Good Science

27 Dec

One evening, as I was holding forth about the effectiveness of Taoist (ancient Chinese) medicine, my friend indicated that I embrace that which is old, while rejecting most contemporary conventional medical treatments. This well-intended criticism made me wonder if I might be letting my emotions take precedence over good scientific logic. As a result, I have been perseverating (as is my wont) for the past few days about the scientific method.

While I am not a research physician, I believe good scientific methodology existed long before someone invented the ‘gold standard’ of double-blind, peer-reviewed, medical research studies found in contemporary medical journals. I consider myself a first-rate clinician with a finely developed ability to Observe and Record.  Observe and Record was perhaps the earliest approach to scientific thinking and in my opinion it may still be the best. Smallpox was eradicated and sterile operating rooms were achieved because of the observations of individual doctors.

I seriously doubt that either Lister or Pasteur sat around thinking ‘how can I become rich and famous.’ Clearly they were curious observers and perhaps they were also infused with a genuine desire to alleviate human suffering. Contrast this with most of the clinical research done in the past three decades. Yes, as I’ve said many times, I don’t trust it. The expense of fulfilling that gold standard for such research dictates corporate or government funding and it’s hard to know the full effect of individual or corporate greed.

Taoist medicine and ayurvedic healing practices are thousands of years old and are still practiced today. Some approaches have been studied by modern researchers (acupuncture for example) and the results are ‘inconclusive.’ What is true, however, is that there are no significant negative side effects. In other words, these practices do no harm. And those of us who have received relief from our pain and suffering through acupuncture, laying on of hands, special breathing techniques and dietary changes (to name just a few) can attest to their effectiveness. Of course, it could all be the placebo effect, or ‘mind over matter,’ or the healing intent of the practitioner. Maybe it all comes down to faith. Is that really a problem?

The Self Cure book makes it very clear that there are certain conditions for which modern, high-tech medicine is necessary and at times almost miraculous in its effectiveness. Briefly, this includes serious infection, severe trauma, and surgical emergencies. But for the rest of what ails us, I prefer the time honored and (to my mind) more scientific approach.

Is it not good science to wonder about the unanswered questions in regard to, let us say, cancer. If you ask an oncologist ‘why did I get cancer,’ she will say ‘we don’t know why some people get cancer and others don’t.’ This is true, but isn’t anybody besides me curious about that? It is imperative that we learn how to prevent cancer, and unscientific not to ask these questions. Hundreds of thousands of lives would be saved, far more than the ‘search for a cure’ has produced.

Perhaps my friend was indeed practicing the kind of scientific method I believe in when he made his comment that evening. I know him to have very keen observational powers, so that his observations of my beliefs and behaviors over the years are accurate. And he did not draw any unwarranted conclusions. He simply stated what he had observed and recorded (in his mind). That’s good science.

A Creative Solution

18 Dec

When I don’t feel well, it is difficult for me to get started on a new writing project. It always follows the same pattern. I start writing from my head, thinking about each idea and each word and struggling to get it ‘just right’ on the page. I call this constipated writing. It’s hard to get it out and it doesn’t leave me feeling satisfied. But after a while a certain ‘flow’ takes over – I think athletes call it getting into the zone – and the words seem to come not from my brain, but from my fingers. When I reach this level, I feel good. Pre-existing symptoms fall away. I feel at ease, content, sometimes even happy.

Many years ago I knew a young woman who was a very talented dancer and choreographer. She desperately wanted to have a baby, and when she finally did, she gave up her work to devote her time to raising the child. Her health deteriorated very quickly. She truly loved the child and was an excellent mother but she became depressed and sickly. At my urging, she allowed other people to take over some of the care of the baby and returned to her creative endeavors. Soon her health and sense of well-being were restored.

Creative people can wither and die if they give up that (creative) part of themselves in order to be responsible spouses, parents and breadwinners. I have seen this happen to talented musicians, writers, artists and woodworkers. This also happens to athletes. It’s probably the same phenomenon and goes back to the concept of energetic flow in the body:  when feeling and energy flow freely through the body, a state of health ensues. When this is blocked, or stagnates, one is prone to disease states.

In the Self Cure book, I advocate expressive exercises such as singing and laughing to open up blocked areas of the body. While these are often invaluable tools for preventing illness and enhancing well-being, their effect pales in comparison to the benefits accrued from allowing one’s creative juices to flow. Most folks have this spark within them, but often they don’t realize how important it is to their health.

