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ABOUT CONSTITUTIONAL MEDICINE
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I've been in full time practice in Christchurch, New Zealand since 1989. Many people with chronic insomnia have come in over those years and, whilst each case needs an individualised approach, herbal medicines and other natural methods have been seen to have a high success rate. There is much common ground between people and some general recommendations are discussed below. Firstly however, from the clinic files, the following cases are shown to demonstrate how different kinds of approaches can be needed to get a good result. Elisa was a GP in her early 50s when she came In 1989, my first year of practice. A friendly, open-minded practitioner, she had insomnia and was deeply averse to becoming addicted to sleeping pills and wanted to try herbal medicines to see if they might help. I got lucky, many later experiences taught me that it is more common that herbs can do a certain amount to help but a lot of the success depends on the person doing some necessary 'work' to address the causes of the problem. In Elisa's case, for whatever reasons, the following herbal formula worked like a charm.
We make our own tinctures from organic dried herbs, so it might be important that you understand that the optimal dose range will vary with different preparations made by different companies or practitioners, The above liquid extracts were combined into a formula to make 210mls, which will easily fit into a 200ml amber pharm round bottle. The dose was 8mls each night (which would last for a month) but she was welcome to take a 2nd dose if she didn't feel sufficiently sleepy from the first one or wanted to take an extra dose during the night if she woke up and wasn't able to easily get back to sleep. Valerian and Hops are a classic sleep combination from European herbal medicine. Their heating and cooling actions balance each other out and make each other stronger. Skullcap & Passionflower are another mind-calming, relaxation-inducing pairing that give an effect that is greater than the sum of their parts. The Licorice is there to help them all blend together and to make the mixture more palatable to take. You can learn more about any of these great sleep allies in the A-Z found here I only ever met Elisa in person just the one time. She called to cancel her follow-up appointment because she didn't need to come back, but she did want some more herbs. Over the next 10 years or so, before she retired, Elisa sent a lot of her own patients with sleeping problems to come and see me. I don't know how many there would have been in total, at least 50, it gave me a lot of early experience in this area and a healthy appreciation for just how difficult a problem it can be in many cases!
I first met Hugh when he was 29 years old and he said he had been having problems with sleeping for the last 7 years. He would feel incredibly tired during the day, want nothing more than to get to bed and to have a deep and lasting sleep, but no sooner would his head hit the pillow then his mind would come awake and he would feel more mental energy and vitality than he had felt all day!
The above extracts were combined to make a 540mls formula, which will just fit into a 500ml amber pharm round. Remembering that we make our own tinctures from raw material, so an equivalent dose from a different company or practitioner might need to be higher or lower, Hugh was instructed to take 10mls one to two times daily at night. Once if things were going well and he didn't need more, an optional second dose if he needed it. The Relaxing tea was to use as freely and frequently as he liked. Some of the herbs in were already in his formula but there would be no harm to have more of them in tea form and we have found that many people like the feel and taste of this tea, especially when they know that they can use at will and that it may help them to unwind at night. The recipe and instructions for it are found here The first step in the healing journey comes from Nature. We come to a point where we are unable to fix ourselves and then these ancient allies, the herbs, can help us to get well. The next step is the 'work'. It is what the patient does to help themselves. Underlying all the old ways of healing is an understanding that living organisms have the ability to self-repair, unless something is getting in the way. The 'work' is usually doing something to remove the obstacles that are getting in the way of that innate, self-healing intelligence. Hugh was a Tiger constitution, more about below, for now why it matters is that his energy, his 'purpose' was clearly not being channelled. He was a bright, ambitious young man who was doing a job that was financially rewarding and kept him physically fit and active but did not require him to use his brains. His creativity, his imagination, his innate desire to explore his limits and find his own way were all being thwarted by the extensive demands of his daily life. As soon as he clocked out of his schedule his brain wanted to have some time at the wheel, even if it meant he lost a lot of sleep! The herbs worked well enough for Hugh to keep using them. We made a few minor changes in the prescription and he did a few experiments to be sure that he really was better when he was taking them than when he didn't (and he needed the full 20mls at night to get an obvious benefit) but clearly there was a much deeper cause that was needing to be addressed. The following year that I worked with Hugh was mostly in the form of talking with him in the manner of a guidance counsellor. Anyone reading that who might be surprised by that should know that to be a good enough herbalist you also need, at times, to be a dietician, an exercise coach, or a counsellor. Holistic medicine means treating the whole person, you don't get to pick out one part of life or one aspect of health as being more important than another, not if you want to get good results with people. Hugh did eventually move into a new position that required him to use and develop his considerable mental abilities. Not only did his sleeping come right but he was a lot happier in himself.
