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A Bright Future for
Light Therapy by David Noton, PhD
(The Forest Institute)
Photic Stimulation
by David Noton, PhD (The Forest Institute)
A
Bright Future for Light Therapy by
David Noton, PhD (The Forest Institute)
Light
Therapy and LIGHT98 |
| In
July 1998, when the summer sun was striving bravely
to overcome a dark and rainy English Spring, a group
of researchers and physicians, leavened by a goodly
crew of new-age healers and visionaries, met at Reading
University near London, to share their experiences
with "light therapy" - the use of light
as a treatment for everything from physical disease
to psychological disorders. The LIGHT98 conference
brought health practitioners from all over the world,
with some amazing stories of treatment and cure.
The conference was
inspired by a very successful light therapy conference
a few years earlier in California, and it has spawned
several successors, such as Light/Sound 99' conference
in Chicago and a Light 2000 conference in Britain.
This article attempts to summarise the freewheeling
discussions at the LIGHT98 conference and give an
overview of the field of Light Therapy.
Light Therapy techniques
range from the most simple and traditional ("Get
outside and get some sunshine and fresh air",
as your Grandmother may have told you) to the most
high-tech and sophisticated forms of light-assisted
psychotherapy (which was developed in California,
of course). These therapies may be categorised by
the form of light used, from simple to sophisticated: |
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Nerve
pathways from the eye to the brain go not only to
the visual cortex, but also to deeper brain areas,
concerned with neurohormones, emotions, etc.
(Source:Light Years Ahead Brian Breiling) |
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Bright Light
- Coloured Light
- Pulsed Light
- Coloured Flickering Light
- Polarized Light
We will consider them in that
order. All these forms of light are applied to the eyes or
experienced with the eyes. There are yet other forms of light
therapy that involve shining light on other parts of the body,
for example, direct light treatment of skin conditions or
cancer tumours. These will be reviewed briefly at the end
of this article.
Bright
Light Therapy
The importance of light for
health and vitality was a perhaps more obvious in ancient
times than it is today. People living close to nature have
an immediate appreciation of the sun, perhaps even worship
it religiously, in a way that is lost when one is insulated
from nature by many layers of technology. Even a hundred years
ago the medical value of sunlight was still well appreciated.
Wounds were known to heal more quickly and with less scarring
when sunlight was used as a disinfectant. Tuberculosis clinics
flourished in the high mountains of Switzerland. Rickets responded
to sunlight. But sitting around in the sunlight takes time
and seems boring in today's busy world, so the discovery of
antibiotics in the middle of the last century pushed aside
most of these slow but natural cures. Taking a pill is sometimes
cheaper and more convenient than staying at a sanitarium.
The modern rediscovery of light
therapy occurred in a more psychological context. Season Affective
Disorder (SAD), also known as winter depression, was identified
as a light deficiency problem which could be corrected with
exposure to bright light, especially on awakening in the morning.
Of all the forms of light therapy, bright light treatment
for SAD is by far the most thoroughly researched and the most
accepted by mainstream medicine. Scientific journal articles
on SAD number in the hundreds by now (1).
Several companies on both sides of the atlantic manufacture
"light boxes", sources of bright artificial light
for SAD sufferers to sit by during breakfast. There is even
a battery-operated light "visor", worn on the head,
to shine light directly into the eyes while allowing the wearer
to move about (2). The ultimate high-tech
natural treatment is a light "alarm clock", a dawn
simulator, which turns on a gradually brightening light source,
starting an hour or two before rising time and reaching its
maximum when the (indoor) sun rises and it's time to get up!
(3)
Once the day is started, there
is still the problem of inadequate and artificial indoor lighting
in the workplace or schoolroom. Conventional fluorescent lamps
emit light which is deficient in many of the colours and wavelengths
of natural sunlight. Numerous studies have shown the benefits
of replacing these lamps with full-spectrum fluorescents,
more closely imitating sunlight (4). Workplace
health statistics improve, school performance improves, even
dental caries in school children was shown to decrease under
full-spectrum lights. These were large studies with large
control groups for comparisons.