You may not see yourself as a creative individual. But think about the things you do that put you in the zone, when you lose track of time because you are so caught up in the flow of what you are doing. For example, many of my patients have reported that they feel best when they are gardening. Despite the hard work involved, they feel peaceful, happy, grounded and safe. Whatever it is that works for you, I urge you to spend some time each day in that state of creative flow. If you feel guilty ‘indulging’ yourself in this way instead of being productive, tell yourself (and anyone else making demands on you) that you are just following doctor’s orders.

Spontaneous Remissions

14 Dec

In medical terminology Spontaneous Remission means recovery (from an illness or condition) without known reason or cause. Many if not most long-term illnesses are characterized by periods when the patient is totally free of symptoms and signs even when no medical treatment has been administered. Examples include most of the auto-immune disorders such as rheumatoid arthritis, Crohn’s disease, and myasthenia, as well as some of the neurological degenerative conditions (notably multiple sclerosis) and even cancer.

These seemingly magical, but usually temporary, ‘cures’ were well known to physicians in a bygone era when illnesses were often allowed to run their course, often due to the lack of any known effective treatments. Nowadays, essentially all diseases are aggressively and continuously treated so that when a remission occurs, it is attributed to the prescribed treatment. It is not known how often the patient recovers in spite of the treatment rather than because of it.

Doctors and researchers, both under the spell of Big Pharma, seem to have lost interest in the phenomenon of spontaneous remissions. But I continue to find it fascinating and an affirmation of the old medical maxim vis medicatrix naturae (the healing power of nature). If I were the Czar of Health Care, I would demand that tons of research grants be awarded to those who would study the natural course of illnesses including spontaneous remissions.

Instead of focusing exclusively on medical interventions (basically surgery and prescription medications) let’s look at what is going on in the body/mind of people during the intervals (often months or years) when they are free of signs and symptoms of their condition. Let’s learn what factors promote natural healing and figure out how to maximize the potential of the healing power of nature.

Wait, you ask, since doctors treat everyone with the same aggressive protocol (being subject to malpractice suits if they don’t), where could you find untreated patients to study? Well, my guess is that I am not the only person on the planet who has opted out of almost all currently conventional medical interventions. I suspect there is a whole cadre of such iconoclasts (perhaps some are my faithful readers) who would be willing to share the scandalous details of our foolish faiths. Are we fiercely religious, or perhaps life-long granolas, or maybe even fearless neurotics -  why are we well when we are well and what aids our recovery when we are not?

Maybe you got well because your spouse finally agreed to let you to have a dog. Please share your stories. Seriously.

Pain

6 Dec

We are talking here about somatic (physical) pain, not psychic pain, not weltschmertz. Wait, you say, I thought you were a mind/body doc, how can you separate these things?  Of course, but I have also said that when we experience physical pain, no matter what the source, we do not want to be told ‘it’s all in your head.’ You are hurting and you need relief until you have the time and inclination to search for the ‘issues’ behind the pain.

What follows are random observations about the nature of pain and some ideas that might be helpful the next time you are hurting.

Acute pain is a danger signal. It is a friend grabbing you by the arm when you are mindlessly stepping out into oncoming traffic. Pay attention. Stop doing the thing that caused the pain or you may well wind up doing irreversible damage to your body. This is especially true, contrary to popular opinion, regarding pain that occurs when you are exercising, especially those of you no longer young.

Pain gets much worse when you strive to suffer in silence. Next time you stub your toe, shout and curse out loud and you will see how much quicker the pain subsides. This is not the same as whining about your pain to mom or a friend – that simply perpetuates the problem by reinforcing your attention to it.

You have a toothache. You don’t know how you are going to get through the night until you can see the dentist. But you go anyway to the latest James Bond movie with your friend. Half way through the movie you notice (if you are observant) that the pain is gone. Of course it returns when the show is over and you have to go home. What is that all about? Why should distraction work so well? I don’t know, but enjoy it while you can. Actually, for me it needs to be a Woody Allen movie.

Pain is always much worse when you believe damage is being done to your body. Think of a venipuncture. The phlebotomist is sticking a needle into your arm. It’s an easily tolerated pain when you realize she can do you no real harm. Same with the pain of acupuncture. When you fear harm is being done, you tense your muscles and your nervous system goes on high alert and the pain becomes nearly intolerable. Acupuncture can do you no harm.

Now all of the above has been about acute pain. When it comes to chronic pain, all bets are off. Especially the chronic pain that persists despite the fact that there is no demonstrable pathology. By that I mean that you’ve had a medical work-up and nothing is wrong with you except the awful pain. When this happens, whether it be persistent headaches, low-back spasm, chest pain, etc. you will need to go deeper if you wish to heal yourself. You will find several practical suggestions for doing this kind of work in the Self Cure book.

