapolyai, A. A., & Zyzanski, S.J. (2001). Therapeutic touch in the treatment of carpal tunnel syndrome. J Am Board Fam Pract, 14(5), 335-342.

The question is, how can the placebo effect have a physiologic basis and still be considered a control? It is significant that in the Blankfield study both the group receiving Therapeutic Touch and the placebo group improved.

In the medical literature a case report is presented of "the successful treatment of phantom leg pain in a 62-year-old man with peripheral vascular disease using the complementary medical technique of Therapeutic Touch." (Leskowitz, 2000). Leskowitz, E. D. (2000). Phantom limb pain treated with therapeutic touch: a case report. Arch Phys Med Rehabil, 81(4), 522-524.

Researchers speculate about the possible role of nonspecific factors like placebo responsiveness or hypnotic dissociation and the applicability of complementary and alternative medicine to phantom limb pain. There was a wondering whether the neurologic mechanisms that generate phantom sensations and the possible mechanism of action of Therapeutic Touch are the same.

What if they are the same? Is not the point of treatment -- successful recovery?

How we communicate with our clients, the tone of voice we use, the confidence we have, the knowledge we convey, is important to the continuation of our business. It is also significant to the health and well-being of our clients. If our clients respect us as practitioners, the placebo effect will enable them to feel and function even better. The placebo effect is enhanced by our talking to them about how the treatment we are doing with them will help them feel better, function better and look better. It is, of course, important for the treatment we are doing to be effective, as well. Mayberg noted, "clinical improvement in the group receiving placebo as part of an inpatient study is consistent with the well recognized effect that altering the therapeutic environment may significantly contribute to reducing clinical symptoms." (Mayberg, 2002). Mayberg, H. S., Silva, J. A., Brannan, S. K., Tekell, J. L., Mahurin, R. K., McGinnis, S., et al. (2002). The functional neuroanatomy of the placebo effect. Am J Psychiatry, 159(5), 728-737.

How well an individual's brain is functioning and what areas are activated influences their experience of the pain. In research on pain, the somatosensory cortex and the insula have been implicated in intensity and location of pain, while the unpleasantness of pain is connected with the anterior cingulate gyrus and the amygdala. "Patients who have had their anterior cingulate surgically removed report they are still able to feel the intensity of pain, but are no longer bothered by it. In contrast, a patient who had his somatosensory cortex removed could still

report pain distress despite difficulties in reporting on sensory aspects of the pain." (Lieberman, 2004). A 2003 study suggested that the anterior cingulate and the right ventral prefrontal cortex regulates the distress of social exclusion by disrupting anterior cingulate activity." (Eisenberger, 2003).

Researchers are also looking into the way we respond to events (both physical and emotional) based on our expectation of what might happen. What do your client's expect? "The ability to predict the likelihood of an aversive event is an important adaptive capacity. Certainty and uncertainty regarding pain cause different adaptive behavior, emotional states, attentional focus, and perceptual changes." (Ploghaus, 2003). Ploghaus, A., Becerra, L., Borras, C., & Borsook, D. (2003). Neural circuitry underlying pain modulation: expectation, hypnosis, placebo.

Trends Cogn Sci, 7(5), 197-200. Certain expectations (such as specific phobias) are mediated through the rostral anterior cingulate cortex and posterior cerebellum. Uncertain expectations (such as generalized anxiety disorder) contribute to activation changes in the ventromedial prefrontal cortex, mid-cingulate cortex and hippocampus. (Plogaus, 2003).

People with Parkinson's disease seem to respond particularly well to placebo treatments from pills and injections to sham brain surgeries. Researchers have demonstrated in patients with Parkinson's disease, the placebo effect produces the same results as pharmaceuticals. "Findings indicate that the placebo effect in Parkinson's disease is powerful and is mediated through activation of the damaged nigrostriatal dopamine system." (de la Fuente-Fernandez, 2001). de la Fuente-Fernandez, R., Ruth, T. J., Sossi, V., Schulzer, M., Calne, D. B., & Stoessl, A. J. (2001). Expectation and dopamine release: mechanism of the placebo effect in Parkinson's disease. Science, 293(5532), 1164-1166; de la Fuente-Fernandez, R., & Stoessl, A. J. (2002). The placebo effect in Parkinson's disease. Trends Neurosci, 25(6), 302-306; de la Fuente-Fernandez, R., & Stoessl, A. J. (2004). The biochemical bases of the placebo effect. Sci Eng Ethics, 10(1), 143-150.

