N A H A The National Association for Holistic Aromatherapy In This Issue: • A Pure Journey • Scoliosis: Part 2 • The Humble Case Study • Teaching Essential Oil Chemistry • Aromatherapy in Hospice • Psychoneuroimmunology • The Aromatherapy Business.... Aromatherapy E-Journal 2010 • 3 Aromatherapy Journal The National Association for Holistic Aromatherapy This is a live journal or in other words an Electronic version of the hard copy journal you are used to receiving. Please scroll your way through to enjoy the journal as you have others in the past. This is the paperless, waste free version that NAHA has adopted. If you have trouble in viewing or would prefer a hard copy or a disk sent to you, please contact us and we will send one out to you. Additional fees apply. Enjoy and we look forward to hearing from you soon! NAHA’s New Board of Directors NAHA Office President: Kelly Holland Azzaro, RA, CCAP, LMT PO BOX 1868 Vice President: Shellie Enteen, BA, RA, LMT Banner Elk, NC 28604 Public Relations: Jennifer Hochell Pressimone Office: (828) 898-6161 Secretary: Gina Rafkind Fax: (828) 898-1965 Director Coordinator: Annette Davis, CN Email: [email protected] Journal Layout: Robyn Harden www.naha.org Journal Editorial Team: Shellie Enteen & Kelly Holland Azzaro NAHA Webmaster: Yelena Vusataya Professional Aromatherapy Volume 2 In This Issue: 4 Aromatherapy in Hospice..............................................................Lisa M. Browder ICA, CR 8 Psychoneuroimmunology and the Implications for the Practice of Aromatherapy.... Elaine Dohms, Certified Clinical Master Aromatherapist 18 Teaching the Chemistry of Essential Oil: Why Bother?...Andrea Butje, Certified Clinical Aromatherapist 22 The Humble Case Study: Gold Dust at Your Fingers!.............Jane Buckle, Ph.D., MA, RN 26 A Pure Journey............................................................................Dr. Rev. St. James Burton, GRMT, LMBT 31 The Aromatherapy Business Offers Practitioners Many Opportunities.....Rose Chard, LMT 37 Scoliosis: Effective Alternative Methods of Treatment Part 2........ Sylla Sheppard-Hanger, LMT and Don McCann MA, LMHC, LMT, CSETT Editor’s note: Agarwood, Aloeswood, Frankincense, Rosewood and Sandalwood species are listed as both threatened and endangered. Please choose a different essential oil to work with to allow the trees to make a sustainable recovery. To learn more about endangered and threatened species please visit www.cropwatch.org for more information. NAHA does not encourage or endorse the purchase, sale or use of endangered essential oils. Disclaimer: NAHA and the NAHA Editorial Board cannot accept responsibility or liability for the information contained in the NAHA Aromatherapy Journal/E-Booklet or on the NAHA Website. The information is shared for educational purposes only and is not intended to diagnose or take the place of professional healthcare. The opinions expressed by the authors in this journal or e-booklet do not necessarily reflect the opinions of NAHA. Please consult your health care practitioner if you are pregnant or have been diagnosed with any serious healthcare problems before using essential oils. Keep all aromatherapy products out of reach of children and pets. Before using essential oils and aromatherapy products please consult with a professional aromatherapist. NAHA asks that all authors and contributors include information on safe use of essential oils and clearly define each essential oil’s common name and Latin binomial(s). NAHA has the right to accept or reject any articles, advertisements or content submitted. NAHA website is a resource-full area for information on Aromatherapy Safety, Applications and Uses. www.naha.org 3 © Copyright 2010 NAHA • All rights reserved Aromatherapy in Hospice: Clinical Challenges Beyond Essential Oil Blending Lisa M. Browder ICA, CR Hospices are well-suited how the pharmaceuticals had not provided the for clinical aromatherapy expected relief. When I suggested adding a blend of programs but they face essential oils to the treatment, she responded, “If our their own unique chall- stuff hasn’t worked, yours isn’t likely to.” enges: investment costs, skeptical clinicians, and That negativity can be pervasive so I would suggest the fear of possible that a good way to squash doubts is to start with staff lawsuits. complaints and offer to treat their headaches, backaches, stuffy noses, etc. Nothing is more The costs associated with convincing than a successful resolution and you will investing in an aroma- need staff support to work effectively. therapy program can be significant so it’s imper- Another thing that will give your program credence is ative to set specific guide- to learn to speak their language. You’ll never assuage lines for what you hope to cynicism by speaking about concepts clinicians view aachieve. Perhaps your goal as New Age fluff – auras, chakras and crystals. You’ll is to have the most comprehensive program in town find that many will profess to believe