The Center for Mind-Body Medicine

Bringing Psychological Healing and Hope to Haiti; Day 1, Part 1 of 2–Arrival

Day 1, part 1 of 2–Arrival

There is a weight to the air; we begin to feel it at the border where we enter from the Dominical Republic. We can smell it, too, in the swirl of dust that forces some to wear masks, in the acrid edge of burned and burning building materials. It grows heavier as we bump around flanks of rubble on the outskirts of Port-au-Prince. In the city, it roughens our voices and presses tears from our eyes.

Happily, surprisingly, we have a place to stay—in the Coconut Villa, a hotel near the airport that is an undisturbed island amidst collapsed houses. Across the street, several thousand Haitians live in tents.

Rosemary Murrain, Star Myrtil, and I are here to see if our approach can help bring psychological relief to the people of Haiti—and to see if we can work with and find support from the large international agencies that are funded to bring food, housing, schools, and emergency medical care to the people. Our approach, which combines such mind-body techniques as meditation, guided imagery, biofeedback, and yoga, self-expression in words, drawings, and movement, and small group support, has made sense to and worked remarkably well with war- and disaster-traumatized populations in Kosovo, Macedonia, Israel and Gaza, in post-Katrina New Orleans, and with US military returning from Iraq and Afghanistan. It’s practical, easy to learn, and feels right to people who are trying to gain control over the thoughts, feelings, and memories that overwhelm them in the wake of catastrophe. We’ve published the only randomized controlled trial (RCT) of any invention of any intervention for war-traumatized kids. It showed an 80% decrease in symptoms of posttraumatic stress disorder in Kosovo high school students, an improvement that was maintained at three months’ follow-up. More recent studies on 1,000 children and adults in Gaza show similar sustained gains in spite of the ongoing constraints and tragedy of life there. Altogether, the several thousand clinicians, teachers, and community leaders’ we’ve trained have made our CMBM model available to hundreds of thousands of children and adults around the world.

Rosemary is CMBM’s new Director of Finance and Administration. Immensely capable, unflappable, fluent in French, she’s an MBA student who has helped to create and lead educational programs throughout Africa. She’s in charge of the logistics that brought us on our journey here, and she will help create necessary partnerships. She’s also, I say with pride, my goddaughter. Star is her friend, a Haitian living in Florida, leading women’s programs there and fluent in Creole as well as French; a human bridge for us to Haiti and to its people.

**************************

I’ll post more this afternoon, about our visit to the tent city outside our hotel and the people we met there.

Jim

"Healing the Wounds of War" in Christian Science Monitor

Dear friends,

The Christian Science Monitor featured an article on our Healing the Wounds of War program in the Middle East! Ilene Prusher interviewed some of our Gaza trainees, and myself, to write this thoughtful piece. She also notes that it is the one-year anniversary of the Israel siege on Gaza, “Operation Cast Lead,” which devastated the people and landscape of Gaza, and from which they are still struggling to recover a year later.

Here is an excerpt of the article, but I hope you check out the original, with some pictures  and related stories on Gaza and the Middle East, here.

Gaza war anniversary: How one group helps victims overcome trauma

By Ilene R. Prusher Staff writer / December 28, 2009

Jerusalem

Rawya Hamam was watching her son deteriorate. Hisham wouldn’t sleep, clung to her incessantly, and said he wanted to go back into her belly so he’d be safe. “Grandma is lucky she died so she doesn’t have to live here now,” the boy told his mother.

It’s not a normal statement to expect from a five-year-old child, but neither were these normal times. A year ago, at the outbreak of war between the militant Palestinian group Hamas and Israel, anything resembling a normal life disappeared into a violent maelstrom that wreaked unprecedented destruction on the Gaza Strip. More than 1,400 Gazans were killed, according to a Palestinian count, in a campaign the Israeli army named “Operation Cast Lead,” with the aim of getting Hamas to stop the daily launch of occasionally fatal rockets onto Israeli communities. Thirteen Israelis were killed in the three-week war. . . . keep reading

We’re so thankful for the recognition of our work in Gaza, alleviating psychological pain and suffering, and all of the work we do, both in the Middle East and here in the US teaching health and mental health professionals to learning to handle their stress and incorporate mind-body techniques into their practice through our Mind-Body Medicine Training as well as our Healing Our Troops program. These warm, caring professionals we train use their skill and wisdom to help families recovering from disaster, like those who survived Hurricane Katrina,  as well as working with troops returning from Iraq and Afghanistan and their families.