It is intriguing that people with Parkinson's are powerfully affected by placebo treatments since the cingulate gyrus, which is involved in the placebo effect, is often dysfunctional in Parkinson's disease. "A defect in anterior cingulate cortex contributes to the cognitive impairments observed in Parkinson's disease." (Grossman, 1992). "Lewy body densities in the entorhinal cortex and anterior cingulate cortex were significantly associated with clinical dementia rating scores." (Kovari, 2003). In a study on gait, the control group had an

increase in brain activity in the medial and lateral premotor areas, primary sensorimotor areas, anterior cingulate contex, superior parietal cortex, visual cortex, dorsal brainstem, basal ganglia and cerebellum. The Parkinson's disease patients revealed relative underactivation in the left medial frontal area, right precuneus and left cerebellar hemisphere, whereas they showed relative

overactivity in the left temporal cortex, right insula, left cingulate cortex and cerebellar vermis. (Hanakawa, 1999). In radiosurgery the cingulate gyrus or the anterior internal capsule is targeted for pain or psychiatric illness. Other anatomic targets include "the trigeminal nerve (for trigeminal neuralgia), the thalamus (for tremor or pain), the globus pallidus (for symptoms of Parkinson's disease), and the hippocampus (for epilepsy)." (Kondziolka, 2003).

A 1997 study referred to the "concept that the striatum and the anterior cingulate gyrus are involved in mood regulation. Dopamine-D2 receptors may constitute a central role in this domain." (Larisch, 1997). Dopamine released is linked to the expectation of a reward. If the expected reward is a therapeutic benefit from treatment, the release of dopamine helps the person feel better whether they are getting the really treatment, a placebo or sham treatment. "We conclude that the release of dopamine in the ventral striatum (nucleus accumbens) is related to the expectation of reward (ie clinical benefit) and not to the reward itself." (de la Fuente-Fernandez, 2002).

More recent research suggests, "a great variety of medical conditions are subject to the placebo effect. Positron emission tomography studies have recently shown that the placebo effect in Parkinson's disease, pain, and depression is related to the activation of the limbic circuitry. The relative contribution of the different neurotransmitters and neuropeptides that are known to be involved in modulating the activity of the limbic system may be disease-specific. Thus, while

the placebo-induced clinical benefit observed in Parkinson's disease would mostly reflect the release of dopamine in the dorsal striatum, the activation of opioid and serotonin pathways could be particularly implicated in mediating placebo responses encountered in pain and depression, respectively. (De la Fuente-Fernandez, 2004). In 2002, Mayberg, noted that the "administration of placebo can result in a clinical response indistinguishable from that seen with active antidepressant treatment. (Mayberg, 2002).

The significance of the placebo effect calls into question that use of blinding in studies. Dean Fergusson, found that only 15 of 191 "gold standard studies" - randomized, placebo-controlled and double blind - published between 1998 and 2001 provided any evidence that the researchers assessed whether the blinding had been effective. Nine of the 15 that studied the effectiveness of the blinding reported that it hadn't worked perfectly. Someone who knows they are getting the real treatment may expect to feel better. The person who is administering the treatment, may unconsciously communicate information and expectations to the patient. (Fergusson, 2004).

Eleven ways health coaches can meet the needs of people with neurological disorders or injured nervous systems
 
    The goal of this Health Coaching practice is to bring more energy, more life and joy into the lives of people living with nervous system disorders such as Parkinson disease, Alzheimer's disease, Multiple Sclerosis (MS), Lou Gehrig's disease (ALS), Friedreich's Ataxia, Polio, Cerebral Palsy, Autism, Macular Degeneration, Strokes, spinal cord injuries and others conditions. Together we can create a life with more freedom and autonomy to do what you want to do. We work with care givers as well to improve their quality of life, develop better relationships, and decrease stress related issues for everyone. Here are ten ways in which we support you.