in “those in order to offer something your competitors might things,” just not for use with their patients. I would not provide. If so, then you’ll want to establish as advise saving those discussions for a time when many innovative uses of the essential oils as possible. you’ve firmly established yourself and then they That will necessarily raise costs since you’ll need a might begin to listen and to take them seriously. higher number of potentially expensive essential oils and a wide variety of supplies – carrier oils, lotions or Learning their language means knowing common creams, spray bottles and jars, inhalers, nebulizers hospice diagnoses, the associated symptoms and and/or diffusers, mixing utensils and bowls, and whether essential oils might be likely to help. Keep in labels. mind that therapeutic essential oils are not appropriate for every symptom; you must know the For me, the major obstacle to overcome was the need diagnosis to determine the feasibility of treatment. to “prove” the program’s worth to staff skeptics. If For instance, hearing “constipation” is not enough that is so for you, you’ll want to start in a small and information. If the diagnosis is colon cancer with a focused way to keep expenses reasonable and complete bowel obstruction, a constipation lotion outcomes measurable. In a society where every would be contraindicated. grocery store item with a smell, whether called “ocean breeze” or “sunny day,” is labeled Likewise, if a patient is complaining of a constant ‘aromatherapy’ why would they simply believe you headache, check the diagnosis. If you hear when you tell them essential oils have physiological “glioblastoma,” you might want to hold your effects on the body? vasodilators and instead opt for something to help him relax. Increased circulation to the brain would A nurse at my facility loved to tell patients and not be helpful for a growing tumor. families (but only if I happened to be present) what a wonderful thing it was to have aromatherapy. Another effective communication tool is being able Shortly thereafter, in one of our interdisciplinary to provide double-blind/placebo or case studies. group meetings attended by representatives from Keep several handy that you can cite or hand out nursing, pharmacy, physicians, social work, volunteer because if you can’t hold your own with services, spiritual care and complementary therapies, science-based clinicians, your program will quickly be the discussion focused on a patient’s symptoms and seen as nice but unnecessary. Continued.....page 5 4 © Copyright 2010 NAHA • All rights reserved Aromatherapy in Hospice: Clinical Challenges Beyond Essential Oil Blending Lisa M. Browder ICA, CR Continued.....page 4 essential oils and that’s great for those of us in hospice. One such case study by Irene Gilliland, RN, One such double-blind/placebo study was doc- CNS, ACHPN, recently published in the umented in the 2003 Journal of Clinical Psychiatry on September/October 2009 Journal of Hospice and the effects of Lemon Balm (Melissa officinalis) on the Palliative Nursing is titled, “Use of Essential oils to management of agitation in severe dementia. The Treat Methicillin-Resistant Staphylococcus aureus in results showed that Melissa is an effective treatment End of Life: A Case Study.” Methicillin-resistant and that an added benefit was that quality of life Staphylococcus aureus (MRSA), a particularly indices also improved significantly. I cite this study virulent bug, can quickly overwhelm a weakened frequently with clinicians who are skeptical of the immune system and is easily transmitted. In this benefits of our Agitation/Anxiety blend and it has study, Lavender (Lavandula augustifolia) was used in made a difference in their acceptance. a saline eye wash for a 102-year-old nursing home patient who had been isolated for three years due to More and more studies are also being done on the MRSA in the eyes. She had been treated with antiviral, antifungal, antiinfectious properties of everything from Oxacillin, Imipenem and Continued.....page 6 Join us at the NAHA Blog NAHA World of Aromatherapy Blog Spot http://worldofaromatherapy.blogspot.com/ An online environment to learn more about NAHA E-Newsletter Articles Aromatherapy Updates Membership Sharing and Support And Much More! Reciprocal Blog web-links available for NAHA Member’s Blogs Fill out the NAHA Online Membership Feedback Form for more information www.naha.org 5 © Copyright 2010 NAHA • All rights reserved Aromatherapy in Hospice: Clinical Challenges Beyond Essential Oil Blending Lisa M. Browder ICA, CR Continued.....page 5 Massage Therapists’ Most Popular Essential Oil Creams: Moxifloxacin, to Mupirocin and Vancomycin. Nothing had worked. Someone suggested essential Dry/Itchy Skin Cream oils and the pharmacy mixed 15 drops of Lavender in 500ml of saline. They soaked a cotton ball in the Lavender (Lavandula augustifolia) solution twice a day and swiped it across the patient’s eyelid. One month later, the