These results are not really
too surprising. Humans evolved outdoors, in sunlight. When
light enters the eyes and strikes the retina, the resultant
nerve signals pass not only to the visual cortex of the brain,
so we can see objects, but also, over separate nerve pathways,
to other brain structures including the hypothalamus, the
pineal and pituitary systems, and the limbic system, causing
hormonal and emotional effects. Visual perception is not the
only function of the eyes; they are also the openings through
which light, almost like a nutrient, reaches the brain.
Coloured
Light Therapy
This "nutrient" view
of light naturally leads one to consider the effects of different
colours of light, selections from the rainbow spectrum of
white light. At one sales table at the LIGHT98 conference
visitors could try wearing spectacles of different colours
(not just rose coloured specs!) and experience the depressive
calm of blue-violet and the stimulation of yellow spectacles.
A large study in schools in
Alberta, Canada, conducted over a whole school year, compared
pupils in classrooms with conventional fluorescent lights
and dull coloured walls against pupils in classrooms with
full-spectrum lighting and walls painted with with warm colours
(5). Both changes separately showed significant
improvements in academic performance and discipline and decreases
in absenteeism due to illness, and the combination of changes
was even more effective.
There is also an entire school
of optometrists who use coloured light to treat patients.
In the 1920's and 1930's Dr. Harry Spitler developed a system
known as Syntonic Optometry which uses coloured light, shone
into the patients eyes, to treat a variety of physiological
and emotional disorders, far beyond the traditional bounds
of optometry. The light is shone into the patients' eyes from
a special light source equipped with a variety of coloured
filters. The underlying principle of this therapy is to balance
the activities of the sympathetic and parasympathetic nervous
systems using colours that are either stimulating or calming.
Practitioners can be found in many countries, though the treatment
is most widespread in the US (6).
Pulsed
Light Therapy
If bright light and coloured
light can have such an effect on the brain, mind and body,
it is to be expected that pulsed light would have even more
effect. Pulsed light certainly grabs one's attention; neurologically
speaking, neurons tend to report only changing stimuli, quickly
tiring of anything steady. So pulsed light might be considered
to be a more aggressive form of light therapy, for more severe
conditions.
A small but growing body of
research studies documents,ents the benefits of this form
of light therapy, technically known as Photic Stimulation.
Pulsed light is shone into the eyes either from a mask or
goggles worn by the patient or by having the patient sit in
front of a larger pulsed light source one or two feet away.
Typically the treatment is applied for 15 or 20 minutes per
day.
In a hospital trial in London,
pulsed light therapy proved more effective than any previously
published treatment for premenstrual syndrome (PMS) (7).
And two separate published studies in the US have shown significant
improvement in children with learning disorders such as attention
deficit disorder (8). Several other studies
have shown good results in the reduction of chronic pain,
including the pain of TMJ, and a photic stimulation device
is currently being marketed to dentist' offices for this purpose.
The neurological basis for this form of light therapy is suggested
by studies by Dr. Norman Shealy in Missouri, who found increases
in the levels of various hormones and neurochemicals after
patients had been treated for 20 minutes with pulsed light
(9).
These and other results in
the field of Photic Stimulation were described in more detail
in the article entitled 'Photic Stimulation' - Positive Health
Magazine (select link at top of page).
Coloured
Pulsed Light Therapy
Some of the most impressive
and moving reports at the LIGHT98 conference involved the
use of coloured pulsed light as a catalyst in the process
of psychotherapy. Here the more subtle emotional effect of
different colours is combined with the penetrating effect
of pulsed light to accelerate the therapeutic process of uncovering
and bringing out deeply buried emotional material for processing
and relief. Clearly this procedure is highly dependant on
the skill of the therapist; the selection of light colour
and flash frequency is an interactive process, involving a
high level of awareness and even intuition on the part of
the therapist (10). A live demonstration
of this technique with a volunteer subject was one of the
more astounding moments of the conference.
