Sophrology is a combination of relaxation techniques which aims to re-balance the body and mind.
The word ‘sophrology’ comes from the Greek meaning ’the science of the consciousness in harmony‘. The system was created by the Spanish-born neuro-psychiatrist, Alfonso Caycedo, in Colombia in the 1960s. It has been very popular for many decades in France, Belgium, Portugal, Spain, Italy and Switzerland, as well as Korea and, increasingly now, in Japan. Sophrology is only just being introduced to the UK, but whilst the combined approach may be new, the individual aspects of sophrology are not.
It is inspired by yoga, Buddhist meditation and Japanese Zen, and incorporates elements of hypnosis, visualisation, meditation, mindfulness, breathing and simple movements for relaxation in a structured set of exercises. The client is guided by the sophrologist, learning the techniques to equip them with a practical set of tools for self-directed use in everyday life. A programme of six to eight one-hour sessions is taught individually or in groups, with the client(s) sitting, lying down or in any position which is comfortable. The three fundamental principles of sophrology are to bring the client into the present, to reinforce positive action and to develop an objective reality. The system is reported to aid relaxation, reduce psycho-emotional issues such as stress, fear and anxiety, and to have a psychological impact on physical symptoms.
Sophrology for antenatal relaxation and preparation for birth
It is estimated that around 87% of pregnant women now use complementary therapies (Hall et al 2010), particularly massage, aromatherapy, reflexology or shiatsu, whilst hypnosis, yoga and meditation have also become very popular in recent years. Although sophrology is a system which would be classified as ‘complementary’ to conventional care, the individual components were traditionally used in the relaxation systems propounded by Grantly Dick Read (1949) and others. Sophrology is widely used by midwives in France and Switzerland, and is considered a valuable component of antenatal preparation for birth. It can be started early in pregnancy, as repetition and practice are thought to increase its efficiency, perhaps through a simple Pavlovian mechanism. Mothers can be taught the basic principles and techniques by their midwives, either in a one-to-one setting or in groups, and they are then encouraged to practise at home. In addition to relieving anxiety and fear of childbirth, it is thought that sophrology can ease many of the physiological discomforts of pregnancy, perhaps by enhancing the mother’s coping mechanisms, or by altering pain perception. Continuing to use sophrology techniques following delivery may help women adjust to motherhood, enhance their relationship with their babies, ease postnatal physical discomforts and emotional issues and possibly prevent or relieve the intensity of postnatal depression.
Evidence for sophrology
Sophrologists claim that the system aids restful sleep, improves concentration, reduces anxiety and increases self-confidence, promoting a feeling of inner happiness. Much of the available research is in French, Portuguese or Spanish; no full papers in English could be found when researching for this paper, and even the number of abstracts available in English is limited. However, there appears to be sufficient evidence to support some of the claims for sophrology, albeit taken from abstracts. Exploration of one complementary therapy database, the National Center for Complementary and Alternative Medicine (NCCAM), a UK/USA collaboration, elicited 89 papers, the earliest published in 1964 and mostly in French. Many of the early papers appear to be case reports and individual comment, with a focus on the hypnosis element of the therapy, particularly in dentistry; the first paper relating to gynaecology was published in 1971.
Several papers have considered the benefit of sophrology for analgesia, and a French study of 7547 women undergoing termination of pregnancy (TOP) (Ferragut 1979) claimed that the use of general anaesthesia was reduced to just 1.9% of patients, although no research methodology details were given in the abstract. A more recent paper (Tregan et al 1994) also explored the use of sophrology for TOP, but any results are difficult to interpret since the relaxation aspects of sophrology were combined with individualised homeopathic prescriptions which are not a normal component of sophrology. The psychological effects have also been explored, including its use prior to investigative procedures. For example, Léophonte et al (2000) used the State Trait Anxiety Inventory to consider its value in patients undergoing bronchoscopy. An observational study of 190 pregnant women (Wagner et al 1989) suggested that those who chose antenatal sophrology for birth preparation developed a closer relationship with their infants than those who chose intrapartum epidural anaesthesia. Similarly, the value of sophrology to ease the psycho-emotional impact of infertility was reported, although numbers of participants were small and no research methodology details were given in the abstract (Heymès et al 2006).