Love goes both ways

1 Dec

You cannot love a flower unless you let the flower love you.

Tolbert McCarroll, 1977

Some of us can recall the days when it was acceptable to engage with other people’s children in the supermarket. You could smile at the kids, talk to them, even pat them on the head. The parents (and often the kids) would smile back at you and perhaps strike up a conversation, like happens now when you pet another person’s dog (I suppose that won’t last long either, as folks become fearful of dog-nappers and canine perverts).

But now it is de rigeur to ignore the kid standing with mommy in front of you on the check-out line. You study the cover of Cosmopolitan which tells you how to have the hottest sex ever with whoever (don’t they know that most five year olds can read?) or you look at pictures of your grandchildren on your smart phone.

Notice I said ‘you.’ Because I refuse to pass up the chance for a delightful connection with kids.  I do ignore kids over 3 or 4 because most of them have been taught to fear. If you smile at them, they’ll cling to mommy and look away. If the mother notices, she’ll shoot you a hostile glance.

But the little ones – babes in arms or toddlers – are still corruptible. Most of them look out at the world from a place of immense curiosity and innocence.  Their eyes are wide with wonder and awe. They take in everything without judgment or fear, including other beings. If you gaze back at the child with the same openness and curiosity and wait for them to respond, they will generally smile at you. Then if you smile back and continue to follow their lead, you can have a marvelous, heart-warming ‘conversation’ (verbal or non-verbal) that will make your day.

The parents, of course, will eventually notice this, and most will react favorably. Or maybe I’m just lucky. Perhaps they see me as too old to pose a threat. Or it might be that they get swept up in the momentary magic of unconditional love and acceptance.

This kind of exchange, the giving and receiving of unconditional love and acceptance, is very important for health. Love, like any other form of energy, is healing when it flows freely. The opposite can be true if it is stuck (i.e. not flowing). Read Self Cure for exercises and meditations to help develop this ability in yourself.

The Fourth Pillar

13 Nov

The principles and practices set forth in the Self Cure Book are based on the Three Pillars, namely Intake, Exercise and Going to the Source. A basic understanding of these is necessary for both the prevention and treatment of all that ails us. The book mentions what I consider to be the fourth pillar but there is little elaboration of it, citing constraints of space and my limited expertise in that area. That fourth pillar is RELATIONSHIPS.

You’d think that having written a recent mini-series of posts on Psychotherapy, I must know something about Relationships, right? Well, yes and no. All those years I spent on both sides of the couch were useful, but a recent health issue of my own resulted in a quantum leap in my understanding of just how important relationships are to our health and well-being. The leap actually is across the great divide between my head and my heart. I use the present tense because I’m still in mid-air.

OK, enough of my feeble attempts at fancy metaphors and poetic prose. Here’s what I discovered. Everyone acknowledges that relationships are important to our health and well-being. Married men live longer. Folks with dogs have less heart disease. In my life, close connection with my family, friends, patients and yes, dogs, has been essential to my well-being. I would feel lost without those relationships. So, why then have I had so many annoying (though not life-threatening) health issues since childhood?

My most recent bout of symptoms went on for more than six weeks, interfering with my work and putting a damper on any real pleasure in my life. A chance encounter with a couple of acquaintances from the distant past resulted in an ‘ah-ha’ moment for me. These people are my age and have acquired the wisdom and experience to send me down a path I had thought was closed to me. I have known for years that my intimate connections with people have come mostly from my head. Yes, I have loved, on many levels –romantic, paternal, filial, etc – but I have not felt that love in my heart.

Wait, yes I have. The love I have had for small children and dogs has been ‘heart-felt.’ My wise friends pointed out that for me, it was safe to love them with ‘all my heart.’ But I harbored an unconscious belief that it was not safe to open my heart to ‘grown-ups,’ including myself. Well, I have discovered that it is safe. It’s a bit scary after all these years, but I can do it and I am doing it. And my long-term symptoms are melting away.

I hope that most of you reading this are able to love with an open heart. But if you are not, I highly recommend this remedy for all that ails you. It’s not easy to learn how to do this, and you might need assistance from a wise friend. If so, send me an email.

Dead Serious

24 Oct

I know, it’s supposed to be deadly serious, but I needed to get your attention. Please take this post seriously because it might just save your life or the life of someone you love.

For years I have railed against the takeover of the medical profession by Big Pharma. The most solid evidence of this is contained in the book by Marcia Angell, MD, “The Truth About the Drug Companies,” published in 2005. If you have doubts about the extent of control of medical research and treatment by corporate interests, read this book.

