Richard G. Petty, MD

Writing and Rewriting Your Own Life Story

I had the privilege of being on the Donna Seebo show yesterday. And when I say that it was a privilege, it really was. It is not often that I find someone who so fully understands the power of an Integrated approach to health and medicine. Toward the end of the call an interesting question came up about the value of journal writing in healing. I am a firm believer in it, I recently reviewed a terrific book by Sheppard Kominars on the topic and I have published a reading list on Amazon.

There is some empirical research to show that journal writing can improve our physical and mental health (1, 2, 3, 4). Why should this be?

One of our most fundamental and enduring needs is to tell people our stories. And even more than that: to leave our stories as the records of our lives. Our stories define us. They are the vehicles of meaning and they serve as the narrative of our views about our world and ourselves. And our stories create our legacy. We all constantly tell stories that shape virtually every human activity from our emotions to our personal relationships and our politics.

It has clear evolutionary advantages to be able to tell good stories, not only for social cohesion, but also as a device to pass on wisdom. But perhaps most of all, storytelling is a device to help us make sense of the world about us.

Jerome Bruner has indicated that children acquire language in order to tell the stories that are already in them. We learn through story telling. The brain breaks down when we no longer manage to make sense of the world around us. Patients with schizophrenia seem to lose the ability to tell a coherent story about themselves or about the world around them.

I am reminded of the tragic letter written by Dimitri Koesnikov, the young Russian submariner on the Kursk who continued to write a letter to his wife, even when he knew that death was inevitable, or the passengers on the Japanese jet liner that crashed in 1985. As the plane went down, people were writing letters. Or people in the Warsaw ghetto who wrote letters and poems even when they knew that they only had minutes to live.

Writing our stories introduces another dynamic: most of us find that putting out thoughts and feelings down on paper helps to give us mental and emotional clarity. Writing helps us to express our individuality and to make connections with others.

Our memories are not just videos of our life events; they are dynamic and malleable and are constantly being edited. So we can change our stories, and with that, remove some of the restrictions that they have imposed upon us. This is not an invitation to enter into a fantasy world or to start lying to yourself or to other people, but is instead an incredibly valuable tool to clear some of the blocks I our lives.

It is a good practice to think through your stories every day. If you care to write about them, that is even better. We need to answer the question: “What are the stories that have defined who you are and how you act?”

When we think about our relationships, isn’t it true that the ones that matter the most and have the most emotional charge attached to them are those in which our stories are intertwined? How often have you met an old friend, after a gap of many years, and found that you no longer have much to talk about, because your stories have diverged so far? How many people maintain family relationships even when their respective stories have nothing in common? Maintaining a relationship out of duty is unfair and disingenuous. Either the stories need to be repaired, or the relationship is doomed.

As an exercise, I would like you to examine some of the dominant stories that have determined some of your personality and your character. And I would then like you to write a brief story about how you would like your life to be.

To help you get started, let me make some suggestions:

•    What is your favorite type of story?
•    What is the first story about your family that you remember hearing?
•    What are your favorite stories about yourself as a child?
•    What are your favorite stories about yourself as an adult?
•    Who are the key characters in your life story?
•    How many of the key characters know each other?
•    Does your life story have a plot line?
•    Could you create a better one?
•    What stories would you like others to tell about you?
•    How would you like your story to end?

I would love to have some feedback if you find this helpful.



“A man's mind is hidden in his writings; criticism brings it to light.”
--Solomon ben Yehuda ibn Gabirol (Spanish-Hebrew Poet, Neoplatonist Philosopher and Mystic, c.1021-c.1058)

“Writing is a form of therapy; how do all those who do not write, compose, or paint manage to escape the melancholia, the panic and fear which is inherent in the human condition?”
--Graham Greene (English Writer, 1904-1991)

Unhealthy America

The Milken Institute has released an impressive study that shows the heavy economic burden chronic disease places on our nation. “An Unhealthy America: The Economic Burden of Chronic Disease” shows the current treatment costs of seven chronic diseases - cancers, diabetes, heart disease, hypertension, stroke, mental disorders and pulmonary conditions – as well as the economic impacts of lost workdays and lower employee productivity. It gives a breakdown across all 50 states and the nation as a whole. The study finds that the annual economic impact on the U.S. economy of the most common chronic diseases is more than $1 trillion, and projects that the figures could reach nearly $6 trillion by the middle of the century.

Though some of the blame for this burden can be blamed on stress and environmental factors, much more of it is a direct consequence of our lifestyle choices interacting with our genes. Most of us are failing to renew, refresh and replenish ourselves, and it is important to recognize that whenever we start debating the costs of health care in the United States.

Integrated Health is based on tailored systems to help people care for themselves by going way beyond diet and exercise, and addressing the psychological, social, cultural, subtle and spiritual components of health and wellness. Healing, Meaning and Purpose is a detailed roadmap for creating the life that you deserve, and we are going to be rolling out a new series of teleseminars and workshops in the New Year.

Empowerment

It is sometimes frustrating to see peoples’ medical problems reduced – incorrectly - to a single factor. Worse yet, failing to see that all the systems of the body, the mind, our relationships, environment and spirituality all have a part to play in the maintenance of our health and the treatment of disease.

I grew up in England and benefited from and then trained and worked in the National Health Service. Which is nothing of the sort: it is a disease management service.

The problem lies not with money or inefficient systems, but with an emphasis on management rather than prevention of disease.

The next revolution in healthcare is not being driven by science and technology, but by empowerment: being given the tools for taking personal responsibility for our own health and well-being.

Not just so that we feel better and may have the chance of avoiding costly medicines, but so that we can grow as individuals.

The ultimate goal of any form of personal development, of psychotherapy and indeed of medicine, is to remove restrictions from people.

Freedom unlocks human potential.

We are inundated with information about health. Much of the information is confused and confusing. Integrated Medicine is based on the idea of integrating different approaches and integrating the different parts of a person and all of his or her relationships form cell to soul.

The key to that is understanding how to fit all the pieces together, whether a person is a Buddhist or a Baptist, a meat-eater, vegan or junk food addict. To be able to answer these kinds of questions:

• What diet is right for me personally?
• What type of exercise should I do at my age, level of fitness and time constraints?
• How can I get the quality sleep that I need with all the demands on my time?
• How can I manage the stress in my life?
• How can I manage my emotions so that I run them instead of them running me?
• How can I have satisfying connections with other people?
• How can I find my meaning and purpose in life?

The good news is that we already have answers to most of those questions and we have developed hundreds of tips and techniques that people can do in minutes a day.

I revealed some in the book and CD series Healing, Meaning and Purpose, and in response to a great many requests, I shall be sharing many of these techniques in the months to come.

“Health is a state of complete harmony of the body, mind and spirit.  When one is free from physical disabilities and mental distractions, the gates of the soul open.”
--B.K.S. Iyengar (Indian Yoga teacher, 1918-)

“If we could learn how to balance rest against effort, calmness against strain, quiet against turmoil, we would assure ourselves of joy in living and psychological health for life.”
--Josephine L. Rathbone (American Sports Physiologist and Pioneer in Health and Relaxation, 1899-)

“Personal transformation can and does have global effects. As we go, so goes the world, for the world is us. The revolution that will save the world is ultimately a personal one.”
--Marianne Williamson (American Author, Unity Church Minister and Lecturer on Spirituality, 1952-)

“Questions focus our thinking. Ask empowering questions like: What's good about this? What's not perfect about it yet? What am I going to do next time? How can I do this and have fun doing it?”
--Charles Connolly (American Psychologist)

Chiropractic Treatment and Diabetes?

There is an interesting, thought still preliminary, article in the Journal of Vertebral Subluxation Research about the possibility that chiropractic manipulation may be able to make a valuable contribution to an overall program of wellness to help people with diabetes.

There is a case report of an insulin-requiring person with type 2 diabetes, whose diabetes stabilized as he had a short course of chiropractic manipulation. I've seen many such cases with acupuncture and homeopathy as well as osteopathic and chiropractic manipulation. But it has always been very difficult to tell if there was a causal relationship.  Diabetes is such a variable group of illnesses that something as simple as stress reduction or a person sleeping better can both help normalize glucose levels, as least for a while.

What I really liked about the article was the measured tone: the editor makes it clear that it's an interesting observation but that it's still early days. Nothing so irritates people in conventional medicine than wild grandiose claims that some treatment or other can cure everything.

The editor also calls for more research, and I totally agree. I've spent the last 25 years trying to get research moving in the fields of complementary, alternative and Integrated Medicine, and we have already had a decent level of success in getting many projects funded and completed.


“The simple exercise of stretching helps to counter the congestions, compressions, and adhesions which obstruct the flow of the vital force through the spinal column with its sixty-two branching nerves and thus to regain energy. This truth of the need of spine-loosening movement is instinctively known by every dog and cat, every lion and tiger, for they apply it immediately after awakening from sleep. The back, the legs, and even paws are bent and stretched and even rolled by them in this natural exercise.”
--Paul Brunton (English Spiritual Teacher and Author, 1898-1981)

Prayer and Healing

We have already talked a little about the associations between active, healthy spirituality and psychological and physical well-being.

Yet another study has highlighted the connection, showing that breast cancer patients who pray in online support groups can obtain mental health benefits.

Researchers from the University of Wisconsin-Madison Center of Excellence in Cancer Communications Research did the study that was that was funded by the National Cancer Institute.

The research looked at message transcripts from 97 breast cancer patients participating in an online support group that was integrated with the Comprehensive Health Enhancement Support System (CHESS) "Living with Breast Cancer" program, a computer-based health education and support system. The patients were recruited from Wisconsin and Michigan.

Surveys were administered before group access and then again four months later. Text messages within the computer-mediated support groups were analyzed using a text analysis program that measured the percentage of words that were suggestive of religious belief and practice (e.g., pray, worship, faith, holy, God). Writing a higher percentage of these religious words within the online support groups was associated with lower levels of negative emotions and higher levels of self-efficacy and functional well-being, even after controlling for patients' pre-test levels of religious beliefs.

One of the researchers had this to say:

"From a psychological standpoint, there are a variety of reasons why cancer patients may benefit from prayer - whether on the Internet or elsewhere. In reviewing the messages, some of the most common ways study participants used religion to cope with their illness included putting trust in God about the course of their illness and consequently feeling less stressed, believing in an afterlife and therefore being less afraid of death, finding blessings in their lives and appraising their cancer experience in a more constructive religious light."

And that is, of course, one set of explanations for the findings.

Or perhaps, as we have seen before, there is a growing body of research to indicate that prayer is effective.

We just have to expect it to be effective. And isn’t that faith?