1. Try Something New
     Try something new or to borrow a phrase from Yoda. Do something new. Yoda, of course,  in Star Wars said, "Do or do not, there is no try."
     You have probably tried a number of ways to improve your function and achieve your goals over the last few years. It is time to try Health Coaching with practitioners who are knowledgeable about the brain, spine, nervous system, and consciousness as well as mind-body approaches from the field of Complementary Medicine including Integrative Manual Therapy (IMT), Matrix Energetics and Acupressure. Contact us form a free consult to see what these approaches can do for you.
     Everyone knows the saying, "You can't teach an old dog new tricks" but do you know the second part? 
     "The fastest way to become an old dog.........stop learning new tricks." 
     There is recent research to support this axiom especially for people with neurological issues. Dragansky, et al in 2008 noted in Training induced structural changes in the adult human brain, that structural and functional brain reorganization and healing can occur well beyond childhood and reorganization and healing are intrinsic properties of the human central nervous system (brain and spinal cord). They report "environmental changes, novel experience and learning new skills modulate brain function and underlying neuroanatomic circuitry (the structure of the brain)."  Draganski, B. and A. May (2008). "Training-induced structural changes in the adult human brain." Behav Brain Res 192(1): 137-142. [Medline Abstract].

2. Increase Self Awareness
    In addition to medical and surgical options, people with Parkinson disease have a number of options which research indicates are beneficial in increasing quality of life. Three approaches are known to improve comfort and function in people with neurodegenerative disorders. These focus on mood and attitude, exercise and nutrition. These are areas where health coaches can corroborate in the achievement of your health and functional goals. One of the health coach's job is to increase the individual's self awareness, help them have insights and encourage tangible action to change, thereby improving success in life, mood, attitude, fitness level, diet and overall quality of life.     
    Health Coaching can be an Intuition Fitness Center for both participants in the coaching relationship.

3. Support Exercise Programs to Improve Posture, Strength and Mobility
    By encouraging accountability and collaborating with the individual on blocks that prevent regular activity, health coaches can make the difference between achieving the best possible function and declining function.
     Improving and maintaining strength and posture provides several benefits to people with neurodegenerative disorders. Stooped postural presentation with forward head carriage, increased curvature of the upper back and forward flexed arms can be caused by many factors including spinal rigidity, loss of normal subconscious posture control, poor balance, and a loss of normal proprioception (movement sensation of the joints). This posture can be improved through manual therapy and exercise.
     "Most of us can have good posture if we force ourselves to stand up tall, but we will inevitably resort back to our original position once our effort ceases. It is critical to understand that posture is a subconscious state. Therefore, any methods aimed to rehabilitate posture must focus on subconscious mechanisms and not simply attempt to exercise the body from a bad position to a better one. The keys to improving subconscious control are to use repetitive movements with medium to long contraction times (10seconds-1 minute), involve whole body movements, and to challenge balance/stability. The best way for Parkinson's patients to help induce subconscious learning is to perform therapeutic exercises along with strong concentration and cognitive thought." (Lander,2009). Lander, J. (2009). "Living with Parkinson's: Strategies for Patients." [Full Text] 
     Think of the first time you tried a new activity- a sport, game, hobby, or musical instrument. You probably had to concentrate very hard to get it right in the beginning. As time passed with more practice and participation the activity became easier and easier until you could do it "with your eyes closed" or "in your sleep" as the sayings go. In other words, the activity became "reflexive." Clients with Parkinson's or other neurological issues affecting posture, must utilize concentration or "cognitive" activity to compensate for the lack of reflexive control resulting from the disease. An analogy of this concept is driving a "standard" automobile instead of an "automatic." The "automatic" car shifts gears on its own (reflexive) but in a "standard" the driver must know when to shift to make the car move efficiently (cognitive). The importance of concentration and mindfulness cannot be underestimated as it relates to learning, exercise, and brain activity." 
     There are many ways to increase awareness and access subconscious learning. Health coaching is one and Matrix Energetics is another. A combination of various approaches have proven very beneficial.

4. Designing Self Care Programs Using Integrative Manual Therapy Reflex Points
     Trained in a range of Integrative Medicine approaches, our Health Coaches can discuss options for self care programs which facilitate nervous system function and healing.
     Integrative Manual Therapy is a hand-on approach which improves nervous system function and overall health and wellness. Similar in some ways to acupuncture points, reflexology, Chapman's reflexes and Emotional Freedom Techniques (EFT) reflexes, Synchronizers are a system of reflex points from the field of Integrative Manual Therapy which can be used by practitioners as well as in a self care program at home. There are Synchronizers for improving nervous system function in general as well as ones thought to influence Dopamine production, cranial blood flow, substantia nigra health, basal gangia balance, calcium level in the bone and muscles, hypothalmus function, cognition, learning abilities and communication as well as many other nervous system functions.