Light
Therapy not involving the eyes
Some forms of light therapy
involve shining light on parts of the body other than the
eyes. The use of blue light as a treatment for neo-natal jaundice
is a well-established medical procedure. A recent study reported
that merely shining light on the back of subjects' knees was
sufficient to alter the timing of the internal circadian body
clock; this suggests that the effects of bright light on SAD,
described above, may not be entirely mediated through the
eyes.
At the LIGHT98 conference several
practitioners reported on body work with laser light or coloured
light applied to acupuncture points in a modern-day version
of traditional Chinese medicine. Another particularly impressive
presentation reported on work done in Russia, over many years
with thousands of patients, using a technique known as blood
photo-modification, in which blood is drawn from the patient,
circulated through a glass tube where it is irradiated with
laser light, and then returned directly to the patient; astounding
results were reported with a wide range of diseases.
Although it is a dramatic example
of the use of light, the photodynamic therapy treatment for
cancer is not discussed in this article, since it is really
an improved form of chemotherapy, rather than actual light
therapy.
Post-Publication
Addition - Polarized Light Therapy
An important form of light
therapy, which was unfortunately omitted from the original
published version of this article, is light therapy using
polarized light. Extensive research, mainly in Eastern European
countries, has clearly demonstrated the value of Polarized
light in promoting the healing of wounds and other hard to
heal conditions such as burns, bedsores and leg ulcers. This
work has been reported in numerous publications, only a few
of which unfortunately are available in the English language
medical literature (11,12).
The early work in this field
was done with laser light, but it was subsequently discovered
that the key aspect of the laser light was its polarization
and that similar effects could be obtained using normal (incoherent)
light that was polarized. The light used is generally in the
range of the visible and near-infra-red spectrum, with any
UV component removed.
It has been shown that polarized
light affects the alignment of fat and protein molecules on
the cell membrane and it is believed that this is the mechanism
through which it promotes cell regeneration and healing.
Further
Information
In a short overview such as
this article it is impossible to give full references for
all the work cited. The following books give excellent overviews
of the whole field of light therapy and provide details and
journal references on much of the work described above:
Liberman, Jacob - "Light,
Medicine of the Future" - Santa Fe, NM: Bear & Co.
1991
Breiling, Brian J - "Light Years Ahead" - Berkeley,
CA: Celestial Arts, 1996
The first book is more comprehensive,
but the second is somewhat more up-to-date, being essentially
a transcription of the 1992 light therapy conference in California.
The proceedings of the LIGHT98 conference at Reading University
have not yet been published, but a lengthy report on the conference
appeared in the magazine section of The Sunday Times (London,
16th August 1998). The article on Photic Stimulation that
appeared in Positive Health, as mentioned above, was in issue
27, April 1998, pages 17-19. Additional information on some
of the therapies mentioned in the present article may also
be obtained from the Forest Institute, for which contact details
are given below.
Scientific
References
Reference 7 is available at this website.
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Schwartz,PJ;
Brown,C; Rosenthal,NE. - "Winter Seasonal Affective
Disorder: A follow-up study of the first 59 patients of
the National Institute of Mental Health Seasonal Studies
programme" - The American Journal of Psychiatry,
153(8):1028, 1996.
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Joffe,RT; Moul,DE; Lan,RW.
- "Light Visor Treatment for Seasonal Affective Disorder:
A multicenter Study" - Psychiatry Research, 46(1):29,
1993.
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Avery,DH; Bolte,MA; Dager,SR.
- "Dawn Simulation Treatment of Winter Depression:
A controlled study" - The American
Journal of Psychiatry, 150(1):113, 1993.
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Ott,JN. - "Colour
and Light: Their effects on plants, animals and people"
- Journal of Biosocial Research, 7(1), 1985.
