Integrative Health Psychology

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Aromatherapy in Psychotherapy

Scents, Memories, and Emotions

The use of pleasant aromas to enhance wellbeing dates back thousands of years. Fragrant oils were used in religious and other ceremonies in the Far East, as well as in ancient Egypt and Greece. Essential oils were extracted from herbs and flowers to create medicines and perfumes, to scent one’s home, and to anoint the ill as well as those who had passed on. Smell is considered to be the most poorly understood of our senses, however, most have experienced the powerful ability of familiar scents to trigger emotions and memories of times past, such as holiday gatherings, as well as of other important moments and people in our lives. Who among us has not passed a restaurant or bakery and been instantaneously transported to another time when a similar dish or baked good was enjoyed, with all of its emotional accompaniments? Have we not all smelled a particular laundry detergent or perfume and thought of a loved family member or former flame? For some, even less-than-pleasant odors can call to mind a cherished memory. I have heard people say that walking into a faintly damp or musty house reminded them of the fun and friendships of summer camp even 30 or more years later.

Today, the term aromatherapy refers to the deliberate use of plant-derived oils to enhance physical and emotional health. Although aromatherapy is still considered outside the realm of medically accepted therapies, as well as mainstream psychotherapy, patients’ interest in this area has grown substantially over the past few decades. Most of those who use aromas for healing tend to do so as part of a whole-person approach to healthcare, rather than as a stand-alone treatment. When applied thoughtfully, aromas may be incorporated into more “mainstream” health care practices with good results.

The Impact of Scents on Stress and Performance: What’s the Evidence?

Research related to the impact of scents, particularly essential oils, on mood has increased since the 1970s. Specifically, there have been several studies on the use of essential oils, such as lavender and rose, as well as other pleasant aromas to reduce stress. Lavender in particular has been shown to reduce self-reports of stress, and in some preliminary research, was associated with increased peripheral blood flow (an effect associated with relaxation) and a decrease in blood pressure, as well as positive changes in heart rate variability. In another trial, peppermint and lavender essential oils were associated with increased accuracy while proofreading.

The calming benefits of pleasant aromas many not be limited to essential oils, however. In at least two studies, coconut scent has been associated with decreased startle response, whereas an unpleasant scent (Limburger cheese) was associated with an increased startle response. A more recent study suggested that exposure to pleasant scent (also coconut) may blunt the body’s response to performing a stressful task and also enhance recovery after the stressor has stopped. It is important to note that most of these studies have had methodological challenges, including having small numbers of people in the trials. The results are thought-provoking, however, and may make intuitive sense to those who have experienced subjective benefits from aromatherapy.

Aroma in Psychotherapy

So, how might this be relevant to the practice of psychotherapy? Pleasant aromas can be paired with relaxation training, such as diaphragmatic breathing, mindfulness practice, hypnotherapy, and biofeedback. Doing so may link the experience of relaxation with the scent sufficiently so that in the future, exposure to the scent alone may be enough to elicit the relaxation response. In cognitive-behavioral therapy, this pairing is referred to as “associative learning” or “higher-order conditioning,” and the goal is for the conditioned stimulus (the scent) to trigger the same response as the biofeedback or breathing, or meditation does.

I have frequently used scent as a therapeutic adjunct during all of the above types of treatments for both children and adults. Many have reported enjoying the use of this tool in session and on their own, and have noticed that eventually, they can more quickly and effectively access a state of calm. Even something like at-home mindfulness practice involves “taking in” and being present with the scent of what one is consuming or doing. Specifically, one may be eating, or drinking, or walking in nature, and really experiencing fully the associated aromas as part of the process. Thus, being mindfully present can be “aromatherapeutic” or at least “aroma-aware” – even without deliberately introducing a specific scent.

At home use of pleasant aroma can be as simple as adding a few drops of an essential oil to a hand or body lotion or hair conditioner, buying natural laundry or cleaning products that feature relaxing or invigorating essential oils, chewing a stick of peppermint gum when proofreading a term paper, or mindfully sipping a cup of fragrant tea.

Common Sense with Scents

When using scent in psychotherapy, it’s important to take into account people’s individual preferences for and aversions to various aromas – as well as the fact that some dislike using any scent at all. Similarly, it is important to inquire about emotional associations to scents that may be popular but could elicit unpleasant memories (“Ugh! My old boss always wore rose oil!”). Finally, it goes without saying that it’s important to 1.) ask about allergies to any scents, 2.) to place undiluted oils on tissue or another object, rather than directly on the person, as many are harmful when applied to the skin at full strength, and 3.) to educate oneself about the properties associated with different oils before introducing them into the work.

For general information about aromatherapy, please visit:

http://www.aromaweb.com

For information about training in clinical aromatherapy and the use of aromatherapy by health professionals, visit Dr. Jane Buckle’s website: http://www.rjbuckle.com/home.html or read her text, “Clinical Aromatherapy: Essential Oils in Practice”

For a recent scientific article describing some of the studies mentioned here, see:

Mezzacappa, E.S., Arumugam, U., Yue, S.I., Stein, T.R., Buckle, J., & Oz, M.C. (2010). Coconut fragrance and cardiovascular response to laboratory stress: Results of pilot testing. Holistic Nursing Practice, 24(5).

(Available to journal subscribers and at many medical or nursing school libraries)

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