“Prayer, like radium, is a luminous and self-generating form of energy.”
--Alexis Carrel (French-born American Surgeon, Experimental Biologist and, in 1912, Winner of the Nobel Prize for Medicine or Physiology, 1873-1944)

"Too often we see prayer as a last resort rather than as our first thought. People will say, “I guess all we can do now is pray!” like that's the last thing, horrible thing to do. And your friend says, “Has it come to that?! Is it so hopeless that all we can do is pray?”
--Rick Warren (American Evangelist and Author, 1954-)

“Though God knows all our needs, prayer is necessary for the cleansing and enlightenment of the soul.”
-- John Sergieff of Kronstadt (Russian Priest who, in 1882, Established the House of Industriousness, 1829-1909)

“Man often thinks that, as God is the knower of the heart, there can be no need of any recital or gesture in prayer: but that it would surely be sufficient if he were to sit in the silence and think of God. But this is not so; it is according to the extent of a man’s consciousness of prayer that his prayer reaches God.”
--Hazrat Inayat Khan (Founder of the Sufi Order of the West, 1882-1927)

“Through prayer, the love of God grows and assumes a form which is called supreme devotion. Forms vanish, rituals fly away, books are superseded, images, temples, churches, religions and sects, countries and nationalities - all these little limitations and bondages fall off by their own nature from him who knows this love of God.”
--Swami Vivekananda (Indian Hindu Mystic and Spiritual Teacher, 1863-1902)

“Prayer is part of man's original nature. He can never be satisfied with merely meditative religion, and naturally and involuntarily inclines to move on to the religion of prayer.”
--Toyohiko Kagawa (Japanese Christian Anti-War Campaigner, 1888-1960)

“All true prayer somehow confesses our absolute dependence on the Lord of life and death.”
Thomas Merton (French-born American Trappist Monk and Writer, 1915-1968)

“There is a relationship between prayer and action. Receptive prayer results in an inner receiving, which motivates to right action.”   
-- “Peace Pilgrim”  (a.k.a. Mildred Norman, American Peace Activist, 1908-1981)

Of Horses and Hearts

I live on a horse farm, so I see the interactions between horses and between horses and humans almost every day. Horses are extraordinarily sensitive creatures with their own sets of emotions and highly developed sense of propriety. They are also very good barometers for the emotional states of humans. We could not work out why one of the horses at another farm was consistently bratty with one particular rider, until we discovered that she was high on ecstasy. Her “energy” was a mess and it totally confused the horse.

On the other hand, horses are often used therapeutically with emotionally and mentally ill and handicapped children and adults. My old horse - Mr. Black - was a perfect therapy horse: nothing ever fazed him.

There is now some more research demonstrating one of the possible mechanisms by which horses may be able to pick up on a rider’s emotional states.

I have a couple of times mentioned some of the work being done at the Institute of HeartMath in California.

Some of their work is controversial, but most has been quite convincing.

I have for several years now been interested in the phenomenon of Heart Rate Variability (HRV). As the name implies, it is a measurement of the beat-to-beat variation in the heart’s rate. Alteration (primarily reductions) of HRV has been reported to be associated with various pathologic conditions like hypertension, hemorrhagic shock, and septic shock. It has found its role as a predictor of mortality after an acute myocardial infarction. It may also be disturbed in major depressive disorder.

I knew about it from the days that I worked at the National Heart Hospital in London, but Roger Callahan – the discover of Thought Field Therapy (TFT) – has been able to show that TFT is one of the few therapies that can normalize it. We also discussed it in the context of the vagal nerve and compassion.

From a pilot study by the Institute and Dr. Ellen Gehrke from Alliant University  it appears that a horse's heart rhythms reflect their emotional state and can respond to the emotional state of a nearby human. When in contact, a horse's heart rate may mirror a human's emotions, implying a close unspoken form of communication between the two.

The study took place at Dr. Gehrke's ranch in San Diego, where electrocardiogram (ECG) recorders were placed on her and also on four of her horses. All five were monitored during a 24-hour period in which the horses were under a variety of normal conditions and activities such as eating, grooming or being alone. Measurements were also done while they were being ridden and accompanied by Dr. Gehrke.

The ECG recorders projected increased coherent HRV patterns for the horses during times of close, calm contact between them and Dr. Gehrke. Coherent HRV patterns have been shown to be the result of positive emotions and facilitate brain function.

Dr. Gehrke said, "Horses receive information from body language and give feedback. They don't think very much, they feel. They are very emotional and honest. They also have a powerful impact on your sense of self and ability to lead."

I don’t think that cardiac coherence is the whole story. They also respond to micro-movements - small movements of the legs, arms and trunk that are all but imperceptible to humans – and we have seen many of them sense events at long range. I travel a great deal and come home at odd times. But several witnesses saw Mr. Black start to become very excited 20-30 minutes before I would arrive home. In England, Rupert Sheldrake has amassed a considerable body of evidence to support those observations.

Nonetheless, this is very important research and I shall be very interested to see the final version once it has been subject to peer review.

"There is something about the outside of a horse that is good for the inside of a man."
--Sir Winston Churchill (English Statesman, British Prime Minister, 1940-1945 and 1951-1955, and, in 1953, Winner of the Nobel Prize in Literature, 1874-1965)

“A man on a horse is spiritually as well as physically bigger than a man on foot.”
--John Steinbeck (American Writer and, in 1962, Winner of the Nobel Prize in Literature, 1902-1968)

“Wherever man has left his footprint in the long ascent from barbarism to civilization we will find the hoofprint of the horse beside it.”
--John Moore (American Man of Letters and Former Archivist and Librarian for the State of Tennessee, 1858-1929)

“I'd rather have a goddam horse.  A horse is at least human, for God's sake.”
--J.D. Salinger (American Writer, Student of Advaita Vedanta and Recluse, 1919-)

And finally:
"In my opinion, a horse is the animal to have.  Eleven-hundred pounds of raw muscle, power, grace, and sweat between your legs - it's something you just can't get from a pet hamster!"
--Unknown Author

Communicating About Complementary and Alternative Medicine

Two of the key points about Integrated Medicine are transparency and integration of different approaches.

It is true to say that all healing is ultimately self-healing, but at the heart of healing lies relationship: how we communicate with every part of ourselves, with other people and with our health care providers. At the most mundane level, there is published data that if a health care provider has a good relationship with the person coming to them for help, the chance that the person will follow through on a treatment plan is four times higher than if they meet a health care provider who just grunts at them.

There is also a magic that can happen in strong, dynamic relationships based on partnership rather than dominance: one of the themes of Healing, Meaning and Purpose.

It worried, but did not surprise me to see a study released today.

Most Americans age 50 and older use complementary and alternative medicine (CAM), such as supplements, herbal products or acupuncture. The trouble is that - according to a survey conducted by AARP and the National Center for Complementary and Alternative Medicine - they often do not tell their doctors or nurses.

It is very much in person's best interests to tell their doctor about the CAMs that they are taking because some unorthodox medicines may interfere with over-the-counter medications, prescription drugs, or other conventional medical approaches. See here for an example of some herbal remedies and supplements that may interact with psychotropic medicines.

As the report says, "Communication between patients and physicians about CAM and conventional therapies is vital to ensuring safe, integrated use of all health care approaches."

It goes on to say something that we have been preaching for years: an open dialog "allows patients and physicians the opportunity to identify CAM practices that might be beneficial and also minimizes risks to a patient from potential therapy interactions."

Among a total of 1,559 individuals age 50 and older surveyed in the spring of 2006, 63 percent reported having used one or more CAM therapies.

According to the survey - which can be found here - people between the ages of 50 and 59 are the most likely to report CAM use.

Forty-five percent of CAM enthusiasts used massage therapy, chiropractic manipulation or other bodywork; 42 percent used herbal or dietary supplements; 15 percent used mind/body practices, including hypnosis and meditation; 14 percent used naturopathy, acupuncture, or homeopathy; and 10 percent had tried energy therapies.

Sixty-six percent of CAM users said they did so to treat a specific health problem; 65 percent for overall wellness; 45 percent to supplement conventional medicine; and 42 percent to prevent illness.

Sixty-nine percent of those who reported using CAM had not discussed it with a doctor.

The intersting qustion is, "Why?"

Forty-two percent said because their doctor never asked; 30 percent said they did not know they should; 19 percent felt there was not enough time during the office visit; 17 percent didn't think the doctor would know about the topic; and 12 percent thought the doctor would be dismissive or tell them not to use CAM.

Women were more likely than men to have discussed CAM use with their doctor (26 percent vs 16 percent) and those younger than age 65 were more likely to discuss CAM use than were older individuals.

The report concludes that "patients need to mention CAM use to their physicians and physicians need to ask about it."

Tea and Milk

Growing up in England, tea is a great deal more than a drink.

Always drunk hot, of course. No normal person would want it served cold.

It is a major social lubricant and is considered by most to be a separate food group. And the health benefits conferred by a nice cup of tea are now known to just about everyone in Britain.

But from an early age I knew that one day I would have to leave the country.

Why?

Because I could never abide the way in which the vast majority of tea drunk in England is destroyed by the addition of milk and sugar. There are even long technical debates about whether to add the milk before pouring in the tea or after? How fast to add the white stuff? How to stir it in?

Since I was knee high to a puppy I was always the odd one out, wanting nothing to do with this wanton destruction of a sublime beverage.

Which should always be enjoyed au naturel. The only thing that might ever sully a cup of fine Earl Grey or Darjeeling might be a little lemon. Anything else?

Yuk.

Well, it now transpires that this isn’t just a matter of taste buds.

A study just published in the European Heart Journal says it all in the title, “Addition of milk prevents vascular protective effects of tea.”

Tests on sixteen healthy postmenopausal female volunteers showed that black tea significantly improved the ability of the arteries to relax and expand, but adding milk completely blunts the effect. The research was supplemented by tests on rat blood vessels. Tea caused the muscle in the vessel wall to relax by producing nitric oxide from the endothelial cells that line blood vessels. Adding milk blocked the production of nitric oxide and the relaxation of the muscles.

Now bear in mind that they were testing black tea. The researchers are now looking at the potentially more potent green tea to see whether its effects are also blocked by milk.

The villain of the piece is a group of proteins called caseins, which they found interacted with the tea to decrease the concentration of catechins in the beverage. Catechins are the flavonoids in tea that mainly contribute to its protection against cardiovascular disease.

The moral of the story? Tea can be wonderful on so many levels. Not only does it taste good, but also it can do wonders for your health.

But please, please, please don’t lose all the benefits by sloshing in a load of milk!

Raw, naked tea is the way to go...

"Thank God for tea! What would the world do without tea? How did it exist? I am glad I was not born before tea."
--Sydney Smith (English Clergyman and Essayist, 1771-1845)

Separation and Integration

“The ego always seeks to divide and separate. The Holy Spirit always seeks to unify and heal.”
--A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

Many of us feel that we have lost or forgotten something important and it nags at us. In the Matrix, Morpheus tries to capture this when he says, “There is a splinter in your mind.”

What we have forgotten is the hidden secret not only to who we are but also to what we may become.

There are hundreds of thousands of books, websites, classes, groups and, of course, religions that all say that they have an answer to those two questions. And I tend to believe that they probably all do. But each has only a part of the puzzle.

Integrated Medicine was always designed to provide answers synthesized from the very best of what is already available.

I am always being asked whether Integrated Medicine is an approach toward health and wellness, a method of achieving personal growth and development or some form of holistic treatment?

The answer is “Yes!”

The goal is not to replace other forms of self-care or treatment, but to integrate and enhance them. The reason for using the term “Integrated,” and why it is a little different from Integrative or Integral medicine, is that it aims to:

1. Integrate an individual’s current health and wellness practices into a combined whole
2. Integrate all the parts of a person, for the quotation is true: the role of the ego is to separate itself from the rest of the Universe, and healing come from the Source: your Informational Matrix, your Inner Light or Soul
3. Integrate healing methods that will ensure that each aspect of you being is addressed and respected so that the healing can flow. Not only of your body, but of your mind, relationships, the planet, society, subtle systems and your spirituality
4. Integrate your views about the nature of reality: healing is not simply a matter of fixing a physical machine. In any case, this is not always possible. The objective is not to “use” methods and insights to heal the body. It is rather to ask that your Overself or Higher Self teach you the right perception of your body and your mind. That is why I am always recommending that the first thing that you can do for yourself is to develop your intuition so that it provides a delicate counterbalance to your ability to reason. If you have ever been to a gym, you know the importance of exercising not just your bicep muscle, but your triceps muscle as well. One without the other will make you lopsided. So it is with intellect and intuition.
5. Integrate the personal you with something beyond yourself. The ultimate aim of Integrated Medicine is not simply to stay well, but to return to Wholeness

And all have been done already with tens of tousands of people around the globe.

Will you be next?