5. Designing a Matrix Energetics Guided Self Care Program
     One way to describe Matrix Energetics is as a quantum physics based form of energy medicine focused on bringing awareness to conscious and subconscious information. Another way is to borrow a phrase from Daoism and say the Matrix Energetics which can be described is not the Matrix Energetics. Contact us to experience Matrix Energetics.

6. Health Coaches Facilitate Neuroplasticity and the Placebo Effect
     Another way of saying neuroplasticity is healing and recovery of the nervous system. Our health coaches have experience working with clients who have improved the function of their nervous system post diagnosis of a neurological disorder. We see people walk after being in a wheel chair for several years due to spinal cord injuries. We see people's walking improve after strokes or nervous system injuries as well as a diagnosis of Parkinson's disease, Alzheimers, Cerebral Palsy, Multiple Sclerosis. We hear people's speech and hearing improve after hearing loss and tinitus (ringing in the ears) as well as in people with a diagnosis of ALS. We see people's vision improve after age 40 or with a diagnosis of macular degeneration, glaucoma, or multiple sclerosis.  We see people's movement improve and muscle start to function again 30 years after functional losses due to polio, Guillain-Barré syndrome (GBS) or other infections of the central nervous system.
     No one can tell us what can't be done because we have seen to many things happen which are commonly labeled impossible. Unlike Alice in Alice in Wonderland, who said, "There's no use trying, one can't believe impossible things." Our expeirence and what we have seen change makes us like the Queen who responded,"I daresay you haven't had much practice. When I was younger, I always did it for half an hour a day. Why, sometimes I've believed as many as six impossible things before breakfast."
     Sometimes people say, "it is just the placebo effect," as if it is nothing but the placebo effect is not nothing. It is something even when we don't understand it.
     People with Parkinson's are more susceptible to the placebo effect while people with schizophrenia are less susceptible than the average person. Perhaps the placebo effect is related to dopamine levels and the reward circuitry supplied by dopamine.
     Ultimate as health coaches we believe people should try out approaches and do what they feel will help them the most because that is the approach that will have the greatest placebo effect in addition to any other benefit it provides. Our Health Coaches knowing how to ask the right questions and how to listen carefully,  saving time, helping eliminate confusion and eliciting insights from the client, which benefits everyone.