patient was retested Geranium (Pelargoneum graveolens) and there was no sign of MRSA present. I love to Roman Chamomile (Anthemis nobilis) quote that one because as our staff gets comfortable with the use of essential oils for things like Muscular Aches & Pains constipation, edema, agitation/anxiety, depression, dry/itchy skin, respiratory issues and nausea, my Lavender (Lavandula augustifolia) attention is being drawn to more specific things like Rosemary (Rosmarinus officinalis) the treatment of MRSA, thrush, C-Diff (Clostridium difficele), flu and a host of others. Fennel (Foeniculum vulgare) Clearly, the practice of aromatherapy in hospice Black Pepper (Piper nigrum) requires a knowledgeable, intrepid aromatherapist Juniper (Juniperis communis) who can pick her way through the minefield but it’s well worth the effort. The Director of Research at the Peppermint (Mentha x piperita) National Hospice and Palliative Care Organization (NHPCO) said there are no available statistics on the number of hospices with an aromatherapy program. I suspect this may be because many have fledgling, Nurses’ Most Requested Essential Oils: ineffectual programs, primarily using Lavender (and nothing more) and often only as a room freshener. The possibilities for aromatherapy in hospice are Agitation/Anxiety Blend for Nebulizers therefore endless at this point. Lavender (Lavandula augustifolia) AlthoJugh enont offnereSd withc a eclainm tthats they will Melissa (Melissa officinalis) prevent or cure disease, essential oils’ known ® Sweet Orange (Citrus sinensis) historical properties, coupled with an array of recent Holistic Aromatherapy reputable studies, show them to be highly effective in Lemon (Citrus limon) hosHpicoeli,s wtiict hA rthoem aadthdeerda bpeyn Ceefirtt oifif chaatvioinng C feowu r(sife asny) contraindications (unlike pharmaceuticals). Because NAHA Level I & II Approved of this, it’s a pet peeve of mine to have clinicians Constipation Cream Introduction · Advanced · Specialized Business suggest it would be unwise to use essential oils in Lavender (Lavandula augustifolia) Emotional Healing · Skin Care · Body Systems hospice because they can cause allergic reactions. Herbal Integration · Animals We routinely use pharmaceuticals that come with a Ginger (Zingiber officinale) laundry list of contraindications (many of them In Historic Downtown Clermont Fennel (Foeniculum vulgare) potentially7 0le2t Wh.a Ml) oanntrdo sye eStt . wCleer mneonvet Fr loqruideastion their use. Likewise, we ke3e5p2· M24a3t ·e 9r6ia2l7 Safety Data Sheets Black Pepper (Piper nigrum) on the chwemwicawl .cjoemnpnonsecnetsn otfs .acllo tmhe synthetic Rosemary (Rosmarinus officinalis) materials in shampoos, soaps, body lotions, laundry Continued.....page 7 6 © Copyright 2010 NAHA • All rights reserved Aromatherapy in Hospice: Clinical Challenges Beyond Essential Oil Blending Lisa M. Browder ICA, CR Continued.....page 6 References: Although not offered with a claim that they will Ballard, CG, O’Brien, JT, Reichelt K., Perry, EK (2003). prevent or cure disease, essential oils’ known Aromatherapy as a safe and effective treatment for the historical properties, coupled with an array of recent management of agitation in severe dementia: the results reputable studies, show them to be highly effective in of a double-blind, placebo-controlled trail with Melissa. hospice, with the added benefit of having few (if any) Journal of Clinical Psychiatry, Jul; 63(7):553-8. contraindications (unlike pharmaceuticals). Because of this, it’s a pet peeve of mine to have clinicians Gilliland, Irene, RN, CNS, ACHPN (2009). Use of Essential suggest it would be unwise to use essential oils in Oils to Treat Methicillin-Resistant Staphylococcus aureus hospice because they can cause allergic reactions. in End of Life: A Case Study. Journal of Hospice and We routinely use pharmaceuticals that come with a Palliative Nursing, Vol. 11, No. 5, September/October. laundry list of contraindications (many of them potentially lethal) and yet we never question their National Hospice & Palliative Care Organization (phone use. Likewise, we keep Material Safety Data Sheets call). on the chemical components of all the synthetic materials in shampoos, soaps, body lotions, laundry Lisa Browder manages the complementary therapies detergents, cleaning products and disinfectants. Yet program at a hospice in Nevada and will be speaking at we use them regularly and without hesitation. the National Hospice & Palliative Care Organization’s September conference in Atlanta on “Aromatherapy I am lucky to be in a hospice that champions the use for Symptom Management in the IPU.” She is the of essential oils for their therapeutic value. I Nevada Director for NAHA and sells therapeutic continually search for the studies and information essential oil products to hospices through her company, that help bolster the case for their safe and effective Scentsibility. use. My goal is nothing less than an aromatherapy program in as many