“To have a curable illness and to leave it untreated except for prayer is like sticking your hand in a fire and asking God to remove the flame.”
-- Unknown Author (Sometimes attributed to “Sandra L. Douglas”)

"A house divided against itself cannot stand.”
--Abraham Lincoln (American Statesman and, from 1861-1865, the 16th President of the United States, 1809-1865)

“In the integral Yoga, the integral life down to even the smallest detail has to be transformed, to become Divine.”
--- The Mother of Pondicherry (a.k.a. Mirra Alfassa, French-born Indian Spiritual Teacher, 1878-1973)

Journals, Science and Personal Empowerment

Education is empowerment: a vehicle to help you to take control of your life.

Regular readers will notice a new list on the left hand side of the blog, entitled "Journals."

It is always my aim to provide you with as much documentation and supporting information as possible. As I have said before, the days of passively accepting the words of an "expert" are coming to an end.

In the self-help arena, we are entering what I refer to as the fourth phase, in which any advice on psychology, relationships, health or medicine must be supported by empirical data. Personal advice is fine, but it has to stand the test of research. But there's an important point that sometimes gets missed: research is not just aimed at testing whether or not something works, but also at improving existing methods. As an example, there is research going on today that is refining and often improving traditional healing techniques that have been in use for centuries.

There are tens of thousands of journals focusing on health and wellness, medicine, psychology and spirituality. I scan a large number of them each week, and if I see something that looks interesting and relevant to our themes of Health, Integrated Medicine, Meaning and Purpose, I delve into it in a great deal of detail before writing an article here.

If you would like to follow up on something that I have written, I thought that it would be very useful for you to have access to some of the main journals.

My criteria for selection were that they had to be peer-reviewed, they had to carry pertinent articles and at least the abstracts of articles would be available on line. A few of the journals publish the whole text of selected articles.

I have not been able to find a listing like this anywhere on line: if something like it exists, it must be well hidden!

I do hope that you find that this new resource will be valuable to you. If people have ideas for other journals I shall have a look at them and tell you what I think! I shall aim to keep the list around about 100 journals and I shall keep things moving: if journals are no longer publishing articles which will support our mission, I shall move them off to make room for someone else.

Intestinal Microbes: A Hidden Cause of Obesity

It is no secret that many famous people swear by colonic irrigation. The late Princess Diana used to say that it helped her stay fit and keep her weight steady, though personally I always thought that good genes and regular exercise were the real explanations.

In previous posts I have talked about some of the emerging lines of evidence suggesting that there are at least four previously little recognized causes of obesity:

1. Stress
2. Salt intake
3. Pesticides
4. Viruses

Following a paper in today’s issue of the journal Nature, it looks as if we shall have to add a fifth: the intestinal microbes that are collectively known as “gut flora.” 

We have within us vast communities of microbes that outnumber our own body's cells by 10 to 1, and may contain 100 times more genes than our own human genome.

We have known for many years that we each contain pounds of these microbes and that they are doing a great deal more than simply sitting there. We have known since the 1950s that many of the microbes are involved in digestion, absorption and immune function. That is one of the reasons why most doctors worry about the unnecessary use of antibiotics: some can knock out the gut flora, sometimes with serious consequences.

It is the first of these – digestion and absorption – that has been attracting attention. Under normal circumstances our bacteria break down many complex molecules like polysaccharides into simple sugars that we absorb and use for energy.

Colleagues from the Washington University School of Medicine in St. Louis have made a remarkable discovery. It seems that the balance of two major families of intestinal bacteria: Firmicutes and Bacteroidetes have a major impact on digestion and obesity. Together these two families constitute 90 per cent of the bacteria in the intestines of humans, and, coincidentally, white mice.

The researchers conducted two parallel studies. In the first they found that as obese people lose weight, the balance between the Firmicutes and the Bacteroidetes changes - the latter increasing in abundance as an overweight person gets slimmer.

The second study used white mice. Here, researchers discovered that the bacteria in the lower intestines of obese white mice were more efficient at extracting calories from complex carbohydrates than the bacteria in the intestines of slimmer mice.

In an earlier study the researchers had shown that the intestines of obese mice had the same depletion of Bacteroidetes as found in the innards of obese humans.

The practical consequence of this finding is immense: it means that if two people are on the same diets and doing the same amount of exercise, one may gain weight and the other stay the same weight. Simply because the person who stayed the same had more Bacteroidetes in his large intestine, extracting fewer calories from the same amount of food. The main reason why his friend gains weight is because he has more Firmicutes and fewer Bacteroidetes.

The researchers suggest that intestinal bacteria could become "biomarkers, mediators and potential therapeutic targets" in the fight against obesity.

I find it impressive that some advocates of natural healing had predicted something along these lines in the early days of the 20th century. I am not too keen on colonic irrigation, though I have many colleagues who use it routinely. But there are many other ways of changing your intestinal flora, including probiotics and prebiotics. You may be interested to look back at a few words that I wrote about them in late August.

I would be happy to detail some other evidence-based strategies that we have used for normalizing intestinal flora.

“A man is not rightly conditioned until he is a happy, healthy, and prosperous being; and happiness, health, and prosperity are the result of a harmonious adjustment of the inner with the outer of the man with his surroundings.”
--James Allen (English Author and Mystic, 1864-1912)

“You cannot poison your body into health with drugs, chemo or radiation. “ Health" can only be achieved with healthful living.”
--T.C. Fry (American Writer on Natural Healing and Originator of the Life Science/Natural Hygiene Course, 1926-1996)

Healthy Relationships are Essential to Your Health

“All of life is relationship.”
--Swami Rama (Indian Spiritual Teacher and Writer, 1925-1996)

When I first started looking at the hundreds of different therapeutic systems that we have on offer, it was striking that they all have at their core the development of a relationship between two or more individuals. One is designated the patient or client and the other the therapist who is helping the patient cure himself or herself. Until the invention of the stethoscope, which was the first step toward separating patients from those treating them, the fundamental nature of a healing relationship was well understood. Sad to say, over the last century and a half orthodox medicine began to minimize the importance of relationship to cure.

Nothing in the Universe exists in isolation: We live in a Universe of relationships. It is inconceivable that anything can exist except in relationship to something else. The entire Universe is made up of integrated systems that function, develop and evolve together. A failure to construct and maintain healthy relationships can be a cause of much distress.

Several years ago I reported some interesting observations. At the time, I was doing a lot of research on diseases of blood vessels. I had developed a laboratory method for taking some of the cells that line blood vessels from volunteers and then growing them in a cell culture dish. We discovered that if we did not have enough cells in the dish, they would all die of “loneliness.”

The exception is cancer cells, which in culture will grow on their own like weeds.

Next, we made an accidental and remarkable discovery. We normally cleared out our cell cultures once a week, but on this occasion I found that I had accidentally nudged one of the dishes to the back of the incubator, where it had been sitting for three weeks. Looking at the cells under the microscope, we could see that they had formed little tubes. Now that might not sound like very much, but it was. The cells had, inside the body of the volunteer, been part of a microscopic tube called a capillary.

To prepare the culture, the cells had been cleaned with all sorts of biochemical treatments to strip them away from everything else so that we would have no contaminating cells. The teaching for years has been that the development of cells and organs is a result of biochemical interactions between different cells of the body driven by the DNA inside the nucleus of the cells. But my cultured cells had no such cells to guide them. How could they “remember” that their role was to make tubes? The most likely explanation is that they are responding to morphic fields. I published the observation in a paper 17 years ago, and others have now replicated it.

It is estimated that at least 80% of our higher cortical functions are directed toward social functions. It is little wonder that failing to use those vast tracts of evolutionary machinery might have sad consequences.

And they do. Social isolation increases the chance of substance abuse and scores of illnesses. And people who have no social supports are much less likely to recover from many major illnesses. On the other hand, being engaged in robust, dynamic relationships provides you with powerful protections against some illnesses.

Relationships are essential to your health.

There are tens of thousands of books on relationships and I have no intention of reiterating material that has been written about a hundred times before.
But based on our principles of physical, psychological, social, subtle and spiritual, let me make these suggestions for constructing and maintaining successful relationships:

1. Partnership: As I discuss in Healing, Meaning and Purpose, it is essential to examine every one of your relationships to see if it is a relationship of domination or partnership: is one person dominating and controlling the relationship, or are both people participating equally? And here is the trick. We are not only interested in the relationship between you and another person or persons, we are interested in ALL your relationships, from cell to soul.
2. Maintaining wellness: all the people in a relationship should do whatever they can to maintain their physical, psychological, social subtle and spiritual well being. Nobody can avoid everything: life will throw you some curve balls, but it is most unfair to burden a relationship with avoidable health worries
3. Responsibility: In the same way that you should not burden others in a relationship with avoidable health problems, you should also not burden them with needless concerns about money or other resources. Arguments about money are one of the main causes of turmoil in marriages, and it is not so much a matter of having insufficient, it is more often a matter of one person being irresponsible.
4. Attention: it is essential to give the other person or persons in a relationship the attention that they deserve.
5. Acceptance: This can be a hard one sometimes, and I am going to write more about acceptance shortly. Suffice to say that mature relationships require a good dose of acceptance. I have written before about an extreme case in which a woman was lamenting the fact that she could find nobody who matched her ideals in a mate. Her list of non-negotiable requirements in a partner ran to some ten pages
6. Kindness: Spontaneous acts of kindness are essential to healthy relationships. If you do not want to offer kindnesses to another person it implies that there is something seriously awry n the relationship. Kindness should not be planned; it should just be part of your normal modus operandi
7. Warmth and affection: Spontaneous warmth and affection are signs of a healthy relationship. But don’t think of that as holding hands and signing kumbaya, it also means being aware of the heart, the essence and the soul of the other person or persons in a relationship. If you have not recently shown some real gratitude for the other person, today might be a really good time to start.
8. Laughter: Do you and your partner(s) have fun together? Are you able to share laughter and to let go of pretence? It doesn’t mean that you have to spend all day watching Laurel and Hardy or telling each other sidesplitting jokes. It means being able to find a new and healthy perspective on life and to find time to enjoy the lighter side of life.
9. Conflict: do you have a healthy way of dealing with anger, conflict and resentment? All three may crop up from time to time, but the key is how you cope with them. It is simply not realistic to follow the advice that you should avoid all conflict. It’s as silly as saying the key to stress management is to avoid stress. You may as well try to avoid gravity. Stress and conflict are universal constants: the trick is learning how to deal with them. In the case of conflict the key – as always - is to communicate and to avoid toxic or corrosive habit patterns
10. Listening: Listening to another person is not a matter of sitting back and allowing sound waves to set up vibrations in your auditory nerve: listening is an active learned skill that involves watching, noticing and being aware of every aspect of a communication. (You may be interested in having a look at another piece that I wrote about communication). Listening involves giving space for a communication to unfold and then asking questions and checking to ensure that both people are understanding every aspect of the exchange
11. Trust: No relationship can be expected o flourish without a healthy dose of trust. Not just in the integrity of the relationship, integrity of the other person(s) involved in the relationship and trust that what you say or do will not be judged harshly
12. Freedom: I have seen more relationships flounder because of a lack of freedom than almost anything else. There is a good reason why freedom is such a powerful political force. For most people, freedom to be themselves and to determine their own destiny is as important as oxygen. Ensure that your relationships have plenty of space to breathe. 

“Relationships are the hallmark of the mature person.”
--Brian Tracy (Canadian-born American Author and Expert on Business and Personal Development, 1944-)

Breast is Best, But…

I think that everyone knows that breastfeeding confers considerable advantages on a baby. So much so that the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life. Though some mothers cannot manage this for a whole range of reasons, and it’s always a real shame when women are made to feel guilty if they cannot breastfeed.