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Wohlfarth,H. - "The
effects of Colour-Psychodynamic Environmental Modification
on disciplinary incidences in elementary schools over
one school year: A controlled study" - The International
Journal of Biosocial Research, 6(1):44-53, 1984.
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A list of practitioners
is to be found in Section VIII.4 of the book "Light
Years Ahead", which is referenced in the Additional
Information section of this article.
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Anderson,DJ; Legg,NJ;
Ridout,DA. - "Preliminary
Trial of Photic Stimulation for Premenstrual Syndrome"
- Journal of Obstetrics and Gynaecology, 17(1):76-79,
1997.
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Russell,HL; Carter,JL.
- "A Pilot Investigation of Auditory and Visual Entrainment
of Brainwave Activity in Learning-Disabled Boys"
- Texas Researcher, Journal of The Texas Center for Educational
Research, 4:65-73, 1993.
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Shealy,CN, et al. - "Effects
of Colour Photostimulation Upon Neurochemicals and Neurohormones"
- Journal Neurol Orthop. Med. Surg. 17:95-97, 1996.
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Vasquez,S; Breiling,B.
- "Illuminating the Windows of the Soul: Facilitating
Psychotherapy with eye movements and strobic coloured
light stimulation" - Bridges (Magazine of the ISSSEEM),
8(2):5-7, 1997.
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Depuydt,K. et al. - "The
Stimulating Effects of Polarized Light on Wound Healing"
- Presented at the 10th annual meeting of the European
Association of Plastic Surgeons (EURAPS), Madrid, May
1999.
-
Kubasova,Y. et al. -
"Investigations on the Biological Effect of Polarized
Light" - Photochemistry and Photobiology, 48(4):505-509,
1988.
About
the Author
About the Author: David Noton,
PhD, is a Director of the Forest Institute, a non-profit organisation
which conducts research and publishes information in the area
of mind-brain-body interaction and development.UK telephone:
020 8444 4141.
About
Positive Health Magazine
Positive Health, in which
this article originally appeared, is a magazine about complementary
medicine, published in Bristol, England. The website www.positivehealth.com
presents many interesting articles from past issues of the
magazine, lists of practitioners, etc. |
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Photic
Stimulation by David
Noton, PhD (The Forest Institute)
Light and Photic Stimulation
Early Work with Pulsed Light
Photic Stimulation and PMS
Photic Stimulation and Migraine
Other Disorders: ADD, Chronic Pain, etc
How Does Photic Stimulation Work?
Further Information
Scientific References
About the author
About Positive Health Magazine
Light
and Photic Stimulation
The importance of light for
health is generally acknowledged, both in folk wisdom and
in modern medicine. For example, insufficient levels of daylight
cause Seasonal Affective Disorder, whose treatment with bright
artificial light is well established. Now many new forms of
light treatment are starting to emerge, some made possible
by modern technology, others perhaps a rediscovery of older,
pre-technological therapies. Most of these new light treatments
involve either coloured light or pulsed light. They have been
found to help a wide range of disorders ranging from medical
conditions, such as Premenstrual Syndrome and Migraine, to
behavioral conditions such as insomnia and Attention Deficit
Disorder. Coloured strobic light is even being used to deepen
and accelerate psychotherapy. This article will describe the
particular form of light treatment known as Photic Stimulation.
In Photic Stimulation gently
pulsed light is shone into the eyes for 15-30 minutes a day.
The Photic Stimulation device is usually similar to sunglasses
or a sleep mask, covering the eyes so as to shut out external
light. Miniature lamps mounted in the device shine light into
the user's eyes. The brightness and flash rate of the light
are controlled by circuitry either inside the glasses or in
a separate control box. Alternatively, some Photic Stimulation
devices are larger, self-standing devices that shine the light
towards the user from a distance of a foot or more; these
latter devices are generally intended for clinical use rather
than home use.