Now it is crystal clear that this takeover has resulted in the medical profession doing more harm than good, even though that is not the intention of most doctors I know. I have suspected for years that the extensive ‘early detection’ screening techniques were resulting in a plethora of invasive testing procedures and interventions that are harming and killing many individuals. I have seen it happen to patients and friends, but of course my anecdotal observations have carried no weight with anyone, even those who are victims of the process.

Now there is proof of this travesty, this violation of the most basic tenet of medical practice, PRIMUM NON NOCERE – above all, do no harm.

For the past week I have been reading a recently published book by Otis Brawley, MD called HOW WE DO HARM. Dr. Brawley is the chief medical officer of the American Cancer Society and a board certified oncologist at Emory University. He is no renegade dispenser of ‘alternative’ methods or ideas. In fact, he has nothing to sell. His compassion for his patients and fellow human beings shines through in this book. That compassion I believe was the motivator behind the risk he is taking in writing this book.

Dr. Brawley’s credentials leave no doubt that this is a man who understands the complexities of cancer research, and for that matter research into other potentially fatal illnesses such as heart disease. By painstaking analysis of the research data, combined with in-depth case histories, he leaves no room for doubt that what we have accepted as ‘standard of care’ is killing us. The most heartbreaking example is the still commonly used PSA test, despite the fact that the test is no longer generally recommended by the US Preventive Services Task Force.

Please buy this book for your doctor. If he or she won’t read it, I urge you to find a doctor who will, and become his or her patient. I am deadly serious about this.

The Pelvis

19 Oct

No doctor specializes in the pelvis. There are urologists if you’ve got urinary disorders (and you guys with prostate problems), gynecologists for ‘female’ trouble, proctologists for the rectum, and orthopedic surgeons if the low back is out of whack. While this makes sense from the doctors’ viewpoint, it is often a travesty for the patient.

If one takes a careful history from any patient with complaints referable to the pelvis, one (that’s me, by the way) finds that it’s all connected ‘down there.’ Here are some examples.

A man I know had trouble peeing (urgency, frequency, burning for you medical readers) and was sent to a urologist after his family doctor determined that he did not have a urinary infection. The urologist did a painful and expensive ‘scoping of the urinary tract but found nothing. Nevertheless, he treated the fellow with antibiotics for a ‘presumptive’ prostatitis, which did not help the symptoms but did cause severe and protracted diarrhea. A psychologist friend of this man, on hearing the sad tale, reminded the fellow that he had always complained about tension in his legs and wondered if perhaps that tension extended to the pelvis as well. Well, it did, our patient admitted, whereupon the shrink referred him to a colleague who taught deep muscle relaxation.  After two painless and informative sessions, the symptoms were gone and did not return. Moral: take a history before subjecting the patient to costly, painful and sometimes dangerous procedures and treatments.

A young woman suffered from endometriosis and infertility (gynecologist) and also was constipated (proctologist, gastroenterologist) and subject to urinary infections (urologist) and painful intercourse (back to gyn). She sought my help because she was depressed (why not, with those symptoms). We talked about her depression, but most of our work was focused on freeing up the chronic tension in the deep muscles of her pelvis through a series of relaxation and energizing exercises that she practiced in the privacy of her home. She was cured of all her symptoms and even became pregnant a year later. Moral: chonic muscular tension causes stagnation of energy which leads to disease states.

A young man suffered from recurrent bouts of severe low back pain, painful anal spasms and premature ejaculation. He was a very angry person but presented himself as Mr. NiceGuy. After years of therapy, he finally was able to express his anger in a self-affirming, useful way. His back pain and anal spasms resolved. Moral: some things take a long time.

Since no doctor specializes in the pelvis, what’s a person to do? Well, if the problem is acute and potentially serious, such as infection or bleeding, see your primary care physician and, if necessary, ask for a referral to an appropriate specialist. But if the problem is chronic or recurrent over months or years and especially when it involves more than one bodily system (as in the examples above), practice self cure methods and consider consulting a body-centered psychotherapist.

PSYCHOTHERAPY: THE MINI SERIES – Part IV – The Body and the Emotions in the Process of Psychotherapy

2 Oct

…the mind plays tricks but the body never lies – Alexander Lowen

I have mentioned that one of the best reasons for starting psychotherapy is if you have chronic or recurrent bodily complaints. Some of these conditions are rampant in our culture, reaching an incidence level of 15-20%.  When one out of five or six people have a ‘disease,’ you can be sure it’s related to life-style. Here a psychotherapist, along with a commitment on your part to follow good health practices, can be much more helpful than your doctor can.