Amongst some of the likely health benefits for both mother a baby:

1. Mother and child are more likely to bond
2. A reduced risk of the child developing some respiratory problems, ear infections and gastrointestinal problems
3. A reduced risk of developing allergies later in life
4. A reduced risk of obesity in adulthood
5. A reduced rate of attention deficit disorder
6. A reduced risk of developing type I diabetes
7. There may also be a reduced risk of developing osteoporosis in later life
8. The mother has a reduced level of stress and postpartum bleeding
9. Mothers who breastfeed have a slightly reduced risk of some types of cancer

To this list we can add that breastfed children are more intelligent. That is not a new discovery. It was first reported in the 1920s. A new study published in the British Medical Journal has re-examined the question. Most of the earlier studies failed to consider the mother’s intelligence, despite the well-recognized association between maternal education and breastfeeding. That association often breaks down in professional women who have to go straight back to work after giving birth, but it remains a key variable.

The researchers examined data from 3,161 mothers and 5,475 children, who were followed in a twenty-five year prospective study. Premature babies were excluded and the children’s’ intelligence was measured up to age five.

The breastfed babies had slightly higher IQs, but the effect was entirely accounted for by their mothers’ intelligence. Breastfeeding itself had little or no effect on intelligence scores. The mothers of the breast-fed children tended to be older and to be more likely to provide the growing child with a stimulating and supportive home environment.

In a separate study from the Australian Raine Study at the Telethon Institute for Child Health Research, that has tracked the growth and development of more than 2500 West Australian children over the past 16 years, it now emerges that children who were breastfed for longer than six months have significantly better mental health in childhood.

Children that were breastfed had particularly lower rates of delinquent, aggressive and anti-social behavior, and overall were less depressed, anxious or withdrawn. This makes sense: apart from the psychological impact of having a mother who is willing and able to breastfeed, breast milk is a rich source of polyunsaturated fatty acids - examples include docosahexaenoic acid and arachidonic acid - that are important for brain development and the growth of nerve cells.

There is also evidence that breastfeeding may reduce the risk of developing schizophrenia later in life, although it is difficult to be sure if it because of the breast milk itself or the kinds of mothers who breastfeed.

Life is Information at Work

“Information is "a difference that makes a difference.”
--Gregory Bateson (English Anthropologist, Social Scientist, Linguist, Cybernetician and Writer, 1904-1980)

Much of the work in which we’ve been engaged needs us to look very hard at what is life? Is it simply a collection of biochemical reactions glowing in the dark, or is it something more complex, laden in meaning and purpose. This is not an academic exercise: unless and until we can better understand the fundamental processes of life, it is difficult to advance the practice of medicine and the processes of health and wellness.

A fundamental tenet of Healing, Meaning and Purpose is that we live in a non-dual Universe, of which consciousness, information and energy are the primary manifestations and principles. I present a great deal of solid scientific material that you can use immediately. It’s all based on the fundamental concept that illness is caused by degradation in the storehouse of information that sustains the body.

Comprehensive treatment and persistent robust physical, psychological, social, subtle and spiritual health is rooted in clear, harmonious, integrated information. And that is why physical treatments – sometimes including medications – may be an essential component of helping someone get well, but is nonetheless just one piece of the puzzle. It is essential also to ensure that the information and communication between each aspect of a person and his or her environment are also clear, harmonious and integrated. Without those other pieces, we may be doing no more than putting a band aid on a problem.

Valentino Braitenberg the former director at the Max Planck Institute for Biological Cybernetics in Tübingen, Germany, has always had some interesting things to say. He is a truly original thinker who’s also, IMHO, a fine human being.

I recently came across this in his last book, Das Bild der Welt im Kopf: Eine Naturgeschichte des Geistes, published in 2003 by LIT Verlag, Munster:

“Living organisms contain information, are the result of information, pass on information, and information made flesh in the conditions that their environmental niches impose for survival. To read this information is to recognize the very essence of a living organism.”

I think that this is the most succinct summary of what is to be a living organism. Yes, of course, you are made up of atoms and molecules. But the key point is that you are maintained by a constantly flowing river of information. Without it your body, your mind, your relationships and your spiritual essence would cease to flow.

Any treatment worth its salt will always be directed toward correcting and modulating and integrating this flow of information.

Anything less, and we are simply moving around the deckchairs on the Titanic.

“The original root of the word "information" is the Latin word informare, which means to fashion, shape, or create, to give form to. Information is an idea that has been given a form, such as the spoken or written word. It is a means of representing an image or thought so that it can be communicated from one mind to another rather than worrying about all the information afloat in the world, we must ask ourselves what matters to us, what do we want to know. It's having ideas and learning to deal with issues that is important, not accumulating lots and lots of data.”
--Theodore Roszak (American Social Thinker, Critic and Writer, 1933-)

“Man must go back to nature for information.”
--Thomas Paine (English-born American Political Theorist and Writer, 1737-1809)

Tips for Trips

I’ve not written any new items for a couple of days while I was in England and out of range of anything resembling a decent Internet connection.

But a grand total of seventeen hours on planes made me think that it’s high time to tell you about some of my tips and techniques for dealing with the rigors of flying.

I’ve got so many of them that my tips will stretch over more than one article.

By now most people will have heard about the importance of:

1. Maintaining hydration: the low pressure and dry atmosphere on planes can quickly dehydrate us. I try to drink at least 20 fluid ounces every two hours that I’m in the air.
2. Avoid drinking alcohol and coffee.
3. Keep mobile. When it is safe to do so: walk up and down the aisle. Stretch your legs and arms and gently rotate your neck while sitting in you seat.

The most worrying things about flying is the risk of developing a Deep Vein Thrombosis (DVT).  This is an important topic: one in 2,000 long-distance passengers will suffer a blood clot, which can be fatal if the clot detaches and reaches the lungs: this is known as pulmonary embolism. DVTs are more likely to occur if there is a change in the rate of blood flow, the character of the blood of the normal functioning of the walls of the large veins. There are a number of well-recognized risk factors for the development of DVTs:

1. Obesity
2. Immobility
3. Oral contraceptives
4. Some cancers
5. Cigarette smoking

There is a great long list of potential causes, but our focus today is on factors that can increase your risk of developing a DVT if you fly.

DVTs have been recognized to occur not just in passengers on planes, but also in people at extremely high altitude.

For many years it has been assumed that the low pressure and the immobility together increase the risk of DVT. But new research from the Universities of Leicester and Aberdeen was published in the Journal of the American Medical Association in May.

In a study of 73 people, the researchers found that sitting for long periods was the main cause, and warned people about all forms of travel.

During the study, the volunteers spent eight hours sitting in chambers with reduced air pressure and oxygen. They were allowed to move around for a couple of minutes each hour. They were then also tested in a chamber without changes in the atmosphere. The idea was to simulate the conditions on a plane. Blood samples were taken before and after each "flight" to check for factors involved in blood clotting.

For all these factors, no significant differences were seen between blood samples taken from volunteers on a simulated flight or exposed to normal air pressure. So it is not the low air pressure and oxygen saturation that is to blame: it is the lack of movement.

It is also unlikely that the advice to take an aspirin before a flight is going to be much help.

During my travels I have seen people selling extracts of horse chestnut (Aesculus hippocastanum) to prevent DVTs. There is actually some research that horse chestnut can help with chronic venous insufficiency. But there is no credible evidence that taking a couple of horse chestnut capsules will prevent a DVT, or the less severe problem of ankle swelling. And horse chestnut is well known to have a number of side effects, so there doesn’t seem to be much point in taking it to prevent ankle swelling and DVTs when flying.

The smart move (ha!) is to do regular exercise during flight, and to avoid dehydration.

I’ll tell you some of my tips for turning flights into highly productive work time and how to avoid jet lag in other posts.

True Integrated Medicine

“Our body is a machine for living. It is organized for that, it is its nature. Let life go on in it unhindered and let it defend itself, it will do more than if you paralyze it by encumbering it with remedies.”
--Count Leo Tolstoy (Russian Writer and Philosopher, 1828-1910)

“The cure of the part should not be attempted without treatment of the whole.”
--Plato (Athenian Philosopher, 428-348 B.C.E.)

Have you ever woken up in the morning with a feeling that something’s not quite right, but you couldn’t quite put your finger on it? That is the feeling that we get if something is out of place. Our minds and our brains have evolved with a remarkable ability to pinpoint things in external space: it was once an important survival mechanism. As we became more complex, those same systems began to be able to tell when things were out of place in our internal environment as well as in our relationships. We are social animals and most of the cognitive systems of the brain are designed to aid and abet our social interactions.

The key to health is to have all of our systems working in harmony. It is absolutely true that 70% of human illness is a result behavior born of bad choices. We make those bad choices when we stop listening to our bodies and heeding our hearts.

People love to place us in categories. I am constantly being asked why all my work contains three parts: cutting edge conventional medicine, natural medicine and self-help. I’ve had people in the publishing business say, “Well, is it health OR self-help?” For me, the answer to that is yes!

We cannot attain health and wellness unless we have done some work on ourselves; we cannot heal ourselves and others unless we have something with which to do the healing. If we are fearful, and moving haphazardly through life with little self-control, it is hard to pay attention to your body, mind, relationships, subtle systems or spirituality. A physician too distracted to focus on and respect another person is unlikely to help him or her get better. A therapist without a strong sense of self would find it hard to help a troubled mind, and a spiritual teacher who had no personal experience of the Higher Realms of existence and no clear moral compass, could devastate the spiritual well being of a disciple.

When we talk about Integrated Medicine, people usually assume that we are only talking about integrating different types of treatment. Yet that is only part of it. We are also aiming to integrate the individual: to enable every aspect of the person to be acting in harmony. When all of our systems are in harmony, pulling together in the same direction, when they are listening to each other and communicating with each other, there is a free flow of energy and we achieve a state of coherence.

And it is this coherence that underlies our sense of health and well being.

For coherence is the key to resilience.

“The patient must combat the disease along with the physician.”
--Hippocrates (Greek Physician, c.460 B.C.E.- c.377 B.C.E.)

“Those whose consciousness is unified abandon all attachment to the results of action and attain supreme peace. But those whose desires are fragmented, who are selfishly attached to the results of their work, are bound in everything they do.”
--Bhagavad Gita

Glycemic Index Revisited

If you are anything like me, you probably find loads of adverts in your mailbox for magical ways to lose weight, either by using some form of the Atkins diet, manipulating cortisol (it doesn’t work), or by paying attention to the glycemic index of the food that you eat.

Last January I summarized some of the recent research that showed that glycemic index and glycemic load were not related to measures of insulin sensitivity or secretion, or to the amount of fat in the body. However, the intake of fiber in the diet was found to have beneficial effects on insulin sensitivity, adiposity and the secretion of insulin by the pancreas. I went on to give some uncontroversial advice on how to eat.

Nobody thought that the glycemic index issue was dead: insulin and the other hormones involved in fat and carbohydrate metabolism are powerful and have multiple roles in the body.

A study published in the Archives of Internal Medicine in July, helps further refine our understanding about glycemic index. High carbohydrate foods with a low glycemic index are the best way to reduce your risk of cardiovascular disease. The problem is that you want to avoid sudden surges in glucose after you eat a meal. What normally happens is that those surges are accompanied by sudden rises in triglycerides and insulin. The three together can cause all kinds of mischief to the insides of your blood vessels. High protein and low glycemic index diets will help with weight, but it’s only the combinations of high carbohydrates with low glycemic index that reduces the risk of vascular disease.

My redoubtable Web Mistress, Carol Kirshner, has found a most useful resource at the University of Sydney, that you can use to help guide your food choices.

This is such a useful resource that we are going to attach it to our blogs and websites.

However, it’s essential that we don’t get seduced by the idea that high carbohydrate/low glycemic index eating is the solution to all of our ills.

