Question Title: WHAT'S UP WITH ME?????

DEAR DR. STEVE,
FIRST OF ALL LET ME THANK YOU FOR THIS WEB SITE. I JUST FOUND IT THE OTHER DAY AND FEEL THAT THIS IS WHAT I WAS SEARCHING FOR.I AM A 39YR.OLD FEMALE WITH HEART DISEASE. I HAD A QUADRUPLE BYPASS 5 YEARS AGO WHICH WENT WELL BUT UNFORUNATLEY I NEVER QUIT SMOKING. MY DOCTORS HAVE SAID THAT I HAVE VERY SMALL ARTERIES WHICH IS WHY I HAVE WHAT I HAVE SO YOUNG.NEEDLESS TO SAY I BEGAN HAVING ANGINA RECENTLY AND HAVE ALL THE TESTS WHICH SHOWED EITHER ANOTHER BLOCKAGE OR I HAD A HEART ATTACK.BECAUSE OF MY AGE AND SMALL ARTERIES THEY WANT TO TREAT ME WITH MEDICATION FOR AS LONG AS THEY CAN.I HAVE BEEN TOLD TO QUIT SMOKING TIME AND TIME AGAIN. I'VE DONE THE PATCH, GUM, HYPNOTISED,ZYBAN,COLD TURKEY,AND NOW I'M GOING TO A COUNCELOR FOR THE FIRST TIME IN MY LIFE TO FIGURE OUT WHY,UNFORTUNATLY THE COUNCELOR ISN'T TELLING ME ANYTHING I DON'T ALREADY KNOW ABOUT THE TRICKS OF QUITTING ETC. I DON'T WANT TO DIE AND I WANT TO QUIT SO DESPERATLEY BUT NOTHING SEEMS TO WORK FOR ME, I'VE GONE TO STOP SMOKING CESSATION WITHOUT ANY SUCCESS.WHAT IS WRONG WITH ME THAT I CANNOT QUIT,WHAT CAN I DO?
I HAVE GONE AS MUCH AS 6 WEEKS WITHOUT SMOKING WITH EITHER THE GUM OR THE PATCH, BUT THEN SOMETHING TRIGGERS ME TO SMOKE.JUST THE THOUGHT OF QUITTING AGAIN MAKES ME SO ANXIOUS INSIDE.I'VE BEEN PUT ON EFFEXOR FOR DEPRESSION,IS THERE ANYTHING OUT THERE FOR ME?THERE IS NOT A DAY THAT GOES BY THAT I DON'T THINK ABOUT NOT SMOKING AND I AM NOT IGNORANT ABOUT MY HEART PROBLEMS, SO...WHAT'S UP WITH ME?
SUE

Dear Sue,

You should be working closely with an M.D. who is an expert in smoking cessation (along with the counseling - by the way, you should share your concerns about the counseling with your counselor, that often helps to improve the working relationship). In cases like yours, I believe in very intensive pharmacotherapy - sometimes I have combined the patch, inhaler, and Zyban. In cases like yours, when the intensive regimen helps a person like you to stop, I would maintain it for quite a while, and only recommend gradually decreasing the medication and nicotine replacement if and when you were feeling good and comfortable about doing so.

For much more on pharmacotherapy and smoking cessation, take a look at http://www.drsteve.org .

Good luck!

DrSteve

The information provided is for general medical education purposes only, and not a substitute for medical diagnosis and treatment provided by your physician.

keywords: nicotine, replacement, bupropion, smoking, cessation

THANKS FOR THE INFO, MY THERAPIST HAD MENTIONED USING EMDR TO HELP ME WITH MY SMOKING, SHE SAID SHE HAS NEVER USED IT FOR A STOP SMOKING TECHNIQUE BUT THINK IT COULD WORK FOR ME,HAVE YOU EVER TRIED THIS PROCEDURE ON ANYONE TO QUIT SMOKING AND DO YOU THINK IT COULD REALLY WORK OR AM I REACHING FOR STRAWS. I AM VERY WILLING TO GIVE THIS APPROACH A TRY.
THANKS AHEAD FOR THE REPLY....
)
SUE

JUST WANTED TO REPOST MY LETTER,NOTICED THE NEW FORUM WAS AT THE TOP!! THANKS

Dear Sue,

I think you are venturing into uncharted territory - there are no scientific studies in the medical literature to support the use of EMDR for smoking cessation. That does not mean that it will be ineffective, simply that it has not be proven to be effective.

