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Flotation-REST (Restricted Environmental Stimulation Technique) in the age of anxiety: Exploring the role and treatment applications of sensory isolation in the modern world
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.ORCID iD: 0000-0002-1690-2573
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Anxiety and the use of Complementary and Alternative Medicine (CAM), such as flotation-REST, have increased markedly during the last decades. Anxiety is reportedly a prevalent incentive for the use of CAMs, despite the present low state of knowledge about their safety and efficacy. Among the anxiety disorders, Generalized Anxiety Disorder (GAD) is currently the most treatment-resistant. There is reason to believe that non-responders to first-line anxiety treatments might be prone to turn to CAM as a solution to their ailments. Taken together, this highlights the importance of enhancing existing treatment protocols for treatment-resistant anxiety disorders, evaluation of CAMs as anxiety-treatments, as well as to investigate the information about CAM provided by private actors. In study 1, described effects relating to the use of flotation-REST were gathered from privately-owned flotation centers’ websites on the Internet. Thematic analysis was used to characterize recurring patterns in the information, and subsequently the results were compared with scientific evidence. Study 2 evaluated flotation-REST as a treatment of GAD by conducting a randomized controlled trial using a GAD sample defined by well validated self-report measures. Study 3 used a phenomenological approach to characterize the experience of undergoing a flotation-REST treatment while having GAD, based on in-depth interviews with individuals that recently had completed treatment. In brief, the current thesis suggests: (1) that the advertised effects of flotation-REST, as provided by private actors, are not adequately in line with scientific evidence and thus could be misleading to consumers; (2) that flotation-REST is a promising complement to existing treatment of GAD; (3) that flotation-REST benefits individuals with GAD by continually providing a relaxing, safe and secluded setting that promotes self-awareness and contact with earlier negative experiences, physical sensations and emotions without the use of maladaptive strategies of avoidance.

Abstract [en]

Despite the fact that our lives are easier than ever before in human history, it has been suggested that we live in an age of anxiety. Concurrent with the increase in anxiety, the uses of alternative methods to alleviate our troubled psyches have also increased. The present thesis sets out to explore a novel form of seclusion and sensory isolation, namely flotation-REST, which seems to be the obvious antidote to a hyper-connected life-style in the ‘age of information’. Considering that the method is used mainly as an alternative treatment provided by privately-owned flotation centers, the current thesis evaluated how well their information about flotation-REST and its effects corresponds with scientific evidence. The thesis also evaluated the method as an intervention of treatment-resistant anxiety and explores how the treatment was experienced. The results indicate: (1) that the information provided on Internet websites by privately-owned flotation centers does not adequately correspond with scientific evidence; (2) that flotation-REST is a promising intervention for generalized anxiety; (3) that the method benefits individuals with generalized anxiety primarily by enabling relaxation in a safe and secluded setting that promotes self-awareness.

Abstract [sv]

