NORTH CAROLINA TRIANGLE’S PREMIER HEALTH PUBLICATION • WITH 70,000+ HEALTH-CONSCIOUS READERS BIMONTHLY

LIFE QUALITY RESOURCES

 pdf of this article

 

For further information about neurofeedback, biofeedback, and psychotherapeutic services offered by Drs. Dan and Lucy Chartier and their associates, contact:

 

LIFE QUALITY RESOURCES

5613 Duraleigh Road, #101
Raleigh, NC 27612
Telephone: (919) 782-4597
www.LifeQualityResources.org

In the Presence of Symptoms
We Don’t Guess, We Test

“We know “We take symptoms very seriously, but we don’t jump to conclusions about them,” says Dr. Dan Chartier. “Symptoms are important because they’re our subjective experience of something that’s not right. Whether it’s pain or feelings of anxiety, as psychologists and psychophysiologists, we’re very much interested in the mind-body connection and the psycho-emotional response.”

Dr. Dan Chartier

Dr. Dan Chartier and his partner and wife Dr. Lucy Chartier are the owners of Life Quality Resources in Raleigh. Together, they have been providing cutting edge psychotherapy services in the Triangle for more than 30 years.

“Our background perspective is this: we don’t guess, we test,” says Dr. Dan Chartier. “What I mean by that is that we go beyond the traditional methods of therapy where psycho-emotional symptoms are all there are to guide the experience. We have a number of methods to assess what’s going on with a person physiologically, which we use to help us link a presenting symptom—anxiety, pain, or depression for example—with what’s actually going on in the body physically.

“So when a patient comes in, we are very interested in listening closely to what they have to say about their experience, and then begin working to figure out how the body is responding or contributing to that emotional distress.”

A patient Dr. Chartier treated a number of years ago was referred to him for a transient but severe abdominal pain. “She had been worked up by various internal medicine specialists,” he recalls, “and being unable to identify a physical source of the pain, they had concluded that job-stress and life-work imbalance were the source of the problem. So her physicians recommended bio-feedback for stress regulation.

“I treated her for a period of time with a standard protocol using measures of muscle tension with surface EMG, peripheral temperature, and heart rate variability training. When we started, she did indeed have an elevated level of tension, which over 10-15 sessions of training she was quite successful in reducing to a normal level.

“However, her pain—her presenting symptom—persisted. At this point we had ruled out excess stress, muscle tension, and anxiety, and resolved any work-life balance issues. At that point I referred her to an internal medicine specialist whom I knew to be an expert diagnostician. It turned out that our patient had a very rare bile duct defect. A minor surgical procedure fixed it, and she was thereafter pain-free.

“The critical piece of the story was that we had to listen carefully to the patient’s experience of the symptom. We had to rule out stress, anxiety, job pressure, work-family-life pressures, and, in approaching it in a step-by-step way, we were able to help her resolve her pain.”

Dr. Lucy Chartier

The Gene Behind the Symptom

Psychiatric symptoms are rarely experienced the same way by two people even when diagnosed with the same condition. Likewise, where one medication may work wonders for one patient with depression, another may experience no benefit at all with the same drug.

Dr. Lucy Chartier, a psychiatric Nurse Practitioner with a PhD in clinical psychology, explained how she approaches the treatment of these complex and individualized patient symptoms in a whole new way.

“Choosing a medication to address a patient’s symptoms of depression, for example, used to be at best an educated guess, and at worst, trial and error. Now, I am able to listen to a patient’s symptoms, and with a simple cheek swab done in office, I can test an individual’s genetic make-up to see which of the medication options available are most likely to work best in that individual’s body to address their symptoms quickly, and least likely to cause side effects.

“Trying to find symptomatic relief for something like depression with medications that take up to a month to start working—all the while simply hoping you chose the right one—can be really frustrating when someone is suffering,” notes Dr. Lucy Chartier. “Genetic testing has dramatically changed the way I prescribe medications, and has allowed a much more systematic and efficient approach to the care I am able to provide.”

Yet, Dr. Chartier points out that even with the roadmap genetic testing is able to provide, there are still some for whom treatment with pharmaceutical agents remains generally unsuccessful. “‘Treatment resistant depression’ is a term for those whose depressive symptoms just don’t respond to the medications for reasons not fully understood,” she explains.

“For these patients,” she says, “neurofeedback is a particularly promising option. Recent research has identified differences in EEG imaging between people with depression who have responded well to antidepres-sants, and those who have not. Based on this new research, new neurofeedback treatment strategies have been developed to target those areas of difference, and help normalize the brainwave frequencies and patterns causing the refractory nature of their depression.”

Furthermore, she notes, these new strategies have been demonstrated to increase the efficacy of neurofeedback for this particular population, often reducing the amount of time needed to attain results.

“The use of neurofeedback to treat depression isn’t new,” Dr. Lucy Chartier clarifies. “I have been using neurofeedback to help patients make permanent changes in the brain in the treatment of depression, along with anxiety, ADD/ADHD, PTSD, and numerous other psychological and behavioral disorders for 20 years. However, this new approach using the same technology for treating what has historically been a very difficult population is really exciting.”

Connecting Symptom to the Body

Symptoms are subjective, but psychophysiologic testing is not. Dr. Lucy Chartier explains how something as simple as the temperature at the tip of a finger can be the key to symptomatic relief. “If you’re a healthy, normal person, relaxed in a reasonably warm room,” she says, “your peripheral fingertip temperatures should be in the 90 degree range. If they’re not, that’s a strong physiologic indication that your body’s in a chronic fight-flight response, which may be related to a long history of feeling pressure or stress or creating a sense of threat. The body reacts to threat by constricting blood vessels, causing cool fingers.

“So when a patient comes in with the subjective symptom of anxiety, for example, we can measure things like fingertip temperature to see how the physical body is reacting in relation to how the patient reports to be feeling. We then can also use the same measure to monitor treatment progress as the patient learns to manage their anxiety, and the fingertips begin to warm.

“The body is continuously seeking balance,” she concludes. “Essentially, we’re about the business of helping people restore a mind-body balance that promotes and supports the healing process and the resolution of symptoms.”