We still need to follow the basic principles of a balanced diet:

1. It is important for you to maintain your energy balance, between input and output
2. Calories do count
3. What you include in your diet is as important as what you exclude: we are designed to consume not just rice and lettuce, but an array of other nutrients
4. Make only moderate dietary changes at any time: making big dietary changes can be a violent attack on your body and your mind
5. Avoid the “trans-fatty acids”
6. Try to consume some Mercury-free omega-3 fatty acids every single day
7. Eat fewer simple carbohydrates
8. Use weight management and exercise strategies that enhance your overall health and well-being
9. Take more exercise: even small amounts can have a big effect.
10. Make it a goal to gradually reduction your overall intake of cereals

Healia, I Thank You!

I've written before to extol the virtues of the new seacrch engine Healia.com.

Well now you can color me REALLY impressed.

My Web Mistress (I'm STILL not at all sure that I should be calling her that {!}), Carol Kirshner and I both asked for two extra things: a widget in the sidebar of a blog that allows you to search Healia directly. And second that it would be possible to open a search result in a new window. So now you can get all the information that I offer, and do all your searching to follow up on things that I've said or suggested, without having to go tearing all over the Internet.

We wanted to offer you "One stop shopping."

A single place where you can find out what's new, or what's tried, tested and true, in Health, Wellness and Personal Development. And a place where you can receive free guidance and support on your journey.

Your time is very valuable, and these new developments should help you enormously.

Healia did all this within seven days of our request, and any company that's going to be that responsive tells me exactly where they are coming from.

So read and enjoy the articles, and be sure to use the Healia search box to follow up on anything that you need.

All the best to you!

Music and the Mind

The next book in the Healing, Meaning and Purpose cycle will be entitled Sacred Cycles. One chapter is entitled Music and the Mind. I am in no doubt that music can produce incredibly powerful healing.

I was interested to read about a small study published in the journal Brain.

Canadian scientists from McMaster University compared 6 children aged four to six who took music lessons for a year with 6 children who did had no music lessons outside school. The six who had lessons attended a Suzuki music school, using a Japanese approach that encourages children to listen to and imitate music before they attempt to read it.

They found the musical group performed better on a memory test also designed to assess general intelligence skills such as literacy and mathematical ability.

The investigators also measured changes in the children's brain electrical responses to sounds during the year. They measured brain activity using a technique called magnetoencephelography while the children listened to two types of sounds: a violin tone or a burst of white noise.

All the children recorded larger responses when listening to the violin tones compared with the white noise - indicating that more of the brain’s activity was being deployed to process meaningful sounds.
All the children responded more quickly to the sounds over the course of the year of the study - suggesting greater efficiency of the maturing brain.

However, when the researchers focused on a specific measurement related to attention and sound discrimination, they found a greater change over the year among the Suzuki children.

In the group having music lessons, there were measurable changes in as little as four months. Previous studies have shown that older children given music lessons recorded greater improvements in IQ scores than children given drama lessons, but this is the first time that such young children have been tested.

Though this is only a small study, it strongly suggests that music is good for children's cognitive development. I ifnd this particularly interesting after researchers appeard to have dismantled the "Mozart Effect." Perhaps they were premature in doing so.

I also take my hat off the researchers. As someone who’s done a lot of scanning and measurement, I know only too well, that to get young children to stay still enough to get meaningful readings must have been a Labor of Hercules!

I’d also like to mention a conference in November that sadly I shall not be able to attend, but promises to be a splendid event. It’s the International Sound Healing Conference, taking place on November 10-14 in Santa Fe, New Mexico. They have a stellar group of presenters, including Jill Purce, Don Campbell, Fabien Maman, James D’Angelo, Master Charles Cannon, John Diamond and a host of other experts in the fields of sound and healing. It should be quite an event!

“Words are the pen of the heart, but music is the pen of the soul.” --Shneur Zalman of Liadi (Rabbi and Founder of Chabad Lubavitch, 1745-1812)

“Music is the wine that fills the cup of silence.” --Robert Fripp (Musician, Guitarist and Spiritual Seeker, 1946-)

When Is It An Illness?

There’s been a very worrying trend in recent years, and that is constantly to medicalize every kind of behavior: we are no longer allowed to be shy, we have to be “socially phobic;” many things once regarded as vices, like excessive gambling, drinking or eating are now being re-cast as impulse control disorders and adolescent temper tantrums could be “Intermittent explosive disorder.” And I now read a report about giving selective serotonin reuptake inhibitors (SSRI) antidepressants to people with emotional lability.

In April of this year the Public Library of Science published a series of articles on the important topic of “disease mongering,” which two authors define as “the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments.” The authors made the point that some of the medicalization of human behavior is being driven by some pharmaceutical companies. They picked on several conditions or illnesses in which claims of prevalence and severity have been inflated in order, they claimed, to generate a need for medicines. One of their targets was female sexual dysfunction, where there has been a serious attempt to convince the public in the United States that 43% of women live with this condition. Many experts have heavily contested those figures.

One of the big worries about expanding the boundaries of an illness is that it is easy to throw out the baby with the bathwater. To use this last example: saying that the figures for female sexual "dysfunction" are inflated can lead some clinicians to dismiss everyone who has a problem, and then not to treat people with genuine organic difficulties. It is tragic to see people referred to a psychiatrist for a physical problem like low testosterone or undiagnosed diabetes or thyroid disease.

There can also be marked differences of opinion about the nature of illness. “Premenstrual dysphoric disorder,” (PMDD), is a particularly severe premenstrual syndrome, with some additional mood features. The American Psychiatric Association has precise diagnostic criteria for PMDD. The regulatory authorities in the European Union decided that this was not a real illness and declined to let a pharmaceutical company market a medicine for it.

I’m all for doing anything that I can to help people and to alleviate suffering. Part of the problem is that it is acceptable to have a “disorder.” The prevailing attitude is that no one can be blamed for being sick. The reality is that by most estimates, 70% of human illness is caused by lifestyle choices. By turning everything into disorders we take away our responsibility for our actions.

Most people are not looking for the causes of their troubles, they want a quick fix. Changing is hard, it is inconvenient and it is much easier to believe a pill will make everything better.

The second issue is that “better living through chemistry” may not be. There’s been a question rumbling round for some time now: has the over-exposure of young people to antibiotics, analgesics and sleeping tablets, been partly responsible for the rise in asthma and in substance abuse in later life? We don’t know the answer but it is important for us to think about.

The third point is that we need to think about what we are doing to ourselves if we want to medicate our way to happiness. Do we really want to deny ourselves the opportunity for becoming happy by our own actions rather than relying on a pill and being told what is normal?

P.S. Four years ago the Nuffield Council on Bioethics produced an important report entitled Genetics and Human Behaviour: the Ethical Context. It looked at some of the ethical challenges that are coming with the constant new discoveries in biology, and warned against the dangers of widening diagnostic categories, to encourage the use of medication by people who would not necessarily be thought of as exhibiting outside the normal range. It is well worth reading.

Laughter is The Best Medicine

“Time spent laughing is time spent with the gods.”
--Japanese Proverb

In the book and movie Anatomy of an Illness, Norman Cousins reported how he overcame a sever arthritic condition with a combination of huge doses of vitamin C, together with a positive mental attitude and hours of laughing at Marx Brothers movies. He wrote that, "I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep. When the pain-killing effect of the laughter wore off, we would switch on the motion picture projector again and not infrequently, it would lead to another pain-free interval."

I’ve had a longstanding interest in the vascular endothelium, the single layer of cells that line blood vessels. Some very small blood vessels consist only of endothelial cells. These cells form the interface between the blood and the tissues, and they are involved in many disease processes. They are involved in diabetic vascular disease, arteriosclerosis, inflammation, many infections, and they play a role in the spread of tumors. There is some new evidence that laughter is good for you in more ways than one.

Investigators from University of Maryland School of Medicine found that watching a funny movie had a healthy effect on blood vessel function, allowing them to expand and contract more effectively in response to changes in blood flow. But watching a mentally stressful movie, like a war drama, may have the opposite effect, causing the vascular endothelial cells to narrow and restrict blood flow. On average, artery diameter increased by 22% during laughter and decreased by 35% during mental stress.

This work follows on from earlier research that showed an inverse association between sense of humor and coronary heart disease: people who laughed a lot seemed less likely to suffer form heart disease.

There is a very nice review article available online that confirms what is intuitively obvious humor and laughter may have a positive influence on health and on the outcome of many diseases.

There may be something to the old saying, "You don't stop laughing because you grow old; You grow old because you stop laughing.”

Acids and Alkalis

Have you seen those books and advertisements about supplements that are supposed to “alkalinize” your body and therefore avoid the effects of nasty acids? Many have frightening titles, like “Alkalinize or Die.” Some time ago I read a whole bunch of these books while I was trying to help two people with interstitial cystitis. This is a nasty problem, and I had failed to help with conventional medicine, naturopathy, acupuncture or homeopathy. One of the many books that I read claimed that altering the acidity of the urine would cure the problem. It did not.

The basis for these claims that we need to alkalinize our bodies comes primarily from three sets of observations:

1. That manipulating the external environment of cells in culture and isolated organs can have dramatic effects on the activity and life expectancy of these cells and organs
2. That some of the products of exercise or metabolism are acidic, and so need to be buffered or expelled from the body
3. A great many anecdotes about people benefiting from following an “alkalinization” protocol of some sort.

That all sounds good, but it is a big jump to go from cells in culture and perfused organs to whole human beings. Or to base medical advice on anecdotes ALONE.

There is also another origin for some of these ideas, and they derive from the work of Edgar Cayce and some oriental healing traditions: I have enormous respect for both.

I'm a card-carrying biochemist and metabolic physician, so some things about acid/base balance I know well.

Our blood is maintained at a pH of 7.42, and even the tiniest shift can cause major health and psychological problems. So there are sophisticated systems for keeping things in balance. Most of the popular books fail to mention much about the easiest way to change pH, and that is by changing your rate of breathing!

We show people how to do that every day in clinical practice. And when doing electrical recordings of the brain – electroencephalograms - hyperventilation is a good way of inducing some types of abnormal electrical activity.

We know a great deal about how changes in the pH of the blood can impact behavior and many physiological approaches. I’ve worked with hundreds if not thousands of people with disturbances in the acid/base balance of their bodies. Usually as a result of diabetes that was out control, but also scores of other illnesses. Many of them rare but educational.

The populist writers then often talk about excess acid being a stressor. So we don’t want to have acid in our systems because it depletes the alkaline buffers that are supposed to keep things in balance. An interesting idea, but one that can quickly be shown to be deeply flawed. It’s easy for a biochemist to calculate the amounts of acid in single cells, organs and the whole body. We’ve done it thousands of times when treating people with medical conditions like diabetic ketoacidosis and lactic acidosis.

Sadly some of the writers of popular books and articles on acids and alkalis have clearly not studied the literature in any detail.

There have also been some examples of what we call the “Trudeau effect:” vague comments about studies that are supposed to have been completed, but which, if they have been read at all, have never been analyzed by the writer. And often odd statements from books and from research are taken out of context and cited as the Gospel truth. There’s a legal loophole that Trudeau and some others get away with saying things about health that are not supported by any data.

Levels of Evidence
An important concept is what we refer to as levels of evidence. In the past it was often thought that the only kind of evidence to be of any value in clinical decision making had to have been obtained by randomized controlled trials. Yet we all know from experience that there are other types of evidence. A teacher or a colleague may have recommended a course of action based on experience or observation, and this can provide valuable guidance. We now recognize four types of clinical evidence:

1. Case reports
2. Case series and uncontrolled observational studies
3. Retrospective database analyses
4. Controlled analytic studies, including randomized clinical trials

You will see from this is that even single case reports go into the mix. Numbers one and two and used not as proof, but as ways to generate testable hypotheses.