(If you kept reading my post, don’t forget to check out the rest of the original CSM article with pictures  and related stories on Gaza and the Middle East, here.)

Jim

Stress and the Economy: My Washington Post Article

Dear readers,

My piece, “Some Simple Steps for the Stressed-Out: Psychiatrist Offers Simple Steps for Coping with Uncertainty,” on dealing with stress from the economic downturn, appeared on the front page of the Washington Post Health Section today.

A middle-aged, working-class woman recently came to my medical office complaining that her back had “seized up.” Her husband had lost both his jobs and was feeling quite disheartened; not long after, her blood pressure had “jumped though the ceiling” and she began sleeping poorly.

Another patient came to see me suffering from crippling anxiety attacks. He had lost the better part of his considerable fortune in the economic collapse. Now he was waking in the middle of each night feeling his chest crushed, unable to breathe, half fearing and half wishing he would die.

I have been practicing psychiatry for 40 years, but I’ve never seen this much stress and worry about economic well-being and the future. There is a sense that the ground is no longer solid, that a system we all thought would sustain us no longer works as we were told it would. In the past, when patients reported job-related stress, it was from unfulfilling work and the anxiety of making choices. “Should I stay in this job that I can’t stand and keep feeling so unhappy?” they would say. Now, I hear about unmeetable mortgages, months without work, fears of ending life in a low-paying, entry-level job. “What went wrong?” my patients say. “What could I have done?” “How can I manage?”

In this uncertain time, symptoms of chronic illnesses — hypertension, back pain, diabetes — that were controlled or dormant are erupting. Low-level depression, whose hallmarks are feelings of helplessness and hopelessness, is endemic.

Large numbers of people across the country are trying to quiet their apprehension with drugs or drink, or have turned to antidepressants, anti-anxiety medications and sleeping pills. But after decades working not only in Washington but also with war-traumatized populations overseas, I’ve found there are simple strategies for helping people cope that are easy to learn, practice at home and, in these stressful times, free.

1.Begin a simple meditation practice. Loss — of jobs or economic security, as well as of a beloved person — is perhaps the greatest and most common of stressors, and the most frequent cause of anxiety and depression. Slow, deep breathing — in through the nose, out through the mouth, with the belly relaxed and soft, and the eyes closed — is a sure “evidence-based” antidote to the stress response that uncertainty provokes. Practicing this “soft belly” technique several times a day for several minutes each time quiets the “fight-or-flight” response that makes people anxious and agitated, and brings us what cardiologist Herbert Benson famously called “the relaxation response.” Financial advisers, child-care workers and soldiers back from a second tour in Iraq with whom I’ve worked have all found, in this simple practice, a source of calm.

2.Move your body. With the possible exception of talking with a sympathetic, skilled human being, physical exercise may be the single best therapy for depression. It’s very good for anxiety as well. Exercise has been shown in animal studies to increase cells in the hippocampus, a region of the brain concerned with memory and emotion, which can be depleted by significant psychological trauma (and financial stress is one of the most significant traumas) or chronic depression. Exercise increases mood-enhancing neurotransmitters in our brains, and decreases the levels of stress hormones that exacerbate chronic illness.

It may not be easy to get moving when you’re feeling defeated, but every step you take, literally as well as figuratively, will encourage you to take the next one. Make sure you do something physical that you enjoy or once did enjoy. Aerobics or yoga classes may feel overwhelming or too expensive. Don’t worry: Dancing at home by yourself works just as well, and so does walking. Exercise is often the first item on my prescription pad.

3.Reach out to others. Human connection — to family, friends, co-workers in the same boat — is an antidote to the sense of aimlessness and isolation that may come from job loss or unexpected economic insecurity. Social connection also helps prevent the chronic illness that can often follow prolonged stress. I see the healing power of group membership every day in mind-body skills groups that colleagues and I organize, when a group member, demoralized and humiliated by job loss, realizes he or she is not the only one. Acknowledging and sharing (but not indulging) this sense of grief and pain is a remarkable source of strength for many people.