Ångesten och användningen av Komplementär och Alternativ Medicin (KAM), som exempelvis flyt-REST, har ökat markant under de senaste decennierna. Ångest har också rapporterats vara en vanlig orsak till att man använder sig av KAM, trots att det i dagsläget finns lite forskning om risker och effektivitet med dessa behandlingar. Generaliserat ångest syndrom (GAD) är i nuläget den typ av ångest-problematik som svarar sämst på rådande behandlingar. Det finns också skäl att tro att de patienter som inte svarar på rådande ångest-behandling inom sjukvården kan vara benägna att söka sig till KAM för att råda bot på sin problematik. Sammantaget så understryker detta vikten av att effektivisera vården av svår-behandlade ångestproblem, utvärdera KAM som används för att behandla ångest, samt att undersöka kvalitén av den information om KAM och dess effekter som tillhandahålls av privata aktörer. I studie 1 samlades beskrivna effekter relaterat till användning av flyt-REST in från hemsidor på Internet som användes av privata flyt-REST center. Tematisk analys användes för att finna återkommande mönster i datan, och resultatet jämfördes sedan med vetenskaplig evidens på området. Studie 2 utvärderar flyt-REST som en behandling av GAD genom att genomföra en randomiserad kontrollerad studie där urvalet bestod av individer med GAD såsom definierat av väl-validerade självskattningsskalor. Studie 3 använde sig av en fenomenologisk ansats med avsikt att karakterisera upplevelsen av att genomgå en flyt-REST behandling för GAD, baserat på djup-intervjuer som gjordes med individer som nyligen hade genomfört en flyt-REST behandling. I korthet kan fynden i denna avhandling summeras med att: (1) marknadsförda effekter av flyt-REST, som tillhandahålls av privata flyt-REST center på Internet, inte är i tillräcklig samklang med rådande vetenskaplig evidens och således kan vara missvisande för användare av metoden; (2) att flyt-REST är en lovande behandling av GAD som bör beforskas och utvärderas vidare då metoden har potential att förbättra rådande behandling; (3) att flyt-REST ger positiva behandlingseffekter för individer med GAD genom att kontinuerligt möjliggöra vistelse i en miljö som upplevs som avslappnande, trygg och avskild; samt vilket främjar själv-medvetenhet och kontakt med tidigare negativa livsepisoder, fysiska sensationer och emotioner utan att använda sig av maladaptiva undvikande strategier.

Place, publisher, year, edition, pages
Karlstads universitet, 2018. , p. 129
Series
Karlstad University Studies, ISSN 1403-8099 ; 2018:1
Keywords [en]
Flotation-REST, Sensory isolation, Sensory deprivation, Anxiety, Generalized anxiety disorder, Complementary and alternative medicine
Keywords [sv]
Flyt-REST, sinnes-isolation, sensorisk deprivation, generaliserat ångest syndrom, komplementär och alternativ medicin
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:kau:diva-65386ISBN: 978-91-7063-827-5 (print)ISBN: 978-91-7063-922-7 (electronic)OAI: oai:DiVA.org:kau-65386DiVA, id: diva2:1165475
Public defence
2018-02-14, 21A342, Karlstad universitet, Karlstad, 13:00 (English)
Opponent
Supervisors
Available from: 2018-01-24 Created: 2017-12-13 Last updated: 2018-01-24Bibliographically approved
List of papers
1. Curing the sick and creating supermen - How relaxation in flotation tank is advertised on the Internet
Open this publication in new window or tab >>Curing the sick and creating supermen - How relaxation in flotation tank is advertised on the Internet
2014 (English)In: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 6, no 5, p. 601-609Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
floating, relaxation, stress reduction
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology with an emphasis on medical psychology
Identifiers
urn:nbn:se:kau:diva-32122 (URN)10.1016/j.eujim.2014.05.005 (DOI)000343923800014 ()
Projects
Floating, Complementary and alternative medicine; Flotation tank therapy; Internet; Advertisement;
Available from: 2014-05-21 Created: 2014-05-21 Last updated: 2017-12-13Bibliographically approved
2. Promising effects of treatment with flotation-REST (Restricted Environmental Stimulation Technique) as an intervention for generalized anxiety disorder (GAD): A randomized controlled pilot trial
Open this publication in new window or tab >>Promising effects of treatment with flotation-REST (Restricted Environmental Stimulation Technique) as an intervention for generalized anxiety disorder (GAD): A randomized controlled pilot trial
2016 (English)In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 16, article id 108Article in journal (Refereed) Published
Abstract [en]

Background: During Flotation-REST a person is floating inside a quiet and dark tank, filled with heated salt saturated water. Deep relaxation and beneficial effects on e.g. stress, sleep difficulties, anxiety and depression have been documented in earlier research. Despite that treatments for generalized anxiety disorder (GAD) are effective; it is till the least successfully treated anxiety disorder, indicating that treatment protocols can be enhanced. The use of Flotation-REST as a treatment of GAD has not been researched. The aim of the present study was to conduct an initial evaluation of the effects in a self-diagnosed GAD sample.