I am copying below a web page which claims that it may be effective in the treatment of chemical dependency. You might email the author and ask him what he bases this claim on. Good luck to you!

DrSteve

EYE MOVEMENT DESENSITIZATION & REPROCESSING:
EMDR
By Steve B. Reed, L.P.C., L.M.F.T.

Eye Movement Desensitization and Reprocessing (EMDR) is a new therapeutic technique developed by Francine Shapiro, Ph.D. in 1987. The method was originated by Dr. Shapiro when she noted that disturbing thoughts suddenly disappeared after engaging in a particular type of eye movement. As she deliberately retrieved the disturbing thoughts, they were no longer upsetting to her. This positive effect prompted her to retrieve other disturbing images, engage in the eye movements, and note the result. Upon discovering that a variety of disturbing thoughts and images were no longer upsetting to her, Dr. Shapiro, began a study to note the effects with others. Since 1987 this methodology has evolved into a multifaceted approach to treat a variety of different problems with a wide number of populations. EMDR is frequently used in the treatment of traumatic experiences and the disturbing feelings and thoughts that accompany trauma. Additional uses include resolution of grief, relief from chronic pain, performance enhancement, smoking cessation, depression and dealing with addictions.

The procedure of this treatment involves the client focusing on a disturbing image while the trained therapist facilitates a type of eye movement by having the client follow the movement of the therapist's fingers across the field of vision.

Traumatic images are physiologically and neurologically arousing and this can interfere with the processing of the information in the brain. Consequently, the experience gets misplaced or frozen in our nervous system. The effect of trauma on the brain is like having a traffic police officer in your brain which gets very tired and sends the distressing signal to an unauthorized parking zone where it gets stored in the wrong area. EMDR retrieves the signal and parks it in the authorized zone.

Researchers do not know why EMDR works. The similarities of the eye movement patterns and Rapid Eye Movement (REM) sleep have contributed to theorizing a connection between the two. Information is processed when dreaming occurs. Dreaming occurs in the stage of sleep known as REM sleep. When the client accesses the disturbing image and thought that accompanies the image while moving their eyes back and forth, the information seems to be processing at an accelerated rate.

With EMDR, feelings of tension are usually significantly reduced, the image seems to change by fading or becoming more distant, and the power of the negative thoughts are often diminished.

EMDR makes the following assumptions about healing:

1. EMDR uncovers hidden aspects of problems.
2. EMDR gets you unstuck and allows a natural movement toward healing.
3. EMDR generates a new perspective of your problem.
4. EMDR allows you to go directly to you healing destination and eliminate incorrect pathways.
5. EMDR creates new pathways beyond the limitations of your previous route.
6. EMDR accesses the natural healing abilities of your deeper self.
7. EMDR enables your ability to let go.
8. EMDR installs positive behaviors and allows you to connect to useful resources within yourself.

The research on EMDR has indicated that the effects remain stable over time. Research on EMDR has reported the following positive therapeutic results:

1. Combat veterans who were not able to be free of symptoms no longer experience flashbacks, or nightmares.
2. People with phobias revealed a rapid reduction of fear and symptoms.
3. People with panic disorder reported recovering at a more rapid rate when compared to other treatment methods.
4. Crime survivors and police officers were no longer disturbed by the after effects of violent assaults.
5. People have been relieved of excessive grief due to the loss of a loved one.
6. Children have been symptom free from trauma of assault or natural disaster.
7. Sexual assault survivors were able to lead normal lives and have intimate relationships.
8. Accident and burn survivors who were debilitated are now able to resume productive lives.
9. Those with sexual dysfunction are now able to maintain healthy sexual relationships.
10. Clients with chemical dependency have decreased tendency to relapse and show signs of stable recovery.
11. People with dissociative disorders progress at a rate more rapid than traditional treatment.
12. Clients with a wide variety of PTSD diagnoses experienced relief from symptoms with EMDR.

E-mail to: stevereed@psychotherapy-center.com

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