4.Find someone who will listen and help you take a realistic look at your situation. When the middle-aged woman with the “seized-up” back came to see me, we discussed her finances as well as her feelings. Although her husband had lost his jobs, her own job, in the health-care industry, was still secure. She and her husband would have to give up some of the “little luxuries” to which they’d been accustomed, but it was clear they could still manage. She needed to relax (using the soft-belly technique), recognize what she could and couldn’t do, give her husband a fair share of the household chores while he looked for another job, and generally unburden her mind, body and spirit. This simple exploratory conversation — and a subsequent heart-to-heart with her husband — allowed her to turn aside the cascade of anxious emotions. Her body began to repair itself.

5.Let your imagination help you find healing — and new meaning and purpose. The wealthy man who came to see me last winter paralyzed by anxiety attacks after losing much of his fortune was able to put his own trauma in perspective by using his imagination.

Though he still was, by most standards, wealthy, his sense of himself as a wise, sure-footed investor had been shattered. He did soft belly breathing to relax and began to cut out and copy pictures from magazines that seemed to him somehow hopeful. He spent days, he told me, copying a photo of a man his age, a grandfather apparently, standing with his arm around a young boy on the verge of the hole where the World Trade Center had been. “The tragedy in the picture is so much greater than my own,” he said, “and I realized that what’s really important is the connection between this man and boy, the hope for the future. I drew it, and I really started looking for this connection in my own life — a connection with meaning now, not money.”

Other patients find relief and assistance from imagining themselves in a safe place and consulting their inner “wise guide” to help them find peace, direction and meaning. This may seem kind of strange at first, but it’s an ancient process used in many indigenous cultures and is actually pretty easy.

First, after breathing deeply and relaxing, imagine someplace safe and comfortable, one you know or one that just arises at the moment in your imagination. As you sit there, you allow your “guide” to appear. Accept whatever image appears — a wise old man or woman, a relative, a figure from scripture or literature, or even an animal. Mentally introduce yourself, and ask this guide a question about what’s troubling you, and then “listen” to the response that comes into your mind. Let the dialogue with you and this guide continue. Often helpful guidance will emerge from your own intuitive understanding.

6.Speak and act on your own behalf. Sometimes this produces rapid and even material benefits: One patient, a financial analyst, talked to her colleague about impending cutbacks; they forestalled a layoff by offering their supervisor a job-share alternative. Often speaking up for yourself produces valuable information and greater peace of mind and clarity: An anxious nanny finally asked her employer, who was herself experiencing a significant decrease in income, if her own job was secure and discovered it was; an IT consultant, asking his boss for a straightforward response, discovered his job was likely to be eliminated and began the search for another job, early, unsurprised and still employed.

There are two common denominators to these six strategies for dealing with and healing from financial setbacks and the unnerving feeling that the ground has shifted. All of them remind us, in times when the economy has made us feel powerless, that there are things we can do to help ourselves. And none of them costs money.

You can read the original article here.

If you like what you read, please make a comment; it’s always great to hear from you here, but it also helps if you leave one on the Washington Post article so that they know you like reading articles with a focus on prevention, wellness, and self-care. You can either do this through their website form (if you login) or by emailing health@washpost.com.  (I’m really enjoying the comments that are already there.) And for those of you who participate in social bookmarking, I also appreciate submissions to Digg, Deli.cio.us, Reddit, and other bookmarking sites.

Thanks for reading, and I hope the techniques in the article will be useful to you and to everyone in these difficult times.

Jim

“Unstuck” E-book release!

Dear friends,

I have some exciting news—thanks to numerous requests, my latest book, Unstuck: Your Guide to the Seven-Stage Journey Out of Depression is being released as an e-book! In my publisher’s own words:

your e-book will be with retailers tomorrow; it should be on sale within 48 hours on Amazon and by the end of next week everywhere.”

“Unstuck” is on Kindle at Amazon.com here (or will be soon).

A warm thank you to everyone who helped by requesting this format. I hope this additional release will allow me, through Unstuck, to help many more people struggling through depression and anxiety (and perhaps, antidepressants) to move toward health and wholeness.

