The term "Bach flower remedies" refers to a unique form of complementary medicine developed in the 1930s by Dr. Edward Bach, an English physician. A pioneer in his day, Dr. Bach was an independent thinker who focused on the patient's emotional state rather than the specific disease that they were suffering from. For he believed it was the imbalance in the patient's emotional state which gave rise to the physical illness rather than a physical cause (Fisher, 1993). He created 38 flower tinctures to deal with these emotional imbalances developed from his observations in nature and his homeopathic background. The flower tinctures are taken by mouth either on their own or with other medications. They are safe, nontoxic, and could be used by everyone from little children to older adults (Barnard, 1990). Over the years, these flower remedies have been rediscovered and have become increasingly popular among healthcare professionals who have integrated them into a number of medical settings, often with remarkable results (Masi, 2003). An understanding of how Bach flower remedies can be utilized in the therapeutic setting can provide an added healing component to psychotherapy.

An Overview of Bach Flower Therapy

To understand the use of flower remedies in therapy, it is important to have a sense of how they originated and how they are used to enhance healing. A noted pathologist, immunologist, and bacteriologist of his day, Dr. Bach was dissatisfied with the role of medicine, feeling that only symptoms were being treated rather than the chronic disease. As an innovative researcher, he first began to develop vaccines for different bacteria and later prepared oral vaccines treating many chronic cases with exceptional results (Vlamis, 1990). Still he felt that the source of disease was not being addressed when he noticed the deep disharmony in a patient as evidenced by worry or anxiety which depleted the individual's vitality and compromised healing (Bach & Wheeler, 1997). Following his inner conviction, he closed his practice and spent his remaining years traveling through England in search of healing plants whose properties could be utilized to treat emotional states (Howard, 1998). Bach created a system with flowers and plants that were uniquely prepared to serve as neutralizers and antidotes to negative emotional states (Masi, 2003) based on his research experience, intuition, and his ability to apply hypotheses to direct patient care.

The flower remedies focused on the belief that the life force energy in plants could be taken into an individual to pattern a more positive healing mental state (Barnard, 1990). Dr. Bach concluded that the life force of a plant was held in its flower and that the flower was at its greatest potency when in full bloom (Downey, 2002). He would pick these fresh flowers, still wet with dew, and place them in a clear bowl of spring water leaving them in the early morning sunlight for a few hours (Masi, 2003). He then removed the flowers from the bowl and preserved the liquid essence the flower was floating in by adding it to brandy. Thus there were no real molecules of the flower, only the vibration of it as held in the water. This vibration then interacted on a subtle energy level with the individual to rebalance the conscious and unconscious as well as dissolve old patterns (Downey). Dr. Bach created 38 flower remedies in this way with each remedy specific for an emotional state (see attached inset for remedies and their use). In these 38 remedies, Bach felt he had covered all aspects of negative thoughts that get in the way of a patient's recovery (Howard, 1998).

To this day Bach flower remedies continue to be prepared in the same way as when Dr. Bach first created them. They also continue to be administered in a similar fashion. Taken orally directly or diluted in water, they appear to have no effect on, and are not affected by, other medications and so can be used alone or in conjunction with many other forms of treatment (Howard, 1998). Depending on the symptoms, the remedies can be used singly or in combination up to a maximum of seven tinctures (Masi, 2003). Because they act as a catalyst in releasing unwanted psychological states, they can augment psychotherapy, enhancing the individual's ability to work through their feelings rather than repress them (Richardson-Boedler, 1998).

Research on the effect of Bach flower remedies has been mostly anecdotal although there are a few small studies that have attempted to validate the effectiveness of flower remedies in psychological illnesses. The primary published study is that of Campanini (1997) who studied 115 patients suffering from anxiety and depression that were treated with flower remedies. The researchers reported 89% improvement in the cases and noted that the remedies were safe without side effects. Further studies by Masi (2003) and Mehta (2002) have used an even smaller sample but have had equally positive results. All the data seem to agree that flower remedies are a safe and a supportive addition to psychotherapy and should be considered in conjunction with other approaches.

Clinical Practice

The therapist who wishes to incorporate Bach flower remedies into their practice needs no formal training, although a course is available online through the Bach Foundation in England (www.bachcentre.com). There is no standard remedy for any disorder as different people experience a similar problem in their own unique way (Masi, 2003). Rather the exchange between patient and therapist elicits the primary emotional issues that interfere with the healing process and allows for a discussion of the most effective flower remedy at the time. Introducing the idea of using flower remedies to a client may initially seem difficult, but if the therapist is familiar with the positive healing effects of the remedies and is clear on their purpose in the process, the client often is willing to give the approach a try. Taking a flower remedy does not produce a dramatic change in emotional state but rather a gradual, subtle, and progressive process that may take weeks or months (Howard, 1998). As emotions shift, remedies may change, with the flexibility of the system allowing for a process tailored to the client's current needs (Mantle, 1997).