hospices nationwide as possible. www.scentsibility.cc 7 © Copyright 2010 NAHA • All rights reserved Psychoneuroimmunology and the Implications for the Practice of Aromatherapy Elaine Dohms, Certified Clinical Master Aromatherapist "When the mind mune system. PNI studies the connections or links thinks, the body between our "state" of mind and our "state" of health. listens" Interest in the relationship between psychiatric syn- dromes or symptoms and immune function has been John Madden, PhD a consistent theme since the beginning of modern medicine. Walter Cannon, a professor of physiology at Harvard University, looked at the need for mental and physical balance throughout the organism and created the term, ‘homeostasis’ in his book, The Wisdom of the Body, published in 1932. Dr. Cannon observed that any change of emotional state in his lab animal, such as anxiety, stress, distress, or rage, was accompanied by total cessation of stomach movement. These studies into the relationship between the Psychoneuroimmunology is a large word that sug- effects of emotions and perceptions on the gests an even larger impact on our future medical autonomic nervous system, namely the sympathetic choices of wellness and healing. The practice of and parasympathetic responses initiated the Holistic Aromatherapy, the use of Essential Oils to recognition of the "freeze fight or flight" response. support and strengthen the immune function, will Picking up on Cannon's work, Hans Selye formed the offer the possibility of improving health through empiric foundation of the ability for an animal to direct effects on the mind/body connection. A adapt, heal, and recover from adverse mental and relationship that defines and supports the concepts physical conditions. Selye's work was summarized in of aromatherapy has been recently enjoying a new the concept of the General Adaptation Syndrome acceptance in western medicine due to the successful (GAS). This syndrome consists of an enlargement of research in the field of Psychoneuroimmunology. the adrenal gland, atrophy of the thymus, spleen, and Psychoneuroimmunology, (PNI) is the branch of other lymphoid tissue, and gastric ulcerations due to biomedical science that explores the relationships an environment of prolonged and/or chronic stress between the nervous system, emotions, and the im- and the body's reaction to the presence of stress related stimuli. Selye describes three stages of adaptation, the initial brief alarm reaction, followed by a prolonged period of resistance and a terminal stage of exhaustion and death. This monumental work led to mid-20th century studies that reported that psychiatric patients experienced immune alterations including a decreased number of lymphocytes and a poor response to pertussis vaccination when compared to non-psychiatric control subjects. In 1964, George F. Solomon, et al. coined the term "psych- oimmunology" and published his landmark paper: “Emotions, Immunity, and Disease: a speculative theoretical integration”, Archives of General Psychiatry 1964; 11:657-74. Continued.....page 9 © Copyright 2010 NAHA • All rights reserved 8 Psychoneuroimmunology and the Implications for the Practice of Aromatherapy Elaine Dohms, Certified Clinical Master Aromatherapist Continued.....page 8 The two major pathway systems are involved in this cross-communication are the Hypothalamic - pitui- In 1975 Robert Ader and Nicholas Cohen at the tary - adrenal axis (HPA axis) and the sympathetic University of Rochester advanced PNI research with nervous system (SNS). The body's primary stress their demonstration of classic conditioning of the management system is the HPA axis. The HPA axis immune function. The previous term of responds to physical and mental challenge to "psychoimmunology" was updated to "psycho- maintain homeostasis by controlling the body's neuroimmunology". Through his highly controlled cortisol level. The two major pathway systems that research with laboratory rats, he determined that are involved in this cross-communication are the there was a scientific connection between stress Hypothalamic-Pituitary-Adrenal axis (HPA axis) and stimulation and immunosuppression. This was one the Sympathetic Nervous System (SNS). The body's of the first reproducible scientific studies that proved primary stress management system is the HPA axis. the nervous system can affect the immune system. The HPA axis responds to physical and mental Up until this point, immunologists believed that the challenges to maintain homeostasis (the body's immune system was an autonomous system and balance or internal environment) by adjusting and functioned independently from other body systems: controlling the body's hormonal level of cortisol. R. Ader and N. Cohen, “Behaviorally Conditioned Dysregulation or disruption of the function of the Immunosuppression”, Psychosomatic Medicine, Vol. HPA axis is implicated in numerous stress-related 37, Issue 4:333-340. diseases. Contemporary advances in