Early
Work with Pulsed Light
The effects of pulsed light
were noted even in historical times: the flickering light
of flames in the hearth or sunlight viewed through the spokes
of a rotating wheel was observed to be relaxing. And in the
1960's and 1970's the consciousness-altering effects of strobe
lights were an important component in the multi-media experience
offered at rock concerts.
Portable Photic Stimulation
devices were produced as a consumer item for home use in the
1970's and 1980's, but they were promoted mainly for recreational
use and for relaxation and stress reduction. It only gradually
became clear that they might have more significant therapeutic
value. described below are the most important of the studies
that have transformed pulsed light from a recreational amusement
into a valuable therapy. We start with the most recent result,
which is also one of the most carefully executed of the Photic
Stimulation trials.
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Photic
Stimulation and PMS
Dr DJ Anderson and his
colleagues at the Royal Postgraduate Medical School
at Hammersmith Hospital in London, England, recently
completed a trial of Photic Stimulation for Premenstrual
Syndrome (PMS). Their results were reported in The Journal
of Obstetrics and Gynaecology (1).
Seventeen women with
confirmed, severe, and long-standing PMS were treated
with Photic Stimulation for 15 minutes a day for 3 months.
The light device consisted of a soft mask, which covered
the eyes and which had red LED lamps mounted one in
front of each eye. The patients were asked to use the
device at home for 15 minutes per day, everyday throughout
their menstrual cycle. They recorded their symptoms
daily for two menstrual cycles before treatment, three
cycles during treatment, and one cycle after treatment
was stopped. On average the women experienced a 76%
reduction in their PMS symptoms at the end of three
months of Photic Stimulation (see graph opposite). This
level of improvement is greater than that reported for
any other PMS treatment, be it fluoxetine (Prozac),
hormones, relaxation or vitamin and herbal supplements.
By the end of the trial most of the women could no longer
be considered to have PMS and would not have qualified
to enroll in the trial. |
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was not blind and thus was open to possible placebo effects.
However, the magnitude and persistence of the improvement
make a purely placebo explanation improbable, especially since
most of the women had previously tried other PMS treatments
without success and were consequently sceptical of this new
and unorthodox approach. |
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Stimulation and Migraine
Previous to the PMS study
described above, Anderson investigated pulsed light
as a treatment for migraine. In a preliminary study,
published in the journal Headache (2),
he found that of a total of 50 migraine headaches in
seven patients, 30 were "stopped" and all
but one of the remainder were "helped". the
median duration of headaches was reduced in all patients
and the interval between migraine headaches appeared
to be increased (see graph opposite). Typically the
patients used the device for 30 minutes to terminate
a headache, though subsequent work appeared to indicate
that a 15 minute session every day was also effective
as a preventative. It was during the work with migraine
patients that it was accidentally discovered that the
treatment was highly effective for PMS.
Both of Anderson's studies
used a "protocol" or flash mode in which the
light shone alternately in left and right eyes, i.e.
the left eye was illuminated for the first half of the
cycle and the right eye for the second half of the cycle.
The flash rate was initially set at 30Hz (i.e. 30 left-right
cycles per second), but the patients had control of
the rate and were instructed to adjust it for personal
comfort. Some preferred rates close to 30Hz, but others
chose much slower rates, as low as 7Hz; successful outcomes
appeared to be largely independent of the flash rate.
Brightness was also under control of the user, to be
adjusted for comfort, but it was observed that generally
brighter was more effective.
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Other
Disorders: ADD, Chronic Pain, etc.
In 1993, JL Carter and HL Russell
of the University of Houston published in The Texas Researcher
(3) the results of a study of Photic Stimulation
with learning-disabled boys aged eight to twelve. The study
used an unusual protocol in which the frequency of the pulsed
light was varied every two minutes between 10Hz and 18Hz;
the Photic Stimulation was also accompanied by auditory stimulation
at the same frequency. the study showed significant increases
in several intelligence measures. However, the number of sessions
required was as high as 80.
