QUESTION: Why is AcuDestress done in groups, not individually?  What are the unexpected implications for individuals and their health care providers? Is there a downside?

ANSWER: Initially, back in 1995, the answer to this question was empirical and arbitrary. Dr. Smith had found and documented that he got better results when the patients attended in groups of six or more. I have speculated about why this is the case, but I was never party to the research, only told it was the case.

When we started to do ear acupuncture in our clinic, we didn't have groups of people who were ready to take this on, so we had to treat

people one by one.

People came in as they usually did for acupuncture, lay down on a bed, had their pins put in place, and were left alone for an hour as the entire treatment. There was no doubt from the outset that more than half of these people had something remarkable happen to them which wasn't at all associated with conversation they were in – because conversation wasn’t part of it.

We did however have a number of people, to our chagrin, who felt nothing happen, and this was disconcerting. There was no routine to follow, the book to read and no instructor to tell us what to do next.

But we did remember what Dr. Smith that said about doing it in a group. And as we had been accustomed to leading groups for years, we decided to get people together afterwards. It was an immediate outstanding success. People were very excited about what was happening to them and couldn't stop themselves from blurting it out to others. The evenings we held were well attended and immediately increased our results by about 10 to 15%.

Not only did we know that Dr. Smith had been right, but it

wasn't rocket science to see that most nights we had a group there were two and sometimes three groups of people who banded together with gusto and who talked in excited and hushed tones about their experience. It was apparent that people were picking up on a commonality, not with everyone but with certain other group members, and they were excited about expressing it. Over time we learned this was the essence of integrating one's newly-learned experience. But it was 10 years before we began to introduce group process to the actual treatment. Again we noticed a big increase in our results.

We wouldn’t call it either empirical or arbitrary now, as we know that the place that our people are going with the process, is a place where they connect at more and more intuitive levels with others, especially, in the beginning, with others who are undergoing a similar process. We find that if people can talk with other people who have had a somewhat similar experience after their treatment, both parties will do better. We long since refused to treat people individually because we simply don't think that alone they get the best we have to offer. We are not about to bargain away peoples possible results.

The unexpected implications for individuals and their health care providers

Some of the problems that we are asked to address in AcuDestress are harder than others. In mainstream psychotherapy sometimes people labeled as narcissistic are weeded out from long-term psychotherapy as the results with them have not been stellar, and the process is often frustrating to the therapist. We see nothing pejorative about the term narcissistic and are not among the practitioners who turn such patients away. We merely recognize the challenge they represent. and that challenge may be that they often oppose rather than accept help. After all, they are, we believe, genetically programmed to oppose stress.

When it comes to putting the whole spectrum of patients in a room together and seeing what happens, one sees that naturally those who move traditionally towards stress (the people we call GOLDS) and those who traditionally move away from stress (the people we call BLUES) find each other easily and engage in animated and therapeutically useful conversation. Mindfulness is learned more easily from others who are mindful! But those who traditionally move against stress as their principal way of dealing with it, the people who might be seen in other contexts as narcissists, are frankly not as quick to see the advantages of comparing notes with like-minded attendees.

If these patients remain isolated, they will not get as much value as those who benefit from brushing up against like-minded individuals rather easily. Thus we see value in making the effort for them. As we don’t always spot these people and their needs in advance, this goes beyond what we were able to discuss with them before the program.

It may even seem like we are making excuses for their lagging behind their compatriots. Even though this may require us to enlist the cooperation of their/your healthcare provider in backing up our request, we

feel assembling such people intentionally in a short but effective follow-up is group is what is indicated. Thus if you are a provider and you have sent your patient to us. You may be asked to help, and this may even involve your speaking to your colleagues about patients who have a similar bent to yours. As we are dedicated to getting results above all, we hope you can be too whether you are a patient or the healthcare provider for a patient who fits in this category. And if you’re a patient reading this, please be aware that we’re using an approach which can deliver more value to you than our not taking it.