If you tell me that you have slept better since you started an alkalinization regimen, I’ll see if what you are doing can be applied to others (that’s a pragmatic study), and also whether there could be an explanation for your report (that will need an analytic or mechanistic study).

When we review evidence or perform meta-analyses we give each type of evidence a rating. Controlled studies are given a higher rating than case reports, because the evidence can be generalized to many individual patients. A further refinement is to factor in the source of the study. So research by a pharmaceutical company or a manufacturer of an herbal supplement tends to get a lower rating than an independent study.

Recently someone did indeed tell me that she had slept better since following a special diet. When we looked carefully at the protocol that she was following, it was probably not the alkalinization, but the hops in the diet.

There are many, many claims of health benefits from various diets. The benefits may be genuine, but we need to be very cautious about attributing the success of a diet or any other form of treatment to just one factor.

There is no question that some illnesses, for instance peptic ulcers or gastro-esophageal reflux disease can be made worse by eating an acid diet, and having acid urine can sometimes be very irritating to the bladder.

But the evidence for the benefits of alkalinizing of the whole body – even if it were possible to do it - just does not exist.

You also need to be aware of a potential consequence of "alkalinizing diets:" they can dramatically alter the absorption of some herbs, medicines and supplements.

So what should you do?

1. The key to any diet is balance: it would be a mistake to be on a diet consisting of just one thing. Experts are always very wary of health claims based on one juice, herb or supplement. Your body is not designed that way: you need a mixture of different fruits and vegetables. When someone tells us that the key to healing is a berry that can only be found in a hidden valley in the Himalayas, we have to ask, “How could that have happened?” How could it be that we evolved or were created with a key ingredient missing?
2. Avoid drinking carbonated drinks. The old story about a can of Pepsi Cola being a good way to remove oil from your driveway is true. In high school we did the experiment of taking a small nail and leaving it in a sealed container with some carbonated soda. The nail had largely dissolved inside a week.
3. Keep up your intake of pure water. The current recommendations vary depending upon the time of year and where you live. In the Southern United States, during the summer time, it is currently recommended that you should drink 120 fluid ounces of pure water each day. I personally prefer pure spring water or distilled water. But also bear in mind that if you choose not to drink fluoridated water, that your chance of dental cavities increases. You can get around that problem by applying fluoride directly to your teeth and then rinsing it out. Ask you health care provider about that.
4. Listen to you body: you should avoid anything that feels irritant, causes indigestion, diarrhea or urinary symptoms
5. Use you intuition: the answers are within you. One of the most valuable uses of your intuition is not to help you pick lottery numbers, but to help you make wise decisions about your body, your relationships and your subtle systems. I have already written a little about some techniques for listening to and amplifying your intuition, and I shall soon be writing and recording a lot more about those essential topics.

Healia is Here!

Several months ago, I wrote about Healia.com, a new and innovative search engine for all things to do with health.

This morning I got the news that I'd been waiting for from Carol Kirshner my Web Mistress (I'm still not sure that's a PC term for her) and researcher. Healia will be officially launched to the public tomorrow, September 18th.

As a writer on health, wellness and personal development, I think that this is going to become a major source of information for me. Much as I love Google, this is a search engine dedicated to these topics.

From a release that I've just received, Healia says that:
The newest version of Healia has several major improvements over our initial version:

• We have enhanced the accuracy and performance of our filtering algorithms
• We are offering additional filters to allow people to filter by the topic of the document when they submit a disease or drug-related search (Try searching on a disease and drug name to see how they are handled differently)
• We provide a “Suggested Result” from a reference site for disease and drug-related searches
• We detect and provide expanded equivalents to common medical abbreviations and acronyms

I've been putting it through its paces, and I must say that I'm very impressed. I'm probably a lot more demanding than most users, and it's very quick and accurate.

If you are a consumer or potential consumer, Healia will likely be the best place to research an illness. Or ways of keeping healthy.

I agree with the points in Carol's evaluation: It would be nice if search results opended in a separate window. Even though I use a laptop for everything (Macintosh, of course), and don't have much screen real estate, with Macintosh OS X, that's not a problem: navigating from one screen to another is a snap. Having to keep going back is a pain in the posterior.

And my cri du coeur: please, please, please could we have a Healia Search widget to add to our blogs??

I do everything that I can to provide my readers with totally accurate, up to date information, and I encourage them to check on everything. I'd love readers to be able to search directly from within medical blogs. It would be a real win/win, IMHO.

Wouldn't it be great to be able to demonstrate it at the Healthcare Blogging Summit in Washington in December???

Religion and Health

I have written and spoken about the association between spiritual and physical health in my books and CDs, and on this blog.

There is yet more confirmation of this link in a paper that just came across my desk. This was an analysis of the published data on religious activity and health.

This was what they concluded:
“Religious intervention such as intercessory prayer may improve success rates of in vitro fertilization, decrease length of hospital stay and duration of fever in septic patients, increase immune function, improve rheumatoid arthritis, and reduce anxiety. Frequent attendance at religious services likely improves health behaviors. Moreover, prayer may decrease adverse outcomes in patients with cardiac disease.”

Since they were looking only at religious interventions rather than spirituality in general, the investigators did not pick up a lot of research into psychiatric illnesses, pain and cancer. That does not detract in any way from this important publication.

As I’ve said before please don’t ever lose touch with your spirituality. It is essential to your health and well-being.

Spirituality and Personal Well-Being

It is no coincidence that most us involved in fashioning the new model of health care are also deeply involved in spirituality. People including Deepak Chopra and Larry Dossey have recognized that health and spiriruality are inextricably linked.

Healing, Meaning and Purpose was written and recorded to support a spiritual journey as part of a comprehensive approach toward wellness.

As I travel the world I am constantly astonished by the ever-increasing interest in spirituality, health and well-being.

A new study has just been published by researchers from the University of Aberdeen in Scotland. Using  data from the 2001 Scottish Social Attitudes Survey, they found that what they called "alternative" spiritual practices could be divided into two groups: concerns with personal well-being and interest in divination. They found something that we have also discovered in the United States. Women, particularly if they are educated, are particularly interested in applying spirituality in their lives to promote their own well-being and the health and wellness of their families. This fits in with other data that have shown that in every culture studied, women are more likely to seek health care, whether they have a skin rash, depression or cancer.

Your spiritual health is essential to the health of your body and your relationships. Please don't ever neglect it.

Thrifty Genes, Thrifty Bodies and the Barker Hypothesis

“They have sown the wind, and they shall reap the whirlwind.”
--The Bible (Hosea, 8:7)

In 1962, a geneticist named James Neel first proposed a “thrifty gene” theory to explain why 60% of adult Pima Indians living in the United States have diabetes, and 95% are overweight. Neel’s theory was that populations like the Pimas, that have for millennia relied on farming, hunting and fishing for food, would experience alternating periods of feast and famine. Neel hypothesized that in order to adapt to these extreme changes in caloric needs, people developed a “thrifty gene” that allowed them to store fat during times of plenty so that they would not starve during times of famine.

A similar theory was advanced to explain the high rates of diabetes in people from the Indian subcontinent, once they are exposed to plentiful supplies of food. These was traced by the great Diaspora from central Asia at the end of the last age, when the ancestors of modern Indians and Pakistanis made the great trek through modern Afghanistan into the Indus valley. A journey that had been impossible at the height of the Ice Age and which was still difficult. The idea was that people who could quickly lay down a lot of intra-abdominal fat would have a huge survival advantage.

This is an attractive hypothesis, but here have always been some problems with it:

1. The gene or genes would have to be able to work with the environment: the Pimas of Mexico and people living in rural India do not have the high rates of diabetes and obesity
2. Despite looking for over 40 years, no such gene has yet been found
3. If the thrifty gene is so advantageous, why doesn’t everyone have it?
4. Until recently, famines were rare and usually occurred every 100-150 years. As John Speakman has pointed out that would mean that most human populations have experienced at most 100 famine events in the course of their evolutionary history
5. Famines do increase mortality but only in about 10% of the population
6. In famines most people die of disease rather than starvation, and the worst affected are the young. Having a “thrifty gene” would not help them survive starvation OR disease
7. Simple genetic models would suggest that famines would not provide enough selective advantage and there has not been enough time for a “thrifty gene” to have penetrated the population

There could yet be some complex genetic model involving “reserve” genes that appear when needed, or some epigenetic inheritance, but we have no evidence for that either.

A second concept is gaining a lot of traction. It is what is known as the “Thrifty phenotype,” and is part of a larger theory called the “Barker Hypothesis.” I’m going to stick my neck out, and predict that David Barker may receive the Nobel Prize in medicine for his discoveries. They are that important.

Essentially the Barker Hypothesis suggests that in addition to genetic, epigenetic and environmental factors in disease, there is another, and that is the intrauterine environment. The idea is that if a mother is malnourished, she can modify the development of her unborn child. From an evolutionary perspective, her body is preparing the unborn child to survive in an environment where food is in chronic short supply, resulting in the “Thrifty phenotype:” smaller body size, lower metabolic rate and a propensity to be less active.

The problem is this. If you are born with the thrifty phenotype and actually grow up in an affluent environment, you are more likely to develop obesity, diabetes and vascular disease later in life. If true – and virtually all the evidence suggest that it is – then it has serious implications for countries that are transitioning from sparse to better nutrition, and may have contributed to some of our current health problems. Many of us were born to mothers who had poor nutrition, either because of the Great Depression, the Second World War, poverty, or just plain poor information about good nutrition during pregnancy. And now we are reaping the whirlwind.

The hypothesis has become sophisticated. If you are born small or premature, then your liver and kidneys may not have completed their final growth spurt, which might predispose you to metabolic problems and hypertension.

The story of how this all came to light would be worthy of Sherlock Holmes himself. English counties used to have people who were responsible for providing midwifery services. In the county of Buckinghamshire a single midwife collected data for almost thirty years. Information about the mother, the length and weight of the baby and the weight of the placenta. Information that would be impossible to collect these days. Some civil libertarian somewhere would probably dream up some way of hiding this enormously important information.

David Barker discovered these extraordinarily good records, and then set about finding the adults that these babies had become. And what he found has changed medicine: babies who had small placentas – a good measure of being small or premature – were more likely to develop obesity, diabetes or hypertension as adults. Then he and others turned their attention to other early physical characteristics and found correlations with health later in life. The highest risk of coronary heart disease was seen amongst people who were born small and became heavier during childhood.

The practical implications?

Find out your own birth weight and anything else that you can about your early development.

If you were a very large baby (bigger than nine and a half pounds), it implies that your mother may perhaps have had a metabolic problem. If you were small (less than five and a half pounds), then you should get the regular health checks that we recommend for anyone in a “high risk” group.

Probiotics: Caveat Emptor

You may well have heard the advice that we all need to keep the bacetria in our intestines healthy. Countless experts have recommended that, as long as we are not lactorse intolerant, we should regularly take some live yoghurt to "re-colonize" our intestines with nice friendly bacteria.

There has just been a briefing in London to warn the public that as many as half of the "probiotic" or "friendly bacteria" products on sale in the United Kingdom could be ineffective and some may even be harmful.

The experts on the panel included Professor Glen Gibson from the University of Reading who is an expert in food microbiology, and recommended sticking to products made by major manufacturers. Too many of the other productsmight not contain the numbers of bacteria advertised, and the icrobes might not survive long enough in the intestines to do much good.

The evidence that probiotics help is still far from settled, as discussed in a recent review. But there are enough reports to think that probiotics may be helpful for irritable bowel syndrome and perhaps inflammatory bowel disease.

An even newer area or interest in the use of "prebiotics:"  short-chain carbohydrates that alter the composition, or metabolism, of the intestinal organisms in a beneficial way.