But the role of the body in psychotherapy goes way beyond illness. Even if you are free of physical health problems, your body reflects who you are as a person and how you relate to the world. Everything, how you move, your posture, even your dress and hair style, speaks volumes about you. The quality of your voice, the set of your jaw, your gestures when you speak and of course your eyes reveal much more about you than the words you utter.

Any really good, experienced psychotherapist notices these things. If he does not, he’s either asleep at the wheel or has problems of his own. Sadly, you can’t know if your therapist is competent in this area simply by the letters after his name. The way you can know is by her responses to you after the first couple of sessions. If she is savvy, she will gently ask, for example, if you have noticed that your fists are clenched when you talk about your mother, even though your words are extolling her maternal virtues. In this way, she begins to bring your awareness into your body and the ways in which it reflects your authentic self.

A therapist who has had special training in ‘body centered psychotherapy’ will be more likely to utilize the clues from your body to enhance your progress in therapy. However, I want to emphasize again that the designations after a person’s name is no guarantee of competence. Please see Part II of this Mini Series regarding how to find a good therapist.

A sure-fire way to speed up the therapeutic process is for you to spend time learning to increase your body awareness. If you learn to listen to the messages your body is sending you as you make your way through your day, life gets a lot easier.

I am not going to try to give you a comprehensive overview of the role of the emotions in psychotherapy. A good therapist knows that there is nothing more important to your growth and change than to know what you are really feeling as you make your way in this world. The reactions of your body to any given situation provide the best clues as to what you are feeling, so you can see that the two subjects are inexplicably entwined. Your emotions are not in your head. They are bodily responses.

It seems to me that people either feel too much or not enough. Or more precisely the latter group doesn’t know what they are feeling. That’s been my problem since childhood, so naturally I’ve become quite an expert on helping folks get to what they are really feeling. The individuals who have very strong feelings that get them into trouble with others are harder for me to understand, but I sure tend to like them a lot. I guess the ideal for us all to work towards is 1) to know what you’re feeling; 2) to be able to experience your feelings fully; and 3) to be able to tolerate your feelings without necessarily needing to act on them. I’m not totally there yet, but I’m working on it and it gets better (and easier!) over time.

PSYCHOTHERAPY: THE MINI SERIES – Part III – Your responsibilities as a patient/client

24 Sep

I’ve changed my mind about this issue over the years as I have grown from a passive-dependent whiny patient into an assertive consumer of mental health services. If you can accept certain responsibilities for your own well-being, I can assure you that you will get a lot more out of psychotherapy. If you cannot yet do this, be patient with yourself while you let the therapist guide you. Just be sure you have done all you can to find a good person (see details in Part II).

Here is a checklist of items in more or less chronological order:

  1. Be on time and pay promptly. A therapist is just another human being. She may hide her annoyance at your lateness or your lagging behind on payments, but it will affect her. In addition, I have always felt that patients get a lot more from therapy when they have to pay out of pocket. So if you possibly can afford it, avoid third party payments.
  2. Try to make a clear statement about what you hope to get out of psychotherapy. Tell the therapist how you want to change and ask her if she can help you with that.
  3. Except for promptness and payments, don’t be a good patient. By that I mean, be real with your therapist. If he makes a suggestion and it doesn’t sit well with you, tell him. If he is any good at all, he’ll be able to help you more if you give honest responses than from your compliance.
  4. It is useful to sit quietly or even meditate for a few minutes before going into the session. You can do this in your parked car or perhaps in the therapist’s waiting room. It also helps to sit for a few minutes after the session before rushing off to the busy-ness of your day. This is NOT the same as thinking about the session or trying to remember what was said – I have actually found that process to be counter-productive.
  5. During the time (usually a week) between sessions, keep notes on thoughts, feelings and ideas that you want to tell your therapist. On the other hand, don’t be wedded to your list. For example, if the first item from your notes takes you and the therapist to new territory and it feels alive and productive, let go of trying to fit the rest of your notes into the session.
  6. Avoid telephoning your therapist except in a real emergency. Even if she offers telephone sessions for a fee, I suggest you steer clear of these – it is rare for any progress to be made this way and it simply reinforces your dependency on her.
  7. Give top priority to your psychotherapy. I am assuming you have embarked on this venture because of some rather severe psychic or somatic pain and that you are not just ‘dabbling.’ Don’t allow yourself to be so busy that you have to miss an appointment and if you accept ‘homework’ from your therapist, make time to do it.

We will finish this mini-series on psychotherapy with the next post, which will deal with the importance of emotions and the role of the body in the therapeutic process. Stay tuned.

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