I first met Grace when she was in her mid-40s. She was an Elephant-Butterfly constitution (again, more about this below) and had been experiencing a lot of difficulties with both falling asleep and staying asleep for much of her adult life. Things had come to a crisis point with the onset of early perimenopause. She was now waking multiple times through the night in extreme discomfort from prickly heat and was feeling desperately stressed and on the verge of a health breakdown.
To make 540mls in a 500ml amber pharm round bottle. Withania is a superb tonic for a person who has become exhausted, 'wired and tired'. Motherwort and Lobelia have their own potent actions on a disturbed nervous system and again, they can all be learned about further in the A-Z here The dose was 10mls twice in the latter part of the day, when she could relax after taking them. This amount of Lobelia will rapidly slow a sensitive person's heart rate and reduce their blood pressure and need to be taken with an awareness that there will need to be at least a few minutes to sit and relax after the dose.
To build her energy and resistance to stress. We get these two herbs in raw form and send them to a local company to encapsulate for us. The dose was 4 capsules of the combined herbs once a day in the morning.
4mls once a day in the morning. Hormonally active herbs are very powerful and have the power to make things much better or worse so, in this case, we used the ancient method of pulse-testing to try to start out with the best allies. This old way is described in practical detail here As much as it would be tempting to not give any 'work' to a person who was so exhausted, to only give herbal tonics and sleep formulas and hope for the best, long experience has taught me that you can set yourselves up for failure by trying to be kind and to avoid the harder work on the deeper causes. Grace had been holding on to far too much tension for far too long. As an EB (Elephant-Butterfly) I was sure that there would be two methods of unwinding her internal tension that would work most reliably and, despite her great fatigue, she was persuaded to commit to them both. The first was to do gentle and sustained exercise on a daily basis. Walking was agreed on as the most accessible and achievable. It didn't matter how slow she took it but she needed to go out for a minimum of 40 minutes a day from day 1 of the treatment program. The second was to take up some kind of activity with her hands that would allow her to relax by doing. Everyone can think of something; writing, drawing, any kind of craft-work. Many EBs have realised by themselves that such activities keep them in good internal health, it becomes a kind of 'meditation in action'. Those who become too busy, who only look after others and forget their own need to create some order and beauty in the world can palpably build up too much tension than can be good for them and somewhere, whether it be their sleep or some other part of their health, inevitably suffers. Grace did not get better quickly. When I think of case histories to share, my mind nearly always goes to the trickiest ones, the ones I had to see the most and work the hardest to help! But we definitely got there in the end, including a successful result with the hormonal 'change'. The last time I saw her, I recall the vivid impression she gave of a person in good health and happiness and how much it contrasted with how wretchedly she had presented herself the first time we met! Lack of sleep is brutal, it is harder on the health than the worst diet, the most sedentary lifestyle. As Shakespeare said, 'ah sleep, that which knits up the ravelled sleeve of care!'
