TUESDAY AUGUST 29 2000 - The Times

Alternative health 

Empathometrics - fewer pills for your ills 

VAL SAMPSON 

When Karen Hulse developed a large red and flaking patch of eczema on her elbow she tried every cream she could find to get rid of it. Nothing worked. Finally, Hulse, a 21-year-old dental nurse from Nottingham, was persuaded by a friend to consult Dr Mark Nanda, a dentist and founder member of the Prescription Free Practice. 

Using a unique combination of techniques developed with his GP colleagues, Dr Trevor Hadfield and Dr Ian Walton, Nanda treated Hulse in two one-hour sessions. Within three days her eczema had vanished. 

"I couldn't believe it," she says. She is convinced that practising the half-hour relaxation that Nanda taught her, just once a week, has since kept the eczema at bay. 

The three medical practitioners met several years ago while training at the British Society of Medical and Dental Hypnosis. "Straightforward hypnotic techniques are OK, but can seem peripheral and old-fashioned," says Hadfield. "We wanted to bring new insights, including our knowledge of neuro-linguistic programming (NLP) and American therapy tools such as reflexive questioning and the hypnotic induction profile, and distil them into standard medicine, rather than them continuing to be regarded as 'alternative'. In doing so, we have created a new approach to medical training." 

The trio christened their new approach "Empathometrics" and discovered that patients with chronic asthma, eczcema and irritable bowel syndrome, who had been seeing hospital consultants unsuccessfully for years, were getting better in two or three sessions using their techniques. 

"We developed a new approach to taking a patient's history, then used new techniques of treatment," says Hadfield. An average consultation with an NHS GP lasts seven minutes; one at the Prescription-Free Practice, which opened in Sutton Coldfield last month, lasts at least an hour. 

"In the standard medical model you listen to a patient to try to make a label so you can write a prescription," says Hadfield. "Our history-taking explores not only the symptom and what is going wrong, but the other things that are going well, so you see what place their symptom has in the overall context of their lives." 

Statistics suggest that only one in ten people who consults their GP will be found to have an organic illness. "The other nine will be referred to a hospital for a full investigation costing several thousand pounds, and then they will be sent back to their GP with the suggestion that perhaps the cause is emotional and they should be treated with antidepressive drugs," says Hadfield. "The number of frequent attenders (patients seen by their GP more than 12 times a year) has risen fourfold in five years. We believe our approach can save the NHS a lot of money." 

Among a wide-ranging list of queries put to patients are: 'What is the most embarrassed you have ever been?'; 'What is the best/worst thing that has ever happened to you?' and perhaps even more intriguing: 'What would you want if your dearest wish were granted?' 

"If the patient immediately wants the symptom made better, you know they are totally focused on getting well, but a few patients will ask for five or six different things first and never mention their symptom," Hadfield explains. "When you ask them how many choices they would make before wanting their symptom better, they suddenly realise that the symptom they came in with is not that important to them." 

Using the work of the American psychiatrist David Spiegel, the practitioners carry out an hypnotic induction profile to measure the extent that a patient will respond to hypnosis. 

"When a patient is in a deeply relaxed state we can communicate with the real person rather than deal with the froth and bubble on top," says Hadfield. "It is at this point that we can use interventions such as NLP, where you can reframe their experiences, or parts therapy, where you talk to different parts of the patient. We will then teach them self-hypnosis in various forms, which is very profound relaxation and excellent for the relief of anxiety. 

"If someone comes to me with a complicated problem and I say 'Take this tablet and your problems will be cured' without finding out the root cause, that is an insult to my patient's intelligence. To practise as we now do in the NHS is bad medicine. It is not true to the standards we were taught because we just haven't enough time." 

They deny that they are encroaching on psychiatry. Hadfield says: "We won't treat people who have psychotic episodes because it is not appropriate and not our training. Psychosomatic illness is very much part of general medicine. We are giving patients support to turn their lives round; to give them more choices and allow them to look at their lives in different ways and to change themselves." 

Though their practice is called Prescription-Free, they do believe that drugs have a place in modern medicine. "If you have an eye infection or a dental abscess, you might sit with us until the cows come home and not get better," says Nanda. "But there is a huge gap that we are able to fill with this approach to patient care, which may reduce reliance on drugs, or get rid of them altogether. 

"We don't want to work like this just in this clinic; we are training health professionals and in five years' time would like to see this approach taught to healthcare workers as rote. Not instead of the training that they receive at the moment, but as an integral part of it." 

For Adrian Allen, an East Midlands DJ, the techniques used by the Prescription-Free Practice cured the dental phobia that had haunted him since childhood. "When I first met Mark I told him that I would have to fight the urge to hit him and trash his surgery while I was sitting in his dentist's chair," he recalls. "Since I started attending his clinic, he has used hypnotherapy and NLP to increase my confidence. When I needed a tooth taken out I thought I would have to be unconscious. In fact, he had built my trust to such an extent that he took out a tooth using only a bit of gel that numbed my gum. It was a revelation; I floated out of the surgery afterwards." 

The Prescription-Free Practice operates as a private clinic; the charge is Pounds 150 an hour.