7. Health Coaches Support Exercise Programs Designed The Way You Want Them
     One of the most important way to maintain and increase health and wellness is through exercise and body movement. Parkinson's, Alzheimer's, heart disease, diabetes, obesity, cancer, arthritis and osteoporosis are all conditions that are improved by exercising. Exercise also helps to relieve mental stress, depression, and dementia. People with injured nervous systems who participate in regular exercise can improve body strength and endurance, thus helping to prevent injuries and falls sustained during daily activities.
     Furthermore, exercise improves blood flow (oxygen) to the brain and actually creates new neuron (nerve cell) branches. These new discoveries of the past 15-20 years support and enhance the long held understanding of the importance of cardiovascular exercise on health. They have also resulted in rapid developments of physical exercise strategies that are meant to strengthen not only the body but also the brain itself. 
     Our health coaches trained to understand the nervous system can help support you as you learn new tricks and fully take advantage of your brain and nervous systems ability to heal.
     Advances in neuroscience reveal that exercise acts at the molecular level to inhibit cell death, increase synaptic efficiency, and promote behavioral recovery in animal models (rodents) of Parkinson's disease (PD). Kleim J, Jones T, Schallert T. Motor enrichment and the induction of plasticity before or after brain injury. Neurochem Res. 2006;11:1757–1769.;  Smith AD, Zigmond MJ. Can the brain be protected through exercise? Lessons from an animal model of parkinsonism. Exp Neurol. 2003;184:31–39.
     Furthermore, research has identified fundamental principles of exercise that contribute to neuroplasticity in animal models of PD and in humans with stroke-related hemiparesis and spinal cord injury. These data challenge the assumptions of current rehabilitative models that there is no potential for neuroplasticity or recovery. The use of exercise as a physiologic tool to promote the body's own endogenous [inside] brain repair mechanisms is a virtually untapped resource. Research in the area of exercise neurobiology has shown that exercise may interfere with multiple mechanisms involved in cell death, stimulate the proliferation of new neurons.
     Traditional approaches that are problem based or that focus on teaching compensations imply that neurophysiologic changes are no longer possible (ie, that it is too late for people with Parkinson's disease, strokes or other neurological issues. Thus, the approaches are typically not based on physiologic hypotheses to directly counteract disease-specific pathophysiology (ie, impaired internally cued amplitude regulation) or principles of motor learning. Altogether, these data suggest that there may be no one superior approach, as long as a critical threshold of high effort (complexity, difficulty) exists over an adequate period of time (repetition). Farley, B. G., C. M. Fox, et al. (2008). "Intensive Amplitude-specific Therapeutic Approaches for Parkinson's Disease Toward a Neuroplasticity-principled Rehabilitation Model." Topics in Geriatric Rehabilitation Vol. 24, No. 2, pp. 99–114: [Full Text] 
     A 2006 study on the benefits of Qigong a movement based approach from China noted, "More patients improved in the Qigong group than in the control group at 3 and 6 months. At 12 months, there was a sustained difference between groups only when changes in UPDRS-III were related to baseline. Depression scores decreased in both groups, whereas the incidence of several nonmotor symptoms decreased in the treatment group only. Qigong exercises were applied as 90-minute weekly group instructions for 2 months, followed by a 2 months pause and a second 2-month treatment period." Schmitz-Hubsch, T., D. Pyfer, et al. (2006). "Qigong exercise for the symptoms of Parkinson's disease: a randomized, controlled pilot study." Mov Disord 21(4): 543-548. [Medline Abstract]. 

8. Coaching the Brain, Changing the Brain
    Developer of Results Coaching and NeuroLeadership programs, David Rock, noted "By linking coaching to brain function we are closer to understanding the ‘active ingredient' in coaching. A Vitamin C tablet has fillers and sweeteners, but without the active ingredient, ascorbic acid, it tastes nice but does nothing to increase our Vitamin C levels. In coaching, the active ingredient is self-directed neuroplasticity, in other words, the brain changing it's internal structure. Without real change in brain circuits, coaching might feel nice but change nothing. 
     The ARIA model of awareness, reflection, insight, action, is a common way in which brain change occurs in coaching. Whatever coaching model you use, change occurs when we stop and focus on a particular circuit (awareness), shift our perspective (reflection), see the situation in another way (insight), then take action to embed the new connections. Here are some things we can do to improve our efficiency as coaches, based on this new understanding: 
     Awareness: The brain has significant limitations when processing new ideas. Our ‘working memory' overloads easily. It's useful to simplify complex challenges to central issues, chunk big issues into smaller ones, and tap into the extra processing power of visuals.
     Reflection: Insight research is showing that prior to an insight the brain is in an alpha state. Alpha states are quiet, representing minimal effortful activity or electrical noise. This state is easily pushed aside by anxiety, uncertainty, even ambiguity. To make a new connection, we need to ask questions that make people quietly reflect on the solution to the challenge they face, not give more attention to the problem. Thus the question ‘What's stopping you?' may not be the most useful way to focus attention when trying to facilitate insight. Instead, try asking ‘What solutions can you sense just beneath the surface?'
     When coaching conversations don't work it is often because a coachee feels defensive. Recent studies show the part of the brain needed for clear thinking becomes less active when we feel threatened. Despite good intentions, coaching often becomes a subtle debate, with the coachee fending off the coaches' ideas. The brain research points to the importance of rapport, trust and clarity as essential components of good coaching, though these are not enough to drive change on their own.
     Insight: Insights have a life of their own, but they can be overlooked if the coach is focused on their own agenda. When a coachee has an insight, we want to pay attention, to strengthen it. To do so, simply ask a coachee about what they saw in their minds' eye when they seem to have made a new connection.
     Action: People are significantly more willing to commit to an action 1 minute after an insight than 5 minutes later. The energy released by an insight is short lived.
In summary, by understanding the phases that the brain moves through as we try on a new idea and then take action, we can improve our capacity to drive change, working with another persons' energy rather than against it.  Rock, D. (2009). "Brain Based Coaching." The Linkage Leader: [Full Text]