Most of the articles on the site where case histories are presented have just two, sometimes three people, but here is the fourth because, aside from the value of emphasising that different approaches can be needed over and above just taking herbal sleep remedies and hoping for the best, I also must present at least one person from the Eagle constitution, as they are surely the ones who suffer from insomnia more than anyone! Kate, 31 years old, has been a recent case at time of writing and we have just had our third, and hopefully last visit, so there has been a fast response. She, like many Eagles, had a long history of flying high during the day and then having considerable trouble with coming back to earth and 'landing' for some much needed sleep. Mostly, Kate had been able to adapt to this and to get at least 5 or 6 hours a night but, in recent times, a new relationship coupled with increased work responsibilities led her to a bad state of affairs with some nights not getting to sleep until the small hours and being likely to wake in a state of nervous tension as little as just 2 or 3 hours later. Kate had always been a person to tough things out and just 'get on with it' but in the last month before she made the appointment she had begun to experience the first panic attacks of her life and was now seriously worried about her state of health. We got started with the following
I should mention that I pulse-tested the Valerian in Kate's case (as mentioned above under Grace's hormonal remedy and linked again here) because some Eagles find it paradoxically stimulating, most likely because they are already on the 'hotter' side of the spectrum and the Valerian can be too heating. She was fine with it in terms of her pulse but would likely have struggled with the pungent smell of Valerian as will always be felt in the liquid form of it. Not everyone is ready or well-suited to taking potent liquid herbal formulae and we get concentrates of Valerian & Hops in dried form and send them to a local company to be put into capsules for ease of use for many. The dose still needs to be high to be sure of a good result though. In Kate's case, and typically for others, I will recommend 4 capsules at night and to not hesitate to use a further 4 capsules if needed.
4 capsules once a day, in the morning, to nourish the nerves.
2 capsules once a day, in the morning. Along with the Hawthorn & Reishi, the St John's is a great 'nervine' herb; one that supports and strengthens the nervous system. It is usually a mistake to think of insomnia as just something that happens at night-time. Most people who have problems with their sleep have too much nervous tension in their systems all the time, it is just when they need to be asleep that it becomes its most uncomfortably noticeable.
To use as freely and frequently as she chose. The recipe and instructions again found here
Also to use freely because this, and the Relaxing tea, were pleasant mind-body adjuncts to the general objective to calm and nourish the nerves. No-one should underestimate the power of a good cup of tea to make a difference in a person's day! The recipe and instructions for the Balm tea are found here
20 drops as freely and frequently as required. The exact formula and related matters are described in the next section. I can imagine that this may look like a long list of medications for someone who was not used to this kind of health-care, but it should be understood that they are all completely non-addictive and most people don't need them for long. Kate's primary 'work' was twofold. Firstly, to take plenty of doses of the relaxing herbal formula and, each time she took it, to practice the 7-11 breathing technique she was taught in her first visit. Secondly, to practice 'worry-time' on a daily basis, at least until she didn't need to use that either. 'Worry time' is a counter-intuitive, but very powerful method to allay the kind of anxiety that can break down sleep, it is discussed further below. Likewise, both the relaxing herbal formula and 'worry time' are covered in much more depth in the detailed article on anxiety found here Kate responded extremely well, and quickly, to the treatment. She doesn't need to come back and had already started 'forgetting' to take her herbs at night, a sure sign that she no longer feels she needs them. Some people need a lot more time and work, but Kate's speed of response is also very typical. We have been using these methods for many thousands simply because they work...
I mentioned above that Hugh was a Tiger, Grace an EB, and Kate an Eagle (I think that Elisa was an Eagle too, but I hadn't learned and developed the constitutional medicine system when I first met her). In any case, this ancient way of understanding our differences, according to how we are naturally either hotter or cooler, and at the same time dryer or damper, underpins much of the approach to what kinds of foods, herbs etc, will best help a person. If you, or someone you care for, are having troubles in this area, you can learn more about the general subject of the constitutions starting here, and then work out which constitution you or they are by going here
After getting a sense of whether a person is naturally cooler or hotter, dryer or damper, the next level of knowledge to take the kind of personal approach that can be essential to a great result is to look into the healing cycle. This is a fascinating subject in itself and understanding it can give great insight into what needs to be done to treat the cause and help healing happen naturally. There are four stages in the cycle; cleansing, activation, nourishment and rest. To learn more about the cycle of healing read here
As you would expect, I think anyone with sleeping problems will be wise to let some help from Nature be the first step. Crucially, this means not only getting the right herbs but also getting them at the right dosage. Our ancestors worked with herbal medicines for countless thousands of years to find out what works, along with knowing how much is needed for it to work. This point is being emphasised because some people think that they have already tried herbal sleeping aids, but they took doses that were far lower than what we have always used historically. Think of taking a quarter or an eighth of an aspirin to cure a headache and you will get the idea. Common commercial preparation of herbs might use as little as a quarter, or an eighth, of the amount that we would use in traditional herbal practice. This is partly due to economics, but it is also a lot to do with safety. If you give a small dose you are playing it safe. It is much less likely people will react badly to your product and the fact is that herbs are highly potent, especially when used in the kinds of doses we have learned to use over those millennia. The following are some of the most important herbal sleeping aids. As you saw in the various formula that were used in the case histories, in practice we use a combination of more than one at the same time. If you keep an open mind re trying different herbs, and you are careful to take a proper therapeutic dose of whatever it is you do try, then it is almost certain that you will get a positive response from at least one of these time-honoured remedies for sleep.
