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The '''Gupta Program''' or '''Gupta Programme''' or '''Amydala and Insula Retraining''' describes itself as "[[brain training|brain retraining]]" techniques designed "to alter [[amygdala]] and [[insula]] activity" in order to treat or cure [[chronic illness|chronic diseases]] including [[chronic fatigue syndrome]] and [[fibromyalgia]].<ref name="Gupta2002" /><ref name="MAIR2020" /><ref name="ASA2018">{{Cite web | url=https://www.asa.org.uk/rulings/harley-street-solutions-ltd-a17-400324.html | title = Harley Street Solutions Ltd | last = Advertising Standards Authority {{!}} Committee of Advertising Practice | authorlink = Advertising Standards Authority | first = |website=Advertising Standards Authority | date = April 11, 2018|access-date=2020-08-29}}</ref> The Gupta program is based on the [[amygdala hypothesis]] of [[chronic fatigue syndrome]], which is not [[peer review]]ed, is unproven, and has not been a focus of research.<ref name="Gupta2002" /><ref name="MAIR2020" /> In 2018, the Gupta Program was found to be making unproven advertising claims including wrongly claiming that it can be used to treat [[fibromyalgia]], [[Electrohypersensitivity|electrical sensitivities]], and [[ME/CFS]] by the Advertising Standards Authority.<ref name="ASA2018" /> The UK's [[ME Association]] charity does not accept adverts for the Gupta Program.<ref name="MEA-ads">{{Cite web | last = ME Association | first = | authorlink = ME Association | date = Sep 19, 2012 | website = [[ME Association]]|archive-url=|archive-date=|url-status=| url = https://meassociation.org.uk/2012/09/new-advertising-feature-started-on-mea-website-19-september-2012/ | title = New advertising feature started on MEA website {{!}} 19 September 2012|access-date=2022-06-03|quote=We respectfully decline any contact from practitioners offering the Lightning Process, Gupta Programme, Mickel Therapy, or any similar training courses.}}</ref><ref name="MEA-CAM">{{Cite web | date = May 30, 2015 | website = [[ME Association]]|archive-url=|archive-date=|url-status=| url = https://meassociation.org.uk/wp-content/uploads/Alt-comp-approaches.pdf | title = Alternative and complementary approaches to management | first = Charles | last = Shepherd | authorlink=Charles Shepherd|access-date=2022-06-03|quote=Publicity for these approaches often includes glowing reports from people who have gained benefit – some of whom then go on to become therapists. However, none of these approaches has so far been subjected to proper clinical trials to assess their efficacy and safety. The MEA does not therefore endorse or recommend any of these treatments.}}</ref> ===Alternative names=== Other names used for the Gupta Program include: * Amygdala Retraining Techniques (ART) * Amygdala Retraining Program (ARP)<ref name="Conf2016">{{Cite web | url=https://growthzonesitesprod.azureedge.net/wp-content/uploads/sites/1869/2020/10/IACFSME-2016-Program.pdf | publisher=IACFS/ME | title = 12th Biennial Conference Syllabus | date = October 2016}}</ref> * Amygdala and Insula Retraining (AIR) * Gupta Amygdala Retraining<ref name="ASA2018" /> * Gupta Programme<ref name="ASA2018" /> The randomized controlled trial of "Mindfulness-Based Program Plus Amygdala and Insula Retraining" (MAIR) involved using part of the Gupta Program but delivered face to face by a qualified psychologist and includes additional [[mindfulness]] for stress, plus "treatment as usual" (for example medication), but the trial did not show evidence of the effectiveness for the Gupta Program.<ref name="MAIR2020" /> == Theory == The hypothesis behind the Gupta Program is that amygdala overactivation and [[insula]] involvement lead to symptoms; that ME/CFS and other diseases are caused by problematic or dysfunctional patterns or activity in the [[amygdala]] and [[insula]] parts of the brain.<ref name="CDC-causes" /><ref name="MAIR2020" /><ref name="website">{{Cite web | last = Gupta | first = Ashok | authorlink = Ashok Gupta | date = | title = Gupta Program {{!