Clinical Example

Jane was a 28-year-old married woman with three children and a part-time job. She had high expectations of her performance and suffered from self -doubt and low self-esteem when she was unable to meet all of her goals. The pressures she puts on herself to "never let anyone down" and to be the perfect mother, wife, and nurse were often unrealistic, leaving her exhausted and overwhelmed. These feelings only contributed to her self-criticism and immobilized her. Jane's husband was caring, but long hours at a very demanding job made it difficult for him to help out at home.

Jane came into therapy initially to deal with the constant exhaustion that she felt was affecting her ability to function. She had been able to handle her stress in the past by exercising (running) but now she felt unable to follow through with such a regimen. Springtime was particularly difficult as it related to family losses in the past. Initially, the sessions focused on exploring these issues as well as incorporating relaxation and stress management techniques. Early on Jane learned that she was pregnant again, and this led to increased immobility, withdrawal, and apathy. Evidently with each pregnancy Jane had experienced some depression which lifted after the birth of the child. The depression had been a little stronger with subsequent pregnancies and this time she felt more immobilized than in the past. A deeply religious individual, Jane had no thought of suicide, seeing this depression as a transitory state that she had to "live through" until the baby was born.

In session, Bach flower remedies were suggested as an approach to help her live through this time. As a safe alternative during her pregnancy, Jane was willing to consider purchasing and using the remedies. Four remedies were suggested to be taken together, diluted in water, three times a day. The remedies prescribed were mustard for depression, larch for low self-esteem, pine for self-blame, and vervain for those who push themselves too far. The Bach flower remedies were folded into the therapeutic process as aspect of the whole treatment. However, this aspect slowly shifted all of the others. As the weeks went by, Jane became less self-critical and rigid in her expectations of herself. Her energy shifted as well. She asked for help, rested more, and seemed to have a greater sense of peace about herself. Jane said that taking the flower remedies seem to "loosen her up somehow" making her less tense. After the birth of her fourth child, Jane continued with the flower essences, adding and changing the formula as she herself changed. Over time it became an essential part of the therapeutic process for her.

Clinical Example

Jody was a 42-year-old divorced woman who had recently gotten remarried and was trying to integrate two households into one. Jody had two teenagers while her new husband had no children of his own. Disciplining the children was becoming a source of tension between the couple and this was only exacerbated by the behavior of Jody's younger daughter, Heather, who was continually testing the limits. Jody found herself arguing frequently with her daughter and getting into such a rage that it frightened her.

She came into therapy hoping she could learn how to deal with her daughter more effectively and understand what was behind her intense emotions. Therapeutic sessions focused on these areas, allowing Jody to explore and express her feelings as well as providing some tools to make the interaction between mother and daughter more productive. As part of that process, Bach flower remedies were suggested as a way of intervening with the anger and decreasing its intensity. Three different Bach flower remedies were suggested to be taken three times a day and whenever she felt intensely angry. They were cherry plum for rage, willow for resentment, and walnut for the process of change. Jody was open to the idea and willing to try "anything that might help." Within the first few weeks of taking the remedies Jody began to notice a change in the intensity of her feelings. She said the remedies seemed to "take the edge off" her emotions and make her more able to choose how she wanted to respond in family interactions. This change in her response shifted the family dynamics, creating openings for members to try something new with each other. As time went on, the anger issue began to dissipate as the family focused on the work they needed to do to communicate with each other.

These are just two brief examples of the use of Bach flower remedies in the therapeutic setting. They give just a sense of the wide range of situations the remedies can be considered for. In the UK there are 400 registered practitioners who have studied this approach seriously and include it actively in their practice (Howard, 1998). Hopefully, with greater usage and research Bach flower remedies can be an important addition to the therapeutic process.

References
Bach, E., & Wheeler, FJ. (1997). The Bach flower remedies. New Canaan, CN: Keats Publishing.
Barnard, J. (1990). The healing herbs of Dr. Edward Bach, Nursing Standard, 4(32): 36-37.
Campanini, M. (1997). Bach flower therapy: Results of a monitored study of 115 patients" La Medicina Biologica, 15(2): 1-13.
Downey, R. (2002). Healing with flower essences. Beginnings, 22(4): 11-12.
Fisher, R. (1993). With Bach flower remedies life can take on deeper meaning, Beginnings, 13(3): 1, 4.
Howard, J. (1998). Bach flower remedies: A personal commentary on the work of Dr. Edward Bach. Complementary Therapies in Nursing & Midwifery, 4(5): 148-149.
Mantle, F. (1997). Bach flower remedies, Complementary Therapies in Nursing & Midwifery, 3(5): 142-144.
Masi, M. (2003). Bach flower therapy in the treatment of chronic major depressive disorder. Alternative Therapies, 9(6): 112, 108110.
Mehta, S. (2002). Oral flower essences in ADHD. Journal of American Academy Child Adolescent Psychiatry, 43(8): 895.
Richardson-Boedler, C. (1998). Applying homeopathy and Bach flower therapy to psychosomatic illness. B. Jain: New Delhi India.
Vlamis, G. (1990). Bach flower remedies to the rescue. Rochester, VT: Healing Arts Press.

Mary Ann LaTorre, RN, MA, CCNS

Author contact: malinvis@yahoo.com with a copy to the Editor: mary@artwindows.com