Remember to let Nature take the first step i.e. take strong herbs in strong doses. What follows, for many, is an effective second step and we are now getting into treating what may be at least a part of 'the cause' of the problem. I am going to trust that you have already read or heard from others about the importance of switching off from screen time and kind of stimulating technology for a decent period of time before you want to get to sleep. For many people it will be of great help to do something to unwind and prepare their systems for rest and sleep by such things as listening to music, reading, doing some relaxing yoga or breathing. If that is all you need to do to ensure the mind is ready for sleep then that's great! However, even with doing things like the above, many people who have trouble falling asleep simply have too much in their mental 'in-box'. They have not had time to think about their problems and their worries through the day so, when they finally get to lay their head on the pillow, even if they are exhausted, they start to think, and think, and think... Another version of the same problem is falling asleep for just a few hours and waking up with an active mind which is already starting to chew over the problems of today, yesterday, or tomorrow. Many people in the modern world do not have enough time to simply think, let alone worry things through, and as a result the mind finds the only free time available to do what it needs to do, in the night-time. Of course, this has a deeply negative effect on energy and well-being, but such is the importance of working through that 'inbox' that we can sacrifice a large portion of our sleep to do it. There is a better way, and that is to make a 'worry-time' during the day. Ideally this will be a time when you are moving your body in a way that does not require thought or attention. Walking works perfectly for many people in this regard but so does any kind of house-work or craft-work when you don't have to concentrate on what you are doing but you are free to think. The main thing is that you don't try to sit or lie still while you do the worry time! When we actually work through the 'inbox' of all the things that are worrying us we do not turn into neurotic wrecks, quite the opposite. An inner calm and quiet comes to us when we work through the worst-case scenarios one at a time. Our worst fears very rarely come to fruition, but they are there nevertheless. It is far better to look at them when you are awake and alert than during the night when you need to sleep and relax. Moving your body helps you to not become stuck in an anxious frame of mind, you can move through the problems just as you are literally moving with your body. The method of what you actually do in the worry time is simple but powerful. Take any subject at all and start thinking 'what is the worst thing that could happen?' Don't pretend to do this exercise, really do it. Imagine the worst, of anything and everything, and then work through it, start with whatever is bothering you the most right now and go from there. Ask yourself 'what would I do about that?' How would I deal with it, who might I ask for help if I really needed it, how would I survive... what would I do?' Being able to worry has been extremely important to our survival throughout evolution. Worrying helps us to avoid many things that can cause us harm or to eventually deal with those stresses that are unavoidable in a better way. The problem with worrying about things when you should be sleeping is that you get all of the emotional content, i.e. tension, agitation and sleeplessness, and none of the intellectual value from the worry, i.e. logical-thinking and problem-solving. Work with the worry, not against it, and you will empty your inbox enough to get a good sleep when you need it.
Herbs that relax the nervous system and consciously emptying the 'in-box' will be enough to see good results in many cases however, some people have other physical issues that are disrupting their sleep and may need to treat those causes for a lasting cure, for example:
If any kind of pain is disrupting sleep, then it may be of much benefit to obtain some, entirely legal, Californian poppy and work with it as described here Something else that may be of help is a spoken commentary called 'relaxing with pain' found here
Please understand that I cannot personally advise you without seeing you in my clinic. |
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© 2011 R.J.Whelan Ltd