Make sure that if you are using a product, it comes from a reputable manufacturer, and that it contains at least 10 million bacteria. And as I said in my title, "Caveat Emptor," "Let the buyer beware."

BMI R.I.P.

For experts in metabolism, we have long worried about the over-emphasis on the use of body mass index (BMI) as the arbiter of a "healthy" weight. It is one of those measurements that is in some senses too easy, and the results are deceiving. I regularly see people claim that a certain BMI will "predict" the risk that someone will develop cardiovascular disease or diabetes. The truth is very diferent.

There are two ways to calculate your BMI:
1. Metric system - Kilograms and Metres
[Your weight] divided by [Your height squared]

2. Imperial System - Pounds and Inches
[You weight] divided by [Your height squared] times 703.5

A person is said to be healthy if his or her BMI is between 18.5 and 24.9.

The trouble with this is that the calculation lumps together fat and muscle: a muscular six foot tall football player weighing 300 pounds and with 3% body fat, would have an "unhealthy" BMI of 26.3. That is clearly absurd, and one of the reasons that most experts use BMI only as one part of an evaluation of health.

Our scepticism has been confirmed by an important study from the Mayo Clinic in Rochester, Minnesota, and published in this week's issue of the medical journal The Lancet.

The researchers looked at 40 studies involving 250,152 patients. Their analysis revealed that people with a BMI of 30-35 were at lower risk of cardiovascular disease than those whose BMI was below 20.

BMI does not correlate well with fat. A better way to distinguish between fat and muscle is to take a cross-sectional view of the abdomen, and to focus on the waist-hip ratio.

A separate study by researchers at the London School of Hygiene and Tropical Medicine of 14,833 people over the age of 75 was published in the American Journal of Clinical Nutrition. They also came to the conclusion that BMI is a poor indicator of health in both men and women in this age group. These researchers also agreed that waste-hip ratio was a better indicator of mortality risk.

This is all music to my ears. For almost three decades we have been teaching about the importance of  different stores of fat and the limitations of the BMI calculation. It has been known since the 1940s that gaining weight on the hips, or developing "lover's handles" are only very weak predictors of diabetes and vascular disease: it is the intra-abdominal fat that is the problem.

There are particular problems with using BMI in the elderly and in some ethnic groups, especially people from the Indian sub-continent and Japan.

The bottom line?

BMI is misleading, and in some age groups and races, grossly misleading.

Much better to use weight and waist-hip ratio.

And BMI only if there is a space on the medical forms where they still need to have it filled in.

 

How Does Fiber Help You?

Unless you’ve been living on Mars (!), you will doubtless have heard of the advantages of increasing the amount of fiber in your diet. A high-fiber diet reduces your risk of colon cancer, constipation, hemorrhoids hypercholesterolemia and insulin resistance syndrome.

We have always wanted to know how fiber does so many magical things at once, and now we may an answer. In a paper published in the open-access Public Library of Science Biology today, by a group from one our local institutions – the Medical College of Georgia in Augusta – collaborating with a researcher from Josai University, Sakado, Saitama in Japan.

The epithelial cells lining the intestine have a life span measured in 1-5 days. They spend their short life times working to process enormous amounts of food residue on its way past. It is this layer of cells that acts as the barrier between the body and items floating past on the inside of the intestine.

Long before it became the topic of some popular books are over-enthusiastic magazine articles, we became very interested in the idea of the “Leaky gut:” the concept that some illnesses are a result of breakdown of the normal integrity of this protective barrier. Over 20 years ago, a friend and colleague at Northwick Park Hospital - Ingvar Bjarnason - did some pioneering work on this important issue. Several recent studies have indicated that a breakdown of this barrier may be involved in several childhood illnesses including allergies and asthma. There is also some early information suggesting that “leaky gut” may be involved in some autoimmune processes involving the intestine. Both zinc supplementation and oats may prevent gut leakiness under certain very specific circumstances.

When the epithelial cells in the gut wall encounter indigestible fibrous foods, the outer covering of the cell ruptures, releasing a coating of cell-protecting mucus. In a matter of seconds, the cell begins to repair itself, in the process releasing yet more of the beneficial mucus. Not only does it lubricate, but also it may keep some carcinogens and allergens out of your system.

The constant buffeting of the cells causes mild damage that increases the level of lubricating mucus. Injury at the cellular level promotes the health of the gastrointestinal tract as a whole.

Here we see a basic principle of nature: many of the same things that apply in the cells of the body apply equally in the life of someone trying to achieve success. Without the buffeting, the cells of the intestine could not produce the mucus on which your life depends.

Without some occasional adversity, you will find it more difficult to grow as a human being.

“Storms make oaks take deeper root.”
-- George Herbert (English Religious Poet, 1593-1633)

“He who knows no hardships will know no hardihood. He who faces no calamity will need no courage. Mysterious though it is, the characteristics in human nature which we love best grow in a soil with a strong mixture of troubles.”
--Harry Emerson Fosdick (American Clergyman, Writer and Broadcaster, 1878-1969)

Friendship and Psychological Distress

“To lose a friend is the greatest of all losses.”
Publilius Syrus (Syrian-born Latin Writer, 1st Century B.C.E.)

Severe and persistent mental illnesses are one thing, but there are many, many more people who are miserable and unhappy, without that unhappiness necessarily getting to the level of an “illness.” The offices of primary care physicians and therapists are full of people in genuine distress for all kinds of reasons.

I first began to think about this many years ago when a woman came to see me and promptly announced, “I’ve come for psychotherapy. I’ve been in therapy for seventeen years, and I want some more.” I wasn’t being in the slightest bit flippant when I responded by asking her if, after seventeen years, she really felt that it had offered her anything? She looked at me blankly, and it soon became very clear that what she needed was not more therapy, but a friend to talk to.

There has been another puzzle: why is it that women are more likely to develop depression than men? The most profound gender difference in mood disorders begins to emerge after puberty, so it would be easy to attribute it all to hormones. But that would be a mistake.

I recently pointed out that there are some fundamental differences in the ways in which men and women interact: women tending to be more relational and men tending to be more transactional. The female sense of self tends to be more entangled with her relationships, while a man’s self-worth and sense of self is more often associated with his achievements. Most of these differences begin to emerge in early puberty: when girls talk to their friends, their conversation tends to be more emotional and to be concerned primarily with relationships, while boys tend to be more reserved and to discuss facts, statistics and achievements. There is some evidence from research in different cultures that these different styles seem to be the norm throughout the world. Yes, there are of course plenty of people of both genders who behave differently, and so it is more accurate to relate these differences to the male and female factor or essence, rather than getting it confused with anatomical differences.

Emotional language tends to put more strain on a relationship, and it is well-recognized that girls’ relationships turn over much more rapidly than boys’ ones. An interesting hypothesis proposed some years ago by Professor Sir David Goldberg, is that this high turnover in relationships may lead girls to experience more disappointing experiences in their social networks, and it is this string of disappointments that predisposes young women to depression.

A happy, healthy, dynamic network of friends is a cornerstone of developing and maintaining psychological resilience. Without them you become progressively more vulnerable to the reversals that affect all of us from time to time.

“A friend might well be reckoned the masterpiece of nature.”
--Ralph Waldo Emerson (American Poet and Essayist, 1803-1882)

“To know how to live in a brotherly way with those around us is to be rich, for each of us, with our face, eyes, voice and thoughts, contributes something alive, something warm, which nourishes everyone.”
Omraam Mikhaël Aïvanhov (Bulgarian Spiritual Master, 1900-1986)

T'ai Chi Ch'uan and Health

I have written about some of the research into the health benefits of T’ai Chi and Qigong.

I was very pleased to see that this month’s issue of T’ai Chi: the International Magazine of T’ai Chi Ch’uan dedicated several pages to some of the research that is being done on the field and advised practitioners to participate in local research projects.

It was that last piece of advice that I particularly liked.

The article by Charlotte Jones, a Chen Style practitioner from Houston, is not a critical review of the literature, and neither is it supposed to be. It lists some of the key findings from studies on balance, osteoporosis, pain and arthritis, blood pressure and cardiovascular health without going through their pros and cons.

But a short list like this is a good jumping off point if you are starting to look into learning T’ai Chi and would like to know some of the possible benefits.

I shall also continue to provide you with more critical reviews of studies as they come out.

Resilience, Misfortune, and Mortality

Much of the development of the ideas of Integrated Medicine has been driven by the idea that a truly effective holistic medicine does not simply integrate different modalities to achieve health and wellness, but is also aimed at integrating all the different aspects of a person into a coherent whole. That was the real reason for choosing the term “Integrated” medicine in the United Kingdom, though “Integrative” and “Integral” medicine are ultimately all aiming for the same thing.

This is quite different from simply adding some acupuncture, an herb or some relaxation therapy to a conventional medical program. Its aim is not so much getting someone better, as to give the whole person – physical, psychological, social, subtle and spiritual - what he or she needs to be able to get themselves back on an even keel, so as to be able to deal with future challenges as they arise. And not just deal with them, but to use challenges as springboards to growth and development.

The whole idea of this system of medicine included an extra dimension that had often been left out: the interaction between the person in trouble and the practitioner. We are social animals, but even more than that it looks as if we are highly interconnected from cell to soul. We have to take into account the impact of a therapeutic interaction on the clinician, as well as the influence of the clinician’s psychological, subtle and spiritual makeup on the individual.

The development of this system of medicine had many parents. One was the American-born Israeli sociologist Professor Aaron Antonovsky who first generated the idea of salutogenesis: the study of the factors that support human health and wellness. He was one of the first to show that people who were relatively unstressed were far more likely to be able to resist illness, compared with stressed people. His interest was not just in what causes disease, but what are the roots of health.

He returned to and discussed, developed and applied an idea that had been around since the work of Sigmund Freud and Roberto Assagioli: that was that our experience of well-being constitutes a Sense of Coherence (SOC). He defined the sense of coherence like this:

"A global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that one's internal and external environments are predictable and that there is a high probability that things will work out as well as can reasonably be expected."

Two recent studies seem to indicate that this concept of coherence is fundamentally correct.

Researchers in Cambridge in the United Kingdom have reported a population-based cohort of 20,921 men and women completed a postal assessment of their lifetime experience of specific adverse events and a measure of their sense of coherence. Those with a weak SOC reported significantly slower adaptation to the adverse effects of life experiences, compared with those with a string SOC, and were more likely to die prematurely. Although the size of the effect was not large, the results suggest that SOC is a potential marker of an individual's adaptive capacity to deal with social stress, which is predictive of mortality

The second study was a systematic review from Finland. I like the way in which the study was done, and it came to this conclusion:

“SOC seems to be a health promoting resource, which strengthens resilience and develops a positive subjective state of health. Salutogenesis is a valuable approach for health promotion.”

So what does this mean for you?

Developing a sense of coherence is a most critical factor in creating and maintaining robust health and ability to adapt to change, be it in health, stress, your relationship or at work.

How do you do that? Healing, Meaning and Purpose spends over a hundred pages or several CDs explaining the most up to date ways of doing exactly that using a process known as Creative Self-Integration.

I do hope that you take the opportunity to sample some of the techniques for yourself.

A Special Offer

Today I'm attaching a first enhanced podcast to my blog.

We've been experimenting for months to get the music, sound and graphics just right. I'm planning to do a great many podcasts in the months to come so that you can listen at your leisure, and I can also share some specific tips and techniques that are tricky to explain using the written word alone.

Today's podcast is a short introduction, some advice on motivation, and an offer.

To commemorate the launch of this new project, I'm also going to extend the offer here.

The Internet is full of people telling you what they think and sometimes even what you should think and do!

That's not my way of doing things. I am here to serve you, and telling you what to do is scarcely an act of service!