}} The Secret of Amygdala Retraining | url = https://www.guptaprogram.com/|website=The Gupta Program|access-date=2022-06-04|quote=}}</ref><ref name="Medical3Pager">{{Cite web | last = Gupta | first = Ashok | authorlink = Ashok Gupta | date = Feb 2021 | title = Medical Pager Final Version | url =https://guptaprog.b-cdn.net/wp-content/uploads/2021/02/Gupta-Program-Medical-Pager-Final-Version.pdf | website=The Gupta Program|access-date=2022-06-04|quote=}}</ref> === '''Content of the Gupta Program''' === The Gupta Program is a brain retraining, mindfulness, and holistic health program accessible via website and a mobile app marketed to people with ME/CFS, Fibromyalgia, and Multiple Chemical Sensitivities (MCS). It contains 15 video-based modules. The program includes breathing exercises, meditations, mindset insights, light yoga and stretching, somatic experiencing exercises, holistic health advice, laughter workshops, and brain retraining exercises including their seven-step brain retraining technique. The Gupta Program also provides shorter options for brain retraining. The Gupta Program initially mails participants a floor chart and a workbook. There is a dedicated section on how to deal with "dips" and setbacks. Ashok Gupta recommends "doing your best and leaving the rest" if you are experiencing a "dip." The program also gives advice on pacing, diet, sleep, posits that being in nature is essential to healing the body. The Gupta Program encourages members to not wait until they are in perfect health to engage in activities they love. The Gupta Program encourages pacing within one's energy level and to not go beyond one's energy boundaries.<ref>{{Cite web|url=https://guptaprogram.com/how-to-pace/|title=ME/CFS And Fibro {{!}} The Gupta Program|last=Ashok|website=https://guptaprogram.com/|language=en-US|access-date=2024-06-03}}</ref> However, some have reported that the way they applied the Gupta Program resulted in them experiencing a "crash" and/or setback. There are two modules on "parts" work. The Gupta Program posits that there are sub-personalities that are trying to protect us or stimulate the nervous system with stress, including the "achiever," "perfectionist," or the "protector", and encourages participants to imagine them as beings, shapes, or colors. He discusses why we develop these "parts," and how we one work with them as if they were friends and even find value in what they can teach. The Gupta Program features meditation, acceptance, pacing, diet, mindfulness, and sleep hygiene as well. The program points participants to other possible areas to explore such as trauma healing. ==Evidence == Evidence is largely limited to patient self-reports. The UK's [[Advertising Standards Authority]] upheld a complaint in 2018 claiming that the Gupta Program was falsely advertised as a treatment for [[chronic fatigue syndrome]]/[[myalgic encephalomyelitis|ME]], [[fibromyalgia]] and electrical sensitivities due to the lack of scientific evidence supporting this claim.<ref name="ASA2018" /> ===Amygdala and insula activity hypothesis === There is no scientific evidence to support the Gupta Program claims that chronic diseases including ME/CFS and Fibromyalgia are caused by problematic or dysfunctional patterns or activity in the [[amygdala]] and [[insula]] parts of the brain.<ref name="CDC-causes">{{Cite web | url=https://www.cdc.gov/me-cfs/about/possible-causes.html | title = Possible Causes {{!}} Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome ME/CFS | last = Centers for Disease Control and Prevention | first = | authorlink = Centers for Disease Control and Prevention | date = 2018 | website = CDC|language=en-us|archive-url=|archive-date=|url-status=|access-date=2022-06-01}}</ref> ===Amygdala and insula activity changes === There is no evidence that the Gupta Program alters amygdala or insula activity. ==Notable studies == *2022, Amygdala and Insula Retraining (AIR) Significantly Reduces Fatigue and Increases Energy in People with Long COVID - [https://www.hindawi.com/journals/ecam/2023/7068326/ (Full text)] *2020, Mindfulness-Based Program Plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibro<ref name="MAIR2020">{{Cite journal | title = Mindfulness-Based Program Plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibromyalgia: A Pilot Randomized Controlled Trial | date = Oct 2020| url = https://www.mdpi.com/2077-0383/9/10/3246/htm|journal=Journal of Clinical Medicine|volume=9|issue=10 | pages = 3246 | last = Sanabria-Mazo | first = Juan P. | authorlink = | last2 = Montero-Marin | first2 = Jesus | authorlink2 = | last3 = Feliu-Soler | first3 = Albert | authorlink3 = | last4 = Gasión | first4 = Virginia | authorlink4 = | last5 = Navarro-Gil | first5 = Mayte | authorlink5 = | last6 = Morillo-Sarto | first6 = Héctor | authorlink6 = | last7 = Colomer-Carbonell | first7 = Ariadna | last8 = Borràs | first8 = Xavier | last9 = Tops | first9 = Mattie | last10 = Luciano | first10 = Juan V. | last11 = García-Campayo | first11 = Javier|language=en|doi=10.3390/jcm9103246|pmc=PMC7599726|pmid=33050630|access-date=|issn=2077-0383|quote=|via=}}</ref> - [https://www.mdpi.com/2077-0383/9/10/3246/htm (Full text)] ::'''Conflict of interest not declared:''' Author and investigator Virginia Gasión (Virginia Gasión Royo) had been a Gupta coach since 2014, which means she earns from people doing the Gupta Program, giving a direct final financial conflict of interest.<ref name="Guptacoaches">{{Cite web | url=https://www.guptaprogram.com/coaches | title = Our Professional Team of Coaches | last = | first = | authorlink = | date = | website = Gupta Program|language=en-US|archive-url=|archive-date=|url-status=|access-date=2022-06-03}}</ref> *2012, A mind-body technique for symptoms related to fibromyalgia and chronic fatigue<ref name="Toussaint2012">{{Cite journal | title = A mind-body technique for symptoms related to fibromyalgia and chronic fatigue | date = Mar 2012| url = https://pubmed.ncbi.nlm.nih.gov/22385563/|journal=Explore (New York, N.Y.)|volume=8|issue=2 | pages = 92–98 | last = Toussaint | first = Loren L. | authorlink = Loren Toussaint | last2 = Whipple | first2 = Mary O. | authorlink2 = | last3 = Abboud | first3 = Lana L. | authorlink3 = | last4 = Vincent | first4 = Ann | authorlink4 = Ann Vincent | last5 = Wahner-Roedler | first5 = Dietlind L.|doi=10.1016/j.explore.2011.12.003|pmc=|pmid=22385563|access-date=|issn=1878-7541|quote=|via=}}</ref> - [https://www.researchgate.net/profile/Loren-Toussaint/publication/229324365_A_Mind-Body_Technique_for_Symptoms_Related_to_Fibromyalgia_and_Chronic_Fatigue/links/59e3bb3f458515393d5b935f/A-Mind-Body-Technique-for-Symptoms-Related-to-Fibromyalgia-and-Chronic-Fatigue.pdf (Full text)] ::The [[Advertising Standards Authority]] rejected this as evidence of effectiveness of the Gupta Program.<ref name="ASA2018" /> ::This was open to patients with [[chronic fatigue syndrome]] but none completed it. Of the 32 patients randomly assigned to Amygdala and Insula Retraining (AIR) plus standard care, 19% (6 patients) dropped out before starting, 19% (6 patients) did not complete baseline measures but did AIR, 41% (13 patients) did AIR but not the follow-up assessments, 22% (7 patients) did AIR and completed follow-up assessments. Twice as many patients completed standard care, including both assessments - 56% (14 out of 25).<ref name="Toussaint2012" /> ===Articles not peer reviewed or from non-academic journals=== *2010, Can amygdala retraining techniques improve the wellbeing of patients with chronic fatigue syndrome? A clinical audit of subjective outcomes in a small sample<ref name="GuptaAudit">{{Cite journal |archive-url = http://web.archive.org/web/20111119095503/http://www.guptaprogramme.com/Amygdala_Retraining_JHH_Sept_2010.pdf |archive-date=2011-11-11 | url = https://www.guptaprogram.com/wp-content/uploads/2019/02/amygdala-retraining-jhh-sept-2010.pdf | last = Gupta | first = A | authorlink = Ashok Gupta | date =September 2010 | title = Can amygdala retraining techniques improve the wellbeing of patients with chronic fatigue syndrome? A clinical audit of subjective outcomes in a small sample. |journal = Journal of Holistic Healthcare |volume= 7 |issue =2 | pages = 12-15 |access-date=2022-06-02}}</ref> - [http://web.archive.org/web/20111119095503/http://www.guptaprogramme.com/Amygdala_Retraining_JHH_Sept_2010.pdf (Full text)] ::The Advertising Standards Authority rejected this as evidence of effectiveness of the Gupta Program.