All my best,

Jim

Gaza Mind-Body Training in the News

Dear Friends,

Check out the great AP story by Karin Laub about our Gaza training–

At the Washington Post (you may have to close an ad first to read it)

Or at Google News

It’s an great take on how our mind-body skills training is an unconventional fit, but an immense help, to people within the Palestinian culture. (Great picture of me shaking & dancing up front, too (!!!))

We’re in Israel now—flying back to the States soon. More soon.

All the best,

Jim

Progress in Gaza

I said that I would write more about our work in Israel and Gaza, but the work-and trying to find funding so that we can continue it-is taking up so much time (joyous, exciting time, to be sure) that I haven’t been able to write.

Still, I thought I would send along this very brief summary that I forwarded to our US Mind-Body Medicine faculty.

 

Hi everyone,

 Just a couple of words from Gaza City: overwhelming, amazing, touching. That’s three words.

 We (Jim, Amy, Afrim, Yusuf, Dan and Lee-Ann) had a great visit with our Israeli faculty. They are doing many interesting and exciting projects including groups that combine mind-body skills and Jewish spirituality, joint Israeli Jewish and Arab groups, and many groups for traumatized children and adults in Sderot. In fact, we made a visit to Sderot and had a chance to talk with teachers who are using mind-body skills in wonderfully creative ways with children in the SCIENCE AND RELIGION SCHOOL. The kids have experienced shelling on and off for eight years and are having all kinds of problems with concentration, bed-wetting and anger.

 Naftali who heads up our Israeli program, is on the track of a major initiative in the South which will build on the work that he and his team have already done.  We are working together on developing cooperative relationships and future funding.

 Thanks to Danny Grossman, a friend to whom Aaron and Debbie Kaplan introduced us some years ago, (with able assists from Naftali and Smadar who handle the administrative work in Israel), we were all able to get into Gaza. It took a couple of extra days for Afrim and Yusuf, but Naftali and Tami and Ayelet from our Israeli faculty kept their spirits high while they waited. Once in Gaza, we began with visits with grieving families. There are whole sections of Gaza that have been completely destroyed and many thousands of people who are without homes. “I am very small,” one ten year old girl told us, “but the tent the 20 of us are staying in is even smaller.”

 We went on for a day of meetings with our Gaza faculty. The next day, we had more site visits including one to Dr. Izzeldin Abuelaish, whose three daughters were killed. He’s an amazing man, an OBGYN who works in Israel as well as Gaza and through some miracle of wisdom and compassion, has managed to transform his suffering into a visionary project for the education of girls in Gaza-“not just so they will think, but so they will think freely”-and a mission to promote greater Israeli-Palestinian understanding.

  We’re now about to start the 4th day of our PTP. Our Gaza faculty, which Jamil heads up, is doing virtually all the lectures and leading all the groups and our international team is consulting/supervising. The Gaza group is doing an absolutely wonderful job. They are so open-hearted and skillful-I’d say over the last 18 months, they’ve each lead anywhere between 6 and 20 groups and it shows.

 Participants (there are over 140 of them) are speaking of issues that they have never before discussed and beginning to solve problems that have troubled them for years-not to mention finding practical ways to ease their high levels of anxiety and deal with nightmares, flashbacks, etc. All of them-faculty and participants-are so eager to learn and to share what they are learning. They are an inspiration to all of us.

 There is much more to tell and I will when I have more time. For now, I send all of you my love as well as my gratitude for being with us on this and many other adventures.

 Jim

Healing in Israel

March 2, 2009

I’m returning to the Middle East after 9 months away, in the wake of the War in Gaza and the ongoing shelling of the south of Israel by Hamas. Read about our mission here.

Our team is in Israel for 4 days: Amy, who runs our program of clinical supervision for our Israeli and Palestinian faculty. Dan and Lee-Ann, who coordinate both programs on the US side and Afrim and Jusuf, psychiatrists from Kosovo, whom I first met when they we’re refugees in Macedonia during the 1999 NATO bombing of Kosovo. Amy and I have worked together for 10 years. Afrim and Jusuf are like brothers. It seems that Dan and I have been everywhere together, and Lee-Ann, our newest member, has done a fabulous job with logistics for the trip.