One of the few recent studies for which a full English text could be found was undertaken in South Korea (Kim et al 2008). A nested case-control study, with 69 primigravidae in each group, aimed to determine whether sophrology decreased adverse perinatal effects. Whilst the number of women requiring oxytocics or giving birth to babies with low serum pH was less in the group who had received antenatal sophrology, there was little difference between the groups in terms of incidence of meconium-stained liquor or low Apgar scores. The researchers concluded that prospective, large cohort, randomised studies are needed to identify whether sophrology has any real benefit. Conversely, a recent retrospective Japanese study (Suzuki et al 2012) showed a statistically significant reduction in urinary biopyrrin, an oxidative degradation product of bilirubin generated under stress, amongst women who had antenatal sophrology compared to those who required regional or general anaesthesia. However, one of the confounding variables in this study was the introduction of music in addition to the meditation, visualisation and breathing exercises, which is not generally used in European sophrology and which may have had a bearing on the overall sense of relaxation.
The combination of several elements of complementary therapies presents a number of confounding variables, since it would be impossible to determine which aspect of the overall system had the greatest impact. It must be noted, however, that this is common to most complementary therapy research. Unlike conventional medical randomised controlled trials, in which a single intervention is measured against a control group, complementary therapy frequently involves the amalgamation of specific elements of a range of therapies, as a package of treatment designed to achieve the therapeutic outcome.
Specific training for midwives to become an accredited sophrology practitioner for birth preparation involves a course of five weekends taken over six months at the Sophrology Academy. Sophrology may offer a new package of tools to be offered by midwives. At a time when parent education is being reconsidered, sophrology may also highlight some new ideas for antenatal preparation for birth classes.
Hall HG, Griffiths DL, McKenna LG 2011. The use of complementary and alternative medicine by pregnant women: a literature review Midwifery. 27(6):817-24.
Grantly Dick Read (1942) Childbirth without fear. Heinemann Medical Books, London
Suzuki M Isonishi S Morimoto O et al 2012. Effect of sophrology on perinatal stress monitored by biopyrrin Open Journal of Obstetrics and Gynaecology 2(2)176-181
Ferragut E (1979). Voluntary interruption of pregnancy: anesthesia or sophrology. [Article in French]. Gňitif 1(5):20-1.
Heymès O, Forges T, Guillet-May F et al (2006). Sophrology: a different tool for infertile couples.[Article in French]. Journal de gynécologie, obstétrique et biologie de la reproduction 35(8 Pt 1):790-6.
Kim HH, Nava-Ocampo AA, Kim SK et al (2008). Is prenatal childbirth preparation effective in decreasing adverse maternal and neonatal response to labor? A nested case-control study. Acta Bio-medica 79(1):18-22.
Léophonte P, Delon S, Dalbiès S et al (2000). Effects of the preparation on anxiety before bronchoscopy. [Article in French]. Recherche en soins infirmiers (60):50-66.
Tregan D, Cailleux-Kreitmann J, Nègre-Garnier C (1994). Patient admission and induced abortion. A different mode: homeopathy and sophrology. [Article in French]. Soins. Gynécologie, obstétrique, puériculture pédiatrie (154):37-9.
Wagner A, Grenom A, Pierre F et al (1989). Maternal behavior toward her newborn infant. Potential modification by peridural analgesia or childbirth preparation. [Article in French]. Revue française de gynécologie et d’obstétrique 84(1):29-35.
For more information or to contact the Sophrology Academy go to www.sophroacademy.co.uk
For other complementary therapy courses for midwives see www.expectancy.co.uk
Contributor: Denise Tiran MSc RM ADM PGCEA; Educational Director, Expectancy, Florence Parot BA; Founding Director, The Sophrology Academy
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