Now that you have got a flavor for my areas of expertise, I am going to ask you what you would like to hear about or learn about or maybe even be amused about!

As you will see if you look at my list of "Categories," there are a few areas in which a great many people think of me as THE expert: the Go-To Guy.

So I get a huge number of questions every day, and I think that most of them merit a detailed response.

So the offer is this: I'm going to invite you to email me a question in any of these categories. Just send me a quick note to healingmeaningpurpose[at]yahoo.com. The shorter the better!

Naturally I cannot diagnose or treat a person online. No responsible clinician would ever do such a thing without performing a full, detailed and personal evaluation.

I'm looking for questions that will be of interest and concern to many people.

I am going to select the hundred and one questions that I can answer with something new: a new perspective, new information or new insight. Or perhaps a question that will be best answered by intuition or by an appeal to the classics or the spiritual Masters and Mistresses who have taught us over the centuries. I am then going to put these hundred and one questions and answers together into an electronic book. I can guarantee you that the book will contain an absolute treasure trove of life-changing information.

How do I know that?

Because of the quality of the questions that I've already received and the kindness of the responses to my answers. 

When it's finished in late October, I'm going to offer the eBook for sale at $49.00.

However.

Anyone who sends a question that I select and can use will receive a FREE copy of the eBook.

I'm totally serious about that, and there's no catch: I really am going to give away almost five thousand dollar's worth of books!

While also, I hope, offering guidance, help, support and inspiration to a great many people around the world.

Enjoy the podcast, and I look forward to hearing from you if you have a question with which you think I may be able to help!

Download podcast.August.18th.2006 1.mp3

Health Maintenance: Screening and Prevention

“An ounce of prevention is worth a pound of cure.”
--English Proverb

There is so much that we can do to help ourselves head off serious illnesses.

1. Adopting the kind of health lifestyle that I’ve discussed on previous occasions . Most of us already know the key items: including what to avoid. 
2. Next, be alert to signs an symptoms coming from your body: the Personal Evaluation of Wellness (PEW), is an ideal guide that took years to develop. I plan to make a computerized version soon.
3. Be alert to messages coming from your environment. If something dreadful happens in your life, it makes no sense at all to try carrying on as if nothing happened. The universe may be sending you a message, so use your intuition.
4. Finally, ensure that you get regular health screening. Here is a resource that will point you to the current recommendations about what you should be doing and when.

“Keep your own house and its surroundings pure and clean. This hygiene will keep you healthy and benefit your worldly life.”
--Sathya Sai Baba (Indian Spiritual Teacher, c.1926-

Health Marketing at the Centers For Disease Control

I was very interested to see that The Centers For Disease Control have launched a website for the National Center for Health Marketing. I learned about it from Carol Kirshner.

This could be an important step for creating and disseminating accurate information about health, and health care options.

I just have one small worry about all this: if insightful and knowledgeable people do not become involved in providing direct input into the enterprise, it is inevitable that the main focus will be on physical interventions: diet, exercise, nutrition, workplace stress and so on. In other words, the medical model. Only because that’s the dominant way of thinking about illness and health.

But as I have been showing in these pages, there are tens of thousands of leading thinkers around the world who have long since recognized the limitations of that medical model, to say nothing of the demonstrable fact that some new Laws of Health and Healing have been emerging over the last century.

I laud this new initiative, but I’m also hoping that it will also include communication about not just the physical, but also the psychological, social, subtle and spiritual aspects of health, wellness and healing.

If these fine people would like some documented research to do so, I know that we can oblige!

What is Your Risk of Developing Breast Cancer?

When I was first practicing in the United States I was stunned when a research coordinator - who was with me as I examined a young woman – complained that it embarrassed her that I asked the patient about breast cancer screening. I had been trained and then practiced for many years in the United Kingdom, where it would have been deemed negligent if I had not asked the question. As I was taught a long time ago, “When you see a patient, man, woman or child, that may be their only contact with a doctor, so take the opportunity to do as much screening and education as you can.” I still take that to be good advice. We have good data that if women did regular breast self-examination and men checked their testicles, that we would each year catch many cancers at the stage when they are still easily treatable.

I was reminded about all this as I read the shocking results of a study that will be coming out in the European Cancer Journal this month.

In a survey of over 10,000 female students from 23 countries, hardly any knew about any of the major risk factors for developing breast cancer. We have obviously done a lousy job a teaching young people about a disease that may in large part be preventable.

This is desperately important. About 30% of illnesses you cannot help: they are the result of genetic mutations, accidents and so on. But 70% of all illnesses are thought to be the result of lifestyle choices.

Breast cancer is a good example. Yes, there are undoubtedly some cases that are largely genetic: genes have been identified in some families that strongly predispose women – and some men – to the disease. But they are uncommon: probably no more than 5-10% of cases. It is likely that the majority of people with the illness do have a genetic predisposition. But the impact of family history is usually small. And remember that biology is not destiny. Lifestyle modification may indeed significantly reduce your risk.

These are the Major Breast Cancer Risk Factors:
1.    Age
2.    Family history (slight risk)
3.    Starting periods at a younger age
4.    Late menopause
5.    Using hormone replacement therapy
6.    Using the contraceptive pill (small)
7.    Alcohol
8.    Obesity

Please do note that this is not the whole list of risk factors. Perhaps the most comprehensive list is here.

Cutting the Risk:
1.    Breastfeed
2.    Having several children, and having them young
3.    Stay in shape
4.    Eat and drink healthily
5.    Don't smoke

The take home message for everyone is this: lifestyle can strongly influence the risk of developing breast cancer. You cannot change everything, but stopping smoking, cutting down on alcohol, reducing weight and taking regular exercise are in the reach of almost everyone.

Technorati tags: Breast cancer Education Risk factors Health screening

Sex, Time and Energy

I was taking a long flight yesterday, which gave me the chance to read through the results of a large survey  done by Men’s Health and Cosmopolitan Magazines. You will see, gentle reader, how widely I spread my net in my ceaseless efforts to bring you important new materials to enrich your life….

The results of this survey of 6,000 men and women seemed at first to make interesting reading. More than half of men and women surveyed saying that they wanted to have sex at least once a day; around half of the women saying that they wanted to have more adventurous sex, and so the list went on. But then I started thinking: “Who are these people?” They certainly don’t sound much like the people that I know, or people with whom I’ve worked professionally.

So I showed the survey to She Who Must Be Obeyed, and she immediately agreed: “How old are they? And how many of them have children?”

Most healthy adults are interested in having intimate relationships, but how many people are too tired and too distracted to do everything that they want to? And how many people are busily multitasking their lives away to the exclusion of everything else? I was recently talking to a married couple who had packed the children off for the evening and had a date night all organized. The restaurant was booked, the theater tickets in hand, and they both fell fast asleep on the couch and missed both.

I’m sorry to disappoint some of my readers, but the world is not quite the way that it is portrayed in some magazines. At least not once you take on responsibilities. The problem with surveys like this is that it can make some people very dissatisfied, for it leads them into the trap of comparison: “If that’s what the survey says, then what’s wrong with me?” The answer is, of course, that there is no such thing as “normal behavior.” What you and your partner like and feel comfortable with is all that really matters, so long as it isn’t infringing on anyone else. Every time another survey like this comes out, every one of my therapist friends sees an increased number of people worried that they aren’t performing up to par.

Sexual mismatches can create a lot of difficulties in relationships, but let me make a suggestion: the most valuable thing to ensure the viability of intimate relationships is not so much to try to learn lots of different techniques, and it is sometimes just not realistic to put aside as much time for each other as you would like. So instead make the time together really count. There is nothing quite as attractive as an intimate occasion marked by complete focus on and awareness of the other person. Feeling the dance of the duality, focusing on all your senses, and, if you can, feeling the subtle systems of the other person. You already know that our experience of the passage of time is highly elastic. Focused awareness of another person can make even five minutes seem like a lot longer, and remember what I have said before, and is an important theme of Healing, Meaning and Purpose: time management is far less important than energy management.

And remember this: you will never be free so long as you are concerned about the opinions of others.

Technorati tags: sex, relationships, time management

Personal Evaluation of Wellness

As a physician, I am trained to know what questions to ask in order to diagnose health problems and understand what course of action needs to be prescribed to alleviate or cure the problem.  I can be a nightmare for my secretary if she makes my schedule tight because I can spend over an hour with a patient on a first visit.  She would argue that it is more like two hours, but I will admit that I take whatever time I need to gather the pertinent information.

I recently wrote an article that allows one to conduct a personal evaluation of his or her own wellness.  Click here to be taken to it.  It is based on my many years of experience and research.  You will notice that the questions cover the 5 main areas (Physical, Psychological, Social, Subtle and Spiritual) that are key to achieving an overall feeling of wellness and good health.

Keep in mind that this is a bit of a shortened version, there are many more questions that can be helpful.  However, this should get you started about thinking of ways to improve your own sense of health, meaning and purpose.

Technorati tags: wellness, health survey,

The Status Syndrome

I have recently seen some reports in the media about a connection between money and longevity: the idea being that the more money you have, the longer you live. Which presumably means that Bill Gates will live forever. Sadly this link between wealth and longevity is a false extrapolation from some very old research. Yes, extreme poverty is associated with excess mortality, not only because of poor lifestyle and lack of access to medical screening and care, but also because adults who were of low birth weight are more likely to develop diabetes and hypertension. And people born into poverty are more likely to have been malnourished before birth, and therefore to be of low weight at birth. This relationship between low birth weight and subsequent disease is likely the result of incomplete development of the liver and kidneys before birth.

A famous study of British civil servants has indeed shown that people who work in more senior positions are more likely to live longer than people working in the lower ranks. But it has nothing to do with money. Once people have passed a certain critical material threshold, lifestyle factors have progressively less impact. There are still more smokers amongst manual workers and hours of hard work means that they have to eat high calorie high fat foods to be able t keep working, and we have not done a good job of showing people how easy it is to eat healthily on a budget.

Sir Michael Marmot is an outstanding epidemiologist working in London, who has spent three decades examining the health consequences of differences in social standing. He has discovered that there is a social gradient that predicts health outcomes: the lower a person’s social rank, the higher their risk for heart disease, diabetes, mental illness, accidents and many other health problems. Once people have passed a certain threshold of physical and material well-being, something else comes into play: other kinds of well-being that have a massive impact upon life. These are autonomy - how much control you have over your life - and opportunities for social engagement and participation. The psychological experience of inequality has profound effects on multiple body systems. Sir Michael has summarized a lot of his research in an eminently readable book entitled, appropriately, The Status Syndrome.

There is an interesting corollary of the Status Syndrome. In his book The Pecking Order, Dalton Conley presents interesting research that indicates that our level of success relative to our siblings is less the result of birth order or genetics and more the result how much family resources – time, energy, money and love - we received while growing up.

There’s not much that you can do about your birth order, but all this research has some important implications.

1. Once you have crossed a threshold that allows you access to nutritious food, exercise, stress management and health care, there is no longer any link between health and wealth. In fact, working and working to get more and more money is associated with increased mortality!

2. The amount of time, energy, money and love that the family is able to give to each child will help shape and structure their future life. That is a hugely important responsibility.

3. Ensure that you feel and know that you are autonomous: that you are in control of your life. I really urge you to work on this. One of the reasons for being concerned about the ever-increasing demands being made upon all of us is that it can make us feel out of control. I spend a great deal of time in Healing, Meaning and Purpose discussing and demonstrating techniques for taking back control of your life.

4. Are you socially engaged and participating in life? Are you doing something for your community or your church? How often do you meet new people and engage with them? Is there someone whom you haven’t seen for a while that really needs a call from you? Please do think about this: it’s not just about socializing; it’s about protecting your health and well-being, and the health and well-being of those around you.

Technorati tags: status syndrome, Michael Marmot