We hit the ground running, heading to Sderot, which has been shelled from Gaza for 8 years, as soon as we wake up on the first morning after our arrival. Naftali, our Israel program director, (we’ve trained some 300 health and mental health professionals in Israel over the last 5 years), is doing the driving, and will be introducing us to colleagues who are dealing with the ongoing trauma in Israel’s south.

First stop: the SCIENCE AND RELIGIOUS ELEMENTARY SCHOOL, a meeting with the principal, Dina Chouri as well as Miri Asoulin, a teacher who has come through part of our training program and heads up the “Havens of Calm” program. “Havens of Calm” is a room apart from the school with bean bag chairs, crayons, games, a place for kids to come express their feelings and simply hang out when they need to. Miri is exactly the kind of teacher you wish your children had-or wish you might have had yourself. She has the kind of smile that erases all the doubts you have about your own worthiness, that makes you feel that everything you do is not just alright, but really really interesting.

Over the last 7 years, while shells fell in and around Sderot, perhaps 60 percent of the kids used the “Havens of Calm” room. During the recent war, and in its aftermath, everyone does.”

“For a long time,” Miri tells us, “the children have been nervous and angry; they have trouble sleeping and are wetting their beds. Now, from the time the war began, there are new symptoms. Now the children tend to find scapegoats. One class had an election for what classmate they wanted to most to be dead. They cannot fight against the rockets, so the anger has to go somewhere,” she says.

“In the beginning,” a psychologist who consults with the school, added, “the children were crying and anxious. Now, sometimes, they go into a total freeze when the red alert (the signal that a Qassam rocket is about to fall). One eight year old girl’s body was like a stone. She couldn’t move her hands or feet for four hours.”

Miri and a number of the other teachers and counselors in this and other Sderot schools find the techniques they learned from The Center for Mind-Body Medicine to be enormously helpful for themselves-for they too work, and often live, amidst the falling rockets-and for the kids. She shows us pictures that the children have done of huge rockets falling on their town and of Gaza burning.

The children seem more hopeful, but their parents are not. In Sderot, and in nearby Shaar Ha Negev, we hear voices of distress and disillusionment. “The people felt strong during the war,” one psychologist tells us. “They thought the rocket attacks from Gaza would be over. But now the war is finished, and still we have Qassams almost every day. What was the point?”

More to come.

We Must Consider CAM for Depression

Dear Readers,

Despite a hectic schedule this January, I’m hoping to keep my blog up-to-date with the exciting events in my practice and at The Center for Mind-Body Medicine (CMBM).

A quick look at my schedule/to-do list:

I’ve just finished leading (along with Kathie Swift, MS, RD, LDN, my co-director) The Center for Mind-Body Medicine’s professional training program in nutrition, Food as Medicine, in San Francisco.

We’re also moving forward with our exciting work with the US Military training health and mental health professionals who are working with active-duty military as well as in the Veterans Administration to use mind-body techniques with vets returning from Iraq and Afghanistan with severe depression, PTSD, and traumatic brain injury. Over 100 of these professionals came to the first phase of our professional training program in mind-body medicine in Minnesota in October 2008. Here’s some data on the difference our training made to them. Most of them are returning for our advanced training–where we teach them how to lead the same kind of mind-body skills groups in which they participated in the first training—this weekend, from January 31-February 4th, once again in Minneapolis.

We’re also moving ahead with a research study funded by the Department of Defense on the use of our model with traumatized veterans and their families.

Last but not least, 30 of us–health professionals, policy makers, and just plain folks–gathered together in my home to develop a report to make recommendations for a National Health Plan to the Daschle/Obama Health and Human Services Administration. We’re continuing to explore ways for CMBM to be involved in creating a top-down support for truly universal and integrative health care for all Americans.

In other news, a recent op-ed of mine was published in the Clinical Psychiatry News, entitled “We Must Consider CAM for Depression.” You can read this succinct argument for wider use of integrative therapies, versus drug-centric treatment, here (you will have to create an account on this website to access it if you don’t already subscribe to CPN, though–sorry.) I was also published in the New York Times science section, writing about a friend and colleague of mine in Gaza going through the terrible bombings there. Read that one here.