<ref name="ASA2018" /> ::This was not published in an academic journal<ref name="JHH">{{Cite web | url=https://bhma.org/journal-information-for-contributors/ | title = Journal - information for contributors | last = | first = | authorlink = | date = | website = British Holistic Medical Association|archive-url=|archive-date=|url-status=|access-date=2022-06-03}}</ref> *2002, Unconscious amygdalar fear conditioning in a subset of chronic fatigue syndrome patients<ref name="Gupta2002">{{Cite journal | last = Gupta | first = Ashok | authorlink = Ashok Gupta | date = 2002 | title = Unconscious amygdalar fear conditioning in a subset of chronic fatigue syndrome patients| url = https://www.guptaprogram.com/wp-content/uploads/2019/02/cfs-hypothesis-medical-hypotheses-article.pdf | journal=Medical Hypotheses|volume=59|issue=6 | pages = 727–735|quote=|via=}}</ref> - [https://www.guptaprogram.com/wp-content/uploads/2019/02/cfs-hypothesis-medical-hypotheses-article.pdf (Full text)] ::The ''Medical Hypotheses'' journal that published this is reported to be the world's most controversial journal,<ref name="MHcontroversial">{{Cite journal | title = Editor says no to peer review for controversial journal | date = 2010-03-18| url = https://www.nature.com/articles/news.2010.132|journal=Nature | last = Cressey | first = Daniel|language=en|doi=10.1038/news.2010.132|issn=1476-4687}}</ref> and describes itself as publishing hypothesis that are "radical, speculative and non-mainstream scientific ideas" and some "where experimental support is yet fragmentary".<ref name="MH">{{Cite web | url=https://www.elsevier.com/journals/medical-hypotheses/0306-9877/guide-for-authors | title = Guide for authors - Medical Hypotheses - ISSN 0306-9877 | last = | first = | authorlink = | date = | website = Elsevier|language=en|archive-url=|archive-date=|url-status=|access-date=2022-06-03}}</ref><ref name="MH-SS">{{Cite web | url=https://www.sciencedirect.com/journal/medical-hypotheses | title = Medical Hypotheses {{!}} Journal | last = | first = | authorlink = | date = | website = ScienceDirect.com by Elsevier|language=en-us|archive-url=|archive-date=|url-status=|access-date=2022-06-03}}</ref> It is peer-reviewed. ==Personal experiences== * 2009, [http://web.archive.org/web/20090405173658/http://www.phoenix-cfs.org/BlogAmygdalaTraining1.htm Amygdala Training part 1 Blog] - Cort Johnson (archived) * 2012, [https://phoenixrising.me/myalgic-encephalomyelitis-chronic-fatigue-syndrome-mecfs-treatments/mind-body/amygdala-retraining/a-psychotherapist-reviews-ashtok-guptas-amygdala-retraining-program-by-tamara-lewis/ A Psychotherapist Reviews Ashok Gupta’s Amygdala Retraining Program] – Tamara Lewis * 2010, [https://cfs-survivors.org/blog/2010/07/11/just-passed-six-months-on-the-gupta-programme/ Just passed six months on the Gupta programme] - Graham Stoney ==See also == *[[Criticisms of The Gupta Program]] *[[Ashok Gupta]] *[[Brain retraining]] *[[Pseudoscience]] *[[Mindfulness]] ==Learn more == * 2018, [https://www.asa.org.uk/rulings/harley-street-solutions-ltd-a17-400324.html Advertising Standards Association complaint result] * 2009, [https://web.archive.org/web/20210422023328/https://www.prohealth.com/library/qa-session-with-ashok-gupta-developer-of-the-amygdala-retraining-program-for-me-cfs-and-fm-held-july-10-2009-26402 Q&A Session with Ashok Gupta developer of Amygdala Retraining Program for ME/CFS, FM] - ProHealth (archived) ==References == {{Reflist}} [[Category:Psychological paradigm]] [[Category:Psychological and behavioral therapies]] [[Category:Potential treatments]] [[Category:Brain training]]
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