N Shealy and his colleagues
at The Shealy Institute have performed a number of studies
of Photic Stimulation for relaxation and for reduction and
management of chronic pain. Their studies included measurements
of levels of endorphins and other neurohormones and neurochemicals,
some of which showed quite dramatic changes as a result of
30 minutes of Photic Stimulation (4). Several
studies have shown significant improvement in management of
chronic pain using combined photic and audio stimulation;
N Thomas of The University of Alberta and D Siever of Comptronic
Devices Ltd, studied TMJ patients (5) and
FJ Boersma and C Gagnon worked with patients with lower back
pain (6), and there have been a number of
other studies that were not published in any peer-reviewed
journal.
Strong anecdotal results have
been reported by clinicians in several other areas, such as
insomnia, fibromyalgia and chronic fatigue, and clinical studies
are planned in these areas. Interestingly, all of the disorders
mentioned above are those which have also been successfully
treated with biofeedback, especially EEG biofeedback. As a
result, Photic Stimulation is increasingly being used by EEG
biofeedback clinicians as an adjunct to biofeedback (indeed,
at a recent biofeedback conference it was remarked that many
biofeedback clinicians are "closet flashers"!)
How
Does Photic Stimulation Work?
Why should pulsed light shone
into the eyes be so effective against PMS and migraine? Published
research shows that during PMS the body's internal daily clock
becomes de-synchronised from the external rhythm of day and
night. Dr Anderson's results suggest that daily use of the
pulsed light helps the clock to re-synchronise. It re-establishes
normal brain function in the visual cortex when used during
migraine aura, thereby stopping activation of the trigeminovascular
system (the cause of pain). It re-establishes normal function
in the brain when used during warning signs for migraine without
aura.
Further
Information
Two excellent general references
on the many forms of light therapy are:
Liberman, Jacob - "Light,
Medicine of the Future" - Santa Fe, NM: Bear & Co.
1991
Breiling, Brian J - "Light Years Ahead" - Berkeley,
CA: Celestial Arts, 1996
Scientific
References
References 1,2 and 7 are available at
this website.
-
Anderson,DJ; Legg,NJ;
Ridout,DA. - "Preliminary
Trial of Photic Stimulation for Premenstrual Syndrome"
- Journal of Obstetrics and Gynaecology, 17(1):76-79,
1997.
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Carter,JL; Russell,HL.
- "A Pilot Investigation of Auditory and Visual Entrainment
of Brainwave Activity in Learning-Disabled Boys"
- Texas researcher, Journal of the Texas Center for Educational
Research, 4:65, 1993.
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Shealy,N; Cady,R; Veehoff,D;
Atwell,M; Houston,R; Cox,R. - "Effects of Colour
Photostimulation Upon Neurochemicals and Neurohormones"
- Journal of Neurol. Orthop. Med. Surg. 17:95-97, 1996.
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Thomas,N; Siever,D. -
"The Effect of Repetitive Audio/Visual Stimulation
on Skeletomotor and Vasomotor Activity" - Hypnosis
- the Fourth European Congress at Oxford.
- Boersma,FJ; Gagnon,C. - "The Use of
Repetitive Audiovisual Entrainment in the Management of
Chronic Pain" - Medical Hypnoanalysis Journal, 7(3):80-97,
1992.
- Noton,D. - "PMS,EEG
and Photic Stimulation" - Journal of Neurotherapy,
2(2):8-13, 1997.
About
the Author
About the Author: David Noton,
PhD, is a Director of the Forest Institute, a non-profit organisation
which conducts research and publishes information in the area
of mind-brain-body interaction and development.UK telephone:
020 8444 4141.
About
Positive Health Magazine
Positive Health, in which this
article originally appeared, is a magazine about complementary
medicine, published in Bristol, England. The website www.positivehealth.com
presents many interesting articles from past issues of the
magazine, lists of practitioners, etc.
This article has been updated
slightly from the original version in Positive Health magazine,
to include scientific journal references and some additional
publications in the area of pain management. |
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