Let me know your thoughts about what we’re doing, how we’re doing it, and how we’re bringing it out into the world! I’ll be in touch too.

Jim

The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First by Mark Hyman, MD Review by James S. Gordon, MD

The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First
by Mark Hyman, MD, Scribner’s: New York: 2009

Review by James S. Gordon, MD

I just finished The UltraMind Solution, a wonderful, ground breaking book that gives new and eminently practical insight into the causes and treatment of mood, behavior, and cognitive disorders. It’s a book I recommend to all of you without reservation.

The UltraMind Solution is by Mark Hyman, MD, a highly skilled, integrated Family physician who is a Center for Mind-Body Medicine Board Member, and a core faculty person in our Food As Medicine training. In The UltraMind Solution, Mark suggests that the most effective and, indeed, scientific way to address the epidemic of psychiatric disorders (affecting 1.1 billion people worldwide) is not with psychotropic drugs that treat postulated alterations in neurotransmitters, but with nutritional therapies that address the underlying biological imbalances that ultimately may disturb neurotransmitter functioning.

The UltraMind Solution is based on the principles of “functional medicine,” a systems approach to chronic disease and to the physical and emotional problems that beset our population. It is a road map for both patients and practitioners, a clear, thoughtful, guide to the ways the body can become imbalanced, and to the simple, natural methods-largely food and supplements-that can be used to restore the imbalances in the entire body, and most particularly, the brain. It’s a book that significantly deepened my own understanding of biological factors in depression. I believe, as well, it will enhance the information on biology that I present in my book Unstuck: Your Guide to the Seven Stage Journey Out of Depression.

In a series of clear, well documented chapters, Mark discusses the “7 keys” to his program, and the ways that readers can use them. These keys include optimal nutrition, hormone balancing, decreasing inflammation, improving digestion, enhancing detoxification, increasing energy metabolism, and calming the mind. In The UltraMind Solution, Mark includes more than 400 well-chosen scientific references and dozens of case studies, together with diagnostic questionnaires. He offers as well clear steps that readers can take to use this information to help and heal themselves. You can learn more about The UltraMind Solution by going to the following website: http://www.ultramindhealth.com/cmbm.

Mark is also presenting a six part webinar series for clinicians on applications of functional medicine to brain and mood disorders. In particular, he will discuss diagnostic and therapeutic approaches to ADD/ADHD, autism, dementia, and depression. Access to these webinars is complimentary for practitioners who obtain a copy of The UltraMind Solution by going to the website below.

http://www.ultramindhealth.com/cmbm

PTSD on Wall Street and Main Street

“You don’t have to go to Gaza to treat posttraumatic stress disorder,” my friend said. “Just come to New York.”

It’s not that the mental and emotional state of the US population is indistinguishable from that of Gaza’s Palestinians — many of whom have lived with eight years of war and civil strife — thousands of lives lost and homes destroyed, and unemployment reaching 40-50 — some say 70-80– percent. Indeed, even those of us hit hardest three weeks into the worst of this unraveling financial crisis, are still technically experiencing only an “acute stress disorder.” But there are signs that each day, this growing financial crisis is traumatizing us more and more. Add to that our costly, life-claiming Middle East war, and we — like the Palenstinians in Gaza — may also be on our way to significant levels of population-wide traumatic stress.

Posttraumatic stress disorder, which by definition lasts longer than several weeks, is characterized by three sets of symptoms: “Hyperarousal,” an agitated state in which the heart may race, concentration and sleep are disturbed, startle responses are exaggerated and anger easily triggered; “Re-experiencing” the original trauma — in nightmares, intense and disturbing memories, and flashbacks; and “Avoidance” of trauma-related thoughts and feelings, coupled often with a sense of detachment and estrangement, emotional numbness and an apprehension about a bleak future.

All these are in abundant supply in those closest to the crisis — the ones who have lost jobs and pensions, older people who see their retirement savings melting away, and people of all ages who cannot keep up payment on their homes. Many who are, or were, working on Wall Street are sleeping fitfully, jiggling their knees uncontrollably in meetings, drinking and eating too much, losing their appetites, and popping antacids and tranquilizers. One broker friend is awake far into the night, worrying about her elderly clients’ inability to live on their diminished incomes and whether or not she will be able to pay her own child’s tuition. Others, like one 30-year Lehman Brothers veteran who is married to a colleague, have receded into states of frozen denial; acting as if somehow everything were still as it was. He dresses as meticulously as he always did and sits for hours at a computer which no longer registers his trades.