9. Improving Nutrition to the Brain
    The accountability of a health coaching program can again be the ingredient which helps support a good nutritional program for the person with a healing nervous system. Similar to exercise, nutrition can be directly or indirectly attributed to nearly all disease processes. One aspect of nutrition (and of health in general) that has gained incredible support over the past few years is that of inflammation. Chronic inflammation has been linked to many disease processes including heart disease, cancer, auto-immunity, fibromyalgia, and pain syndromes. Alzheimer's and Parkinson's have also been linked to chronic inflammation. Many medical and nutritional therapies are now focusing exclusively on limiting (or preventing) chronic inflammation of the body.
     A few years ago the Institute of Functional Medicine (IFM) held a nutritional conference with speakers addressing "Neuroinflammation: The Brain on Fire" and what could be done with food, nutritional supplements and lifestyle changes to decrease inflammation in the nervous system and in the whole body.

10. Attitude, Mood, and Coaching for Change
     Before any action can be taken, whether it is posture correction, exercise, a nutritional change or improving relationships, there has to be aan awareness and a choice to make a difference- to try or to do as Yoda would say. The person with a neurological issues is the only one that truly understands what it is like. Only that person can decide to make the effort to improve function. Obviously, it will be more difficult for some than others. A support system can be in place to help maintain focus, encouragement, and a positive mental attitude. We all need a coach, mentor, or partner when times are hard on us. We would love to join the other people who are there for you.

11. Improve Relationships with Your Support Network
     Health Coaches can ask questions, actively listen and guide you as you discover how to solve problems, improve performance and regulate emotional states. Changing the environment internal and external in which you live your life can facilitate changes in behavior, in practice, in interactions. Health Coaching is all about improving relationships. Your relationship with yourself, your mind, your body, with exercise, nutrition, activities of daily living, as well as with everyone in your support network and neighborhood. Your friends and family will see the changes you can make and respond by being easier to talk to, more willing to listen and understand and more enjoyable company.

     Are you ready to create your ideal recovery program, satisfying business or activities, more quality time, loving and fulfilling relationships, more energy, more balance and more fun? Then, please call us or email us to find out what we can do for you.

References
Burnham, K. (2010). "Ten ways health coaches can meet the needs of people with neurological disorders or injured nervous systems." [Full Text] at Visualize Health . net
Murphey, E (2008). "The PHI Coaching Approach." [Full Text]
King, L. A. and F. B. Horak (2009). "Delaying mobility disability in people with Parkinson disease using a sensorimotor agility exercise program." Phys Ther 89(4): 384-393. [Full Text].

Quality of Life Management 101

Chronic Conditions
     Chronic just means something has been going on for a while or it hasn’t changed in a positive way for a while. Chronic says nothing about the potential for healing and shifts in the condition. 
    At Visualize Health we see so many people who are healing and recovering from a wide variety of conditions, previously considered chronic or degenerative.
    Many chronic conditions can be improved by simple changes to healthy lifestyle habits such as visualization, exercising, eating better, managing your stress/anxiety, losing weight and attaining freedom from addictions. 
    The personal health coaches at Visualize Health work with individuals who have a diagnosis of diabetes, high blood pressure, high cholesterol, or other chronic issues such as arthritis, back pain, Parkinson’s, Multiple Sclerosis, Fibromyalgia, Celiac disease and more.

Motivation and Performance
     “Organizations have learned that highly motivated and fulfilled employees at all levels produce high-performance results for the organization.”  Laura Whitworth (2007) in Co-active coaching: new skills for coaching people toward success in work and life. 
    Our body can be thought of on some level as a large organization of cells.  When each cell is highly motivated, fulfilled and in high performance mode, results for the individual person can be a remarkable quality of life. At Visualize Health, we use health coaching principles all the way from a look at relationships at the team or business organization level to a look at health on a cellular level, working always with the individual person and their needs.

