A BRIEF OVERVIEW OF RESEARCH REGARDING THE EFFECTIVENESS OF RESTRICTED ENVIRONMENTAL STIMULATION THERAPY AS A COMPLEMENTARY TREATMENT FOR A RANGE OF BEHAVIORAL DISORDERS
Baylah David, Ph.D.
Neurobehavioral Health Services, 5363 E. Pima, Suite 100, Tucson, Arizona 85712, (520) 321-0373
The use of sensory restriction as an intervention which alters human consciousness began in 1951 with the opening of the McGill University Perceptual Isolation Laboratory, mandated, primarily, to study the mind-altering effects of monotonous environments. By 1960 or 1961 systematic
exploration of sensory restriction as a therapeutic modality in the treatment of psychological disorders began, with the study of its effect on various types of mental illness among people inpatient in psychiatric hospitals. Research into the use of such an environment as a therapeutic intervention has evolved considerably in the intervening forty years, and has focused primarily on its use in the treatment of addictive disorders. This paper reviews the research bases and effectiveness of Restricted Environmental Stimulation Therapy (REST). REST is a psychotherapeutic practice that places the client in an environment with a drastically reduced level of external stimulation. Research evidence indicates that REST consistently has beneficial effects on medical, psychological, and behavioral health outcomes, particularly when used in conjunction with other therapies.
For thirty years research has been conducted on the use of “sensory restriction” as a smoking cessation intervention. About twenty research studies have been conducted. The findings have been consistent: when used by itself, in studies with follow-up periods ranging from 12 months to 5 years, 25% of REST subjects achieved long term abstinence . When REST was combined with other effective smoking cessation treatments (e.g. behavior modification , hypnotherapy ) in studies with follow-up periods ranging from 18 months to 5 years, 50% achieved long term abstinence. In a few clinical studies, one to two years in duration, REST has been combined with weekly support groups. In those instances 75-80% have maintained abstinence for the length of the study . Success rates for REST as an adjunct or complementary therapy are dramatically better than most other available treatments. For example, at the end of one year the success rate of the nicotine patch alone is 5% and combined with behavior modification 20%. Studies of the use of anti-depressants such as Zyban/Wellbutrin for smoking cessation, which show a 40-50% success rate, have not included follow-up data longer than one year and are contra-indicated for a large segment of the cross-addicted population, specifically those with eating disorders. In addition to the non-invasive and brief nature of the REST treatment, two factors distinguish it from others with regard to smoking cessation: its notably low relapse rate and the remarkable characteristic that it lifts physical craving for nicotine, thereby removing the aversive factor of physical withdrawal.
Eating disorders & alcoholism
Additional studies have shown REST to be effective in treating various eating disorders, in decreasing heavy drinking, and in treating a variety of other behavioral and mental health disorders. In three studies of REST as a treatment for obesity, REST was followed by slow continuous weight loss over the 6 month follow up period . Another study examined REST as a treatment for bulimia , and have found the success rate equivalent to that with smoking cessation 50%. REST has been found effective in decreasing the alcohol consumption of heavy drinkers, in some cases resulting in total cessation. Heavy social drinkers treated with 2 hours of REST and anti-alcohol educational messages during the treatment, reduced their alcohol consumption 56% in the first two weeks after the treatment. That reduction was maintained at 3 and 6 month follow-ups . A Washington State University study (1990) found that, for heavy drinkers, after exposure to one 12 hour or 24 hour REST session, the average daily onsumption of alcohol continued to drop over 6 months of follow-up. The 24-hour group’s average consumption before REST was 42.7 ounces per day, immediately post REST was 23.3 per day, 16.0 per day at 3 months and 12.7 at 6 months.
A University of Arizona study examined chamber REST as a complementary relapse prevention technique with substance abusers enrolled in traditional outpatient substance abuse treatment programs. At the end of 4 years of follow-up 43% remain continuously sober and drug free. None of the control group did so for eight months of follow-up .
Addiction in its various manifestations, and smoking cessation in particular, have been the focus of the largest body of chamber REST research; about three-fourths of all subjects were exposed to REST as treatment for an addiction/”behavioral disorder”. In addition, however, a meaningful body of research has been conducted, over several decades, on the effect of chamber REST in treating a variety of more traditional psychiatric and psychological disorders (e.g., phobias, obsessive compulsive behaviors, anxiety, depression, autism and schizophrenia), as well as chronic pain, stuttering and hypertension. (references available) The “side effects” of REST treatment are often even more dramatic than its effectiveness in achieving explicit behavioral goals. In a group of patients undergoing REST as part of a smoking cessation program, several of the participants reported that their time in the chamber was used to think more deeply than usual about other life problems, and that solutions found as a result of this experience were applied successfully afterward. The list of benefits included an increase in exercise and/or a decrease in caffeine or “fattening food” consumption, and a solution of interpersonal problems, with family members (constant arguments, withdrawal, perceived rejection) and at work (insufficient recognition, failure to assert oneself).
A British psychiatrist published a case of unexplained muscular tension, hypertension, neck pain, and generalized anxiety which was positively impacted by a 24-hour chamber REST session. Not only did the patient achieve normal blood pressure and a relief from the somatic symptoms that made medication no longer necessary, he also reported a significant change in his outlook on life. The history of REST research seems to have revealed what traditional cultures knew for thousands of years that solitude and sensory reduction facilitate healing of many disorders. Because REST requires a minimal investment of time, has a paucity of contra-indications, augments the effectiveness of existing treatments and potentiates the effectiveness of other therapeutic interventions, we owe it to those we serve to utilize it as a tool.