The Center for Mind-Body Medicine

Amazing Graces: Days Two, Three and Four

The Missing Twin: Part Two

For two years whenever the teacher closes her eyes to sleep or rest she sees “only all darkness.” After a while of doing Soft Belly, it changes. By the second day she is “seeing colors” and pronounces herself “very satisfied.” That first night she returned home and, just as we had done in the training, she shook and danced with her surviving son. The next night, after we had used imagery, she tells him to “close your eyes and say what you see.” “A house and a sailboat,” he tells her. She is amazed. This is exactly what she had drawn in the picture of how she would be without her biggest problem. On the third day she tells her group, “My smile is back.” She brings her son to a party and we kid around and dance a bit. Her smile lights up the restaurant.

Then, on the fourth day, when I give my talk on Trauma and Transformation she finds herself, like so many others, remembering and crying. “I am afraid the crying will never stop,” she confides. That she will never again locate the smile which has so remarkably reappeared. Toni tells her that smiles and sorrows can live alongside one another in the same person, that she felt that way when she did our training after Katrina destroyed so much in her own state. She and I and our whole team have seen it in Kosovo, Israel, and Gaza, and indeed everywhere we’ve gone.

When people are frozen in shock and grief all the emotions are deadened. As our work unfolds, they recover what they have lost. Years ago, I remember teenage Kosovan girls in a refugee camp in Macedonia. When they shook and danced the tears they had held back finally came, tears for the loss of fathers and brothers dead, imprisoned, or fighting. Only after they cried could they laugh with the ordinary joy of girls.

On the fourth night, the teacher returns. She is going to partage, to share, everything she is learning with her husband.

James S. Gordon MD, a psychiatrist, is the author of Unstuck: Your Guide to the Seven Stage Journey Out of Depression and the Founder, Director of the Center for Mind-Body Medicine in Washington, DC, and Dean of the College of Mind-Body Medicine with Saybrook University.

Woodstock Wisdom

Festival Crowd

Hey, I know I’m a little late, but I was a little late to Woodstock too.  I hadn’t planned on going, but then another doctor as young as I was then called me up, desperate–actually, crazed. “You’ve got to get up here, man. They’ve got hundreds of thousands of people coming, and there’s no food, no place to stay, nobody to take care of them.”

“I saw on television that the roads were jammed.”

“Forget about it, man—we’ll send a helicopter.”

And he did.

And that’s how my girlfriend Sharon and I–veterans of the civil rights and anti-war movements, former residents of the Haight-Ashbury and Berkeley, and passionately committed to “health care for all”–found ourselves on the way to Bethel, New York.

Looking back this week on Woodstock, forty years later, wondering if there was anything I had to add to everything that everyone who was or wasn’t there has had to say, I realized I had actually learned a lot in those three days and that the lessons might be worth sharing.

Woodstock was a triumph of peace and love. It was a terrible mess.

Here they are, in the order they came to me.

* Always be ready to help. When someone asks with real need, you have to pay attention. Inconvenience–dicey travel plans, the loss of a precious few days of a psychiatric resident’s vacation—is really a small deal. Utter lack of knowledge about the conditions we were walking into or the support available to us once we got there—let it be, see what happens. Bottom line: if it feels right and necessary, do it.

* If you’re meant to do something, it’s likely, in spite of all improbabilities, that it will happen. I know, I know, this sounds hopelessly hippie-ish and “New Age,” but what am I going to do? Jung gave this acausal connection between internal intention and external events the more dignified name of “synchronicity.” Let’s call it that.

A helicopter did indeed take us from LaGuardia to a field near Bethel. It landed to pick up some performers. Questions were raised about whether we should be debarked so that Joan Baez’s mother could accompany her. “We can all go,” Sharon said cheerfully, but highly insistently. “We’re all needed.” And indeed, we did—Joan, her mother, and the two of us.