psychiatry, immunology, neurology, and other integrated disciplines of Continued.....page 10 medicine have fostered enormous growth for PNI. In 1985, research by Candace Pert revealed that The International Federation neuropeptide-specific receptors are present on the of Professional Aromatherapists cell walls of both the brain and the immune system. The discovery that neuropeptides and neuro- transmitters act directly upon the immune system shows their close association with emotions and suggests mechanisms through which emotions and invites enquiries from aromatherapists regarding: immunology are deeply interdependent. Showing that the immune system and the endocrine system In Essence are modulated not only by the brain but by the our quarterly professional aromatherapy journal – adynamic and versatile forum for contributors central nervous system itself has a huge impact on of international standing how we understand emotions and disease. Annual Weekend Conference PNI research is looking for the exact mechanisms by held in the UK – an opportunity to which specific brain-immunity effects are achieved. be informed and inspired! Evidence for nervous system - immune system inter- IFPA Practitioner Membership actions exists at several biological levels. The im- join the UK’sleading aromatherapy professional mune system and the brain communicate to each association – run bypractitioners forpractitioners other though signaling pathways. The brain and the immune system are the two major adaptive systems IFPA, 82 Ashby Road, Hinckley, Leics LE10 1SN [email protected] www.ifparoma.org of the body. During an immune response the brain Tel: +44 (0)1455 637987 and the immune system "talk" to each other and this Registered Charity No. 1091325 process is essential for maintaining homeostasis. © Copyright 2010 NAHA • All rights reserved 9 Psychoneuroimmunology and the Implications for the Practice of Aromatherapy Elaine Dohms, Certified Clinical Master Aromatherapist Continued.....page 9 and bi-polar disease, in addition to autoimmune hypersensitivity and chronic infections. The HPA axis activity and cytokines (cell-messenger, hormone-like proteins that are produced in the Chronic secretion of stress hormones, glucocortaids hypothalamus) mediate and control the body's initial (CGs) catechcholamines(CAs), as a result of disease, inflammatory and adaptive responses that are may reduce the effect of neurotransmitters, including necessary to maintain homeostasis or internal serotonin, norepinephrine, and dopamine or other balance. Like the stress response, the inflammatory receptors in the brain leading to dysfunction of reaction is crucial for survival. neuro-hormones. The abnormalities and the failure of the adaptive systems to resolve inflammation Like the stress response, the inflammatory reaction is affect the well-being of the individual, including crucial for survival. Systemic inflammatory response behavioral parameters, quality of life and sleep. results in stimulation of four major programs that are Systemic anti-inflammatory feedback and/or mediated by the HPA axis and SNS: hyperactivity may be key factors in some metabolic and cardiovascular disorders and health. This same • the acute phase reaction systemic neuro-inflammation and neuro-immune • sickness behavior activation have been shown to play a role in the etiology of several neurodegenerative disorders such • the pain program as Parkinson's and Alzheimer's disease, multiple sclerosis, pain, and AIDS-associated dementia. • the stress response Never before has the phrase, "Stress will kill you!" Common human diseases such as allergies, meant more to today's individual. autoimmune diseases, chronic infections and sepsis There is now sufficient data to conclude that immune are all characterized by dysregulation of the modulation by psychosocial stressors and/or pro-inflammatory verses anti-inflammatory sit- interventions can lead to actual health changes. uation. Recent studies show pro-inflammatory cyt- Although changes related to infectious disease and okine processes take place during depression, manic wound healing have provided the strongest evidence to date, the clinical importance of immunological disruption is highlighted by increased risks across many medical conditions and diseases. Stress is thought to affect immune function through emotional and behavioral manifestations, such as fear, anger, sadness, and tension and physiological changes such as heart rate, blood pressure, and sweating. Researchers have suggested that these changes are beneficial if they are limited in duration, however, when stress becomes chronic, the body is unable to maintain homeostasis or equilibrium. T.B. Herbert and S. Cohen examined 38 studies of stressful events and the immune function of healthy adults and published their results in the Journal of Psychosomatic Medicine in 1993. They found con- sistent stress-related increases in increased numbers Continued.....page 11 © Copyright 2010 NAHA • All rights reserved 10