And the symptoms are also present with more or less intensity in many of the rest of us who feel the financial foundations crumbling under our feet. I have been hearing from retirees who are waking up in the middle of the night, panicked, to pore over diminished budgets, then fall asleep worrying that their fixed incomes will no longer permit them to live in the houses they saved a lifetime to buy. A colleague out West tells me her psychiatric inpatient service is overflowing with people whose loss of homes and jobs has undermined their precarious emotional, as well as economic, security. Meanwhile, anxious and depressed people, unable to afford gas for the long trip to the outpatient clinic, call in for more prescriptions for tranquilizers, antidepressants, and sleeping pills. And children may be just as deeply affected as their parents; according to The Washington Post, a recent national survey of 500 teenagers found that already, “70% fear ‘an immediate negative impact’ on the security of their families.”

Former senator Phil Gramm’s infamously dismissive comment declaring the US in the midst of a “mental recession” is likely to turn out to be true in a way he never intended. Financial irresponsibility and lack of oversight are indeed creating the conditions for “mental” disturbance. The associated loss of confidence and hope further threatens the trust upon which credit and the financial markets depend.

Even when trauma is reliably over, the feelings of being overwhelmed and stuck persist. Five years after the war in Kosovo, we found that 44% of all high school seniors in the Suhareka region still had symptoms of PTSD. And when stress is ongoing, its symptoms and the accompanying depression are continually reinforced. Some Americans will never recover financially or emotionally from the loss of jobs and homes and savings. Others will be long unemployed, and their misfortune and lack of income — and the emotional distress both bring — will affect businesses in their communities as well as in their own families and friends. Meanwhile, vast numbers, perhaps our entire population, will likely feel the uncertainty and vulnerability that the ongoing and deepening financial crisis is provoking — feelings that still bedevil so many who lived through the Great Depression. One recent landmark study on the influence of genetics and “life stress” showed that of all possible causes, financial setbacks were most likely to contribute to depression.
In Gaza and Israel — where the consequences and threats of terrorist bombings are ever-present — and in Kosovo and New Orleans, my colleagues and I have helped tens of thousands of fearful and vulnerable people in the midst of chaos. We teach them meditation, deep breathing and movement techniques, mental images, and exercise. Learning these techniques, they find places of calm and control within themselves, discover solutions to problems that had seemed unsolvable, and raise their depleted physical and emotional energy. Acting to help themselves, they find antidotes to the helplessness and hopelessness that are the hallmarks of depression and traumatic stress. Learning together they discover mutual support and a renewed sense of community.

In Gaza, in the most vulnerable parts of Israel, and in New Orleans, there is another factor that makes people’s stress and depression — and, yes, their anger as well — so much worse. This is the sense of being dismissed and neglected by the larger world on which they had once depended.
These feelings of neglect, deception, and disrespect are only increasing as the financial crisis deepens here and expands overseas. They must be addressed. The various bailouts are initial investments in confidence as well as credit, the first signs of a public assumption of responsibility. But they are only a down payment on the far more comprehensive measures that must follow, and should only be the first step in the government’s effort to regain the trust that is necessary to real recovery.

As a country, we must honestly admit to and address the causes of our crisis — greed, arrogance, and indifference. Then we must begin to pay honest, ongoing attention to the concerns of a population that feels betrayed, vulnerable, and abandoned. These steps will promote stress reduction as well as provide fiscal reassurance. Meanwhile, we have to learn, quite literally, to breathe deeply, to relax in the midst of fear and uncertainty, to trust that we, like the Israelis and Palestinians and New Orleanians, can grow and change through adversity. We cannot avoid the fear and the stress in the world in these troubled times. We can however, learn to live more peacefully with them.

Republished with permission from The Huffington Post

First published October 23, 2008, 10:52 AM EST at

http://www.huffingtonpost.com/james-s-gordon/ptsd-on-wall-street-and-m_b_137160.html

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