The Coaching Relationship
     Coaching is a form of conversation, a dialogue between the coach and client or organizational team with qualities including respect, openness, compassion, empathy, and a rigorous commitment to speaking the truth. 
     Coaching is not about solving problems, although problems will be solved. It is not primarily about improving performance, attaining goals, or achieving results, although all of that will certainty happen in an effective coaching relationship. 
    Coaching is chiefly about discovery, awareness, and choice. It is a way of effectively empowering you to find your own answers, encouraging and supporting you on the path as you continue to make important choices.

Questions and Answers
    Questions and Answers come from the you, from you inner wisdom, the power of your mind and subconscious. The coach does not deliver answers. The coach asks questions, inviting discovery. The client may never have sought the answer before the coach asks the question - the question creates the channel for self-discovery - but the answer is already there for you.
     Clients are more resourceful, more effective, and generally more satisfied when they come up with their own solutions. And because they choose the solution, they are more likely to follow through with action. When what they need really is expert advice, they will have motivation to find that, too.

The Coach
    Your coach at Visualize Health is someone who listens to the very best in others, even when they can't hear it in themselves. A coach is someone who cares that people create what they say they want, that they follow through when they choose. The coach is there to hold people accountable and keep them moving forward toward their dreams and goals.  

Impact of Visualizing Health

    If you answered yes to any of the questions above, Visualize Health can have a positive impact on your situation. Working with your own personal health coach will help you achieve the healthy lifestyle changes to significantly impact your ability to recovery from symptoms.

     Our goal at Visualize Health goal is to help you begin and maintain new healthy way of functioning which will improve the quality of your life. All along the way, your coach supports, encourages, challenges and motivates you.

Introducing Your Health Coach: Kimberly Burnham

 I look forward to working with you and learning about your health needs and goals. Please feel free to contact me via email with any questions you may have. I'm here to support you in your effort to create the life you desire.

 I have a diverse educational background which has allowed me to see as the Japanese say, “there many ways to get to the top of Mount Fuji.” I completed my PhD in Integrative Medicine in 2006 on "The Effect of Integrative Manual Therapy on the Symptom’s of Parkinson's Disease." and have done substantial research into the benefits of Complementary and Alternative Medicine (CAM) enabling me to understand the health concerns of my clients and work as part of a health care team, when desired, communicating effectively with my client as well as their health care providers.

 In 1993, I graduated Sutherland-Chan Massage Therapy School in Toronto, Canada. An excellent education there prepared me for a move into the health care field. I also spent 5 years studying at the Canadian College of Osteopathy, which helped me each individual person in a holistic way. My training in cranial work, energy medicine, Brain Stimulating Method, Listening with the Whole Body, Clinical Hypnotherapy, and Non-Violent Communication has developed my ability to listen to the client and perceive shifts as they progress towards their goals.

 I have been in private practice using Integrative Medicine, Manual Therapy, Matrix Energetics and Health Coaching for the last two years in West Hartford, CT as well as consulting in a number of physical therapy clinics across the country. Before that as the Director of Knowledge Management at the Center for Integrative Manual Therapy, I answered questions for clients, students and the general public about what non-surgery and non-medication related therapies can do for healing and health. Two of my favorite quotes around the potential of an integrative approach to health and consciousness are, "Any sufficiently advanced technology is indistinguishable from magic." Arthur C Clarke, Science Fiction Writer and "Magic is the art of causing changes in consciousness at will" Dion Fortune.
 
 My global perspective on health and good living is the result of growing up in Colombia and in Belgium and later teaching English and studying shiatsu in Japan. My favorite place in all the world to Scuba dive is the Red Sea off the coast of the Sinai Peninsula in Egypt. I agree with Albert Einstein that , “the most important decision we make is whether we believe we live in a friendly or hostile universe.." My world view is that we live in an abundant universe supportive of each of us having quality of life.

 I currently live in West Hartford, CT with my partner and enjoy traveling, most recently working in Germany and touring Turkey, where I visited a memorial to Rumi, one of my favorite poets who said, "There is a field out beyond right and wrong. I will meet you there.".

 I practice Tibetan meditation, Wisdom Healing Qigong and love growing fruits and vegetables in my garden. These activities center and calm me, allowing me to be more present for my clients. They also empowers me to change and reach my personal goals. As Richard Bartlett, developer of Matrix Energetics says, "Change now, while you still can. Change now because you can, change now because it is the right thing to do. Change now because there is no right, no left, no time left, no space left. Only you. Change"