Methods: This study was a randomized, parallel group, non-blinded trial with 1:1 allocation ratio to waiting list control group (n = 25) or to a twelve session treatment with flotation-REST (n = 25). Inclusion criteria’s were: 18–65 years and GAD (as defined by self-report measures). The primary outcome was GAD-symptomatology, and secondary outcomes were depression, sleep difficulties, emotion regulation difficulties and mindfulness. Assessments were made at three time points (baseline, four weeks in treatment, post-treatment), and at six-month follow-up. The main data analyses were conducted with a two-way MANOVA and additional t-tests. Forty-six participants (treatment, n = 24; control, n = 22) were included in the analyses.

Results: A significant Time x Group interaction effect for GAD-symptomatology [F(2,88) = 2.93, p < .001, η2p = .062] was found. Further analyses showed that the GAD-symptomatology was significantly reduced for the treatment group (t(23) = 4.47, p < .001), but not for the waiting list control group (t(21) = 0.98, p > .05), when comparing baseline to post-treatment scoring. Regarding clinical significant change, 37 % in the treatment group reached full remission at post-treatment. Significant beneficial effects were also found for sleep difficulties, difficulties in emotional regulation, and depression, while the treatment had ambiguous or non-existent effects on pathological worry and mindfulness. All improved outcome variables at post-treatment, except for depression, were maintained at 6-months follow. No negative effects were found.

Conclusion: The findings suggest that the method has potential as a complementary treatment alongside existing treatment for GAD. More studies are warranted to further evaluate the treatments efficacy. 

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Flotation-REST, Flotation-tank, Sensory isolation, Generalized anxiety disorder, Anxiety, Emotion regulation, Relaxation
National Category
Applied Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-41216 (URN)10.1186/s12906-016-1089-x (DOI)000372861300001 ()
Projects
Floating
Available from: 2016-04-04 Created: 2016-04-04 Last updated: 2017-12-13Bibliographically approved
3. Characterizing the experience of flotation-REST (Restricted Environmental Stimulation Technique) treatment for generalized anxiety disorder (GAD): A phenomenological study
Open this publication in new window or tab >>Characterizing the experience of flotation-REST (Restricted Environmental Stimulation Technique) treatment for generalized anxiety disorder (GAD): A phenomenological study
2017 (English)In: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 12, p. 53-59Article in journal (Refereed) Published
Abstract [en]

Among the anxiety disorders Generalized Anxiety Disorder (GAD) is currently the most treatment resistant, suggesting that treatment protocols could be enhanced. A promising treatment of GAD is flotation-REST (Restricted Environmental Stimulation Technique), which in earlier studies has been shown to alleviate symptoms in GAD. Although, research on flotation-REST as a treatment of GAD has shown promising results no study has explored how the treatment is experienced. By applying a phenomneological perspective the present study aims to characterize the experience of undergoing flotation-REST treatment while suffering from GAD. Nine participants with GAD, as defined with self-report measures, participated. Data was collected by semi-structured interviews that were conducted after the completion of a twelve session treatment profram with flotaiton-REST. The Empirical Phenomenological Psychological (EPP) method was usedfor gathering and analyzing the data. The analysis resulted in six themes that characterize the experience of undergoing a flotation-REST treatment while having GAD: (1) obstacles in treatment, (2) a relaxed and safe vantage point, (3) non-ordinary states of consciousness, (4) connecting with oneself, (5) new attitudes and coping strategies, (6) enhanced life-quality. The results highlights that flotation-REST treatment of GAD was experienced as a comprehensive processes that were both challenging and pleasant. The results indicated that the method positively affected symptoms and the core issue associated with GAD on an experiential level. The present study also genereated some initial understanding regarding potential mechanisms that migh mediate and maintain positive treatment effects when flotation-REST is applied as an intervention of GAD. 

Keywords
Anxiety, Generalized anxiety disorder, Phenomenology, Flotation-REST, Sensory isolation, Flotation-tank therapy
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-65365 (URN)10.1016/j.eujim.2017.04.011 (DOI)000414230000008 ()
Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-01-08Bibliographically approved

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