* Be patient, if it’s necessary, even when you really don’t want to be. This, I have to admit, is a lesson I’ve had to keep re-learning many times these last forty years, but Woodstock gave me a clear, undeniable glimpse of its usefulness.

Everyone was helpful, but no one actually knew how to find our friend, the doc who called. “He’s here” . . . “there” . . . “behind the stage” . . . “over by those tents.” Hopelessly lost half a dozen times, we picked our way among hundreds of thousands of bodies and got righteously irritated that no one seemed to know our friend or where we should go or where supplies could be found, or who else might be in charge—“Listen, you guys flew us up here to do this job. There are already kids all over the place with cut feet, sore throats, and bad trips. It’s starting to rain, and it’s gonna get worse.”

“Oh, wow, man,” they said. “That’s far out. Would you like some food, booze, hash, acid? Would you like a hug?” We had to laugh.

* If you build it—and they really need it—lots of people will come. Without supplies or shelter, we set up at the edge of the huge bowl where the bands were playing, Our spot was marked only by a sign, “First Aid.”

People started lining up immediately. An hour or so later, miraculously, antiseptics and bandages, sutures, and antibiotics started arriving, Wavy Gravy, the prince of hippie self-help, sent some guys with a tent.

* Opposition will come your way. The line is from reggae musician Jimmy Cliff (he wasn’t at Woodstock) but the truth is universal. By the second evening of the festival, more than 100 people were regularly in line outside our little tent. Some needed sutures—Sharon reminded me the other day how impressed she was with my one-hand surgical ties, and I am too, though I honestly don’t remember them. Others had respiratory infections and were working on pneumonias. And a very large number, quite young even to my 27-year-old eyes, had taken improbable quantities of unnamed and perhaps unnameable substances, and were deeply distressed. I went down the line triaging, and discovered about fifty of them.

“We need a bigger tent,” I told a guy who’d shown up with a two-way radio, “a real big one for 50-100 people.” The big tent arrived and I invited all the mentally, emotionally and psychically challenged to come inside. I spent time going from one to the other and realized the mission was truly impossible. There were simply too many, and despite Sharon’s best efforts the line outside our little tent was growing long.

* Self-care and mutual help are fundamental tools of all healing. This is a lesson I’ve been learning ever since my first days as a student on hospital wards, and it’s one that I’ve devoted much of my professional life to exploring and teaching to others. The couple of days in the big tent at Woodstock highlighted it luminously. Absolutely unable to care for all these people myself, and with only a couple of untutored volunteers available, I came up with a game plan. I asked all those who had taken too many ‘uppers’—amphetamines, cocaine, and the like—and were fidgety, agitated, and utterly at a loss to know what to do—to walk around vigorously, insistently holding, leading, urging on all those who had overdosed on ‘downers’ like heroin, barbiturates, quaaludes, and liquor. I asked the remaining kids, who were lost in the dark forests of psychedelia to sit on the floor of the tent in pairs or threesomes or fours. “Hold each other,” I instructed, “listen to each other. Take care of your brothers and sisters.” I told the volunteers to keep their eyes open and to get me in case of crisis. Every half hour or so I checked in.

The walking, holding, and hugging went on all night. The next morning, some of the young people, happy and calm enough, dropped by to thank me; others simply sat listening to the music.

* Nothing is perfect. Woodstock was a triumph of peace, love, and community, says just about everybody who was there. Millions of people now regard it as a touchstone, an example of what’s possible when you set aside fear and prejudice and promote love and peace. Yes. Woodstock was a self-indulgent mess, say some others, skeptical and cynical perhaps, and maybe scared of the unleashed id of the experience. And there’s some truth there too.

But there were other issues. I was, amidst the pleasure of the celebration, the impressive kindness and sharing, troubled by something else I saw and felt, a certain kind of dislocation and sadness in some of the young people.

They said they were disoriented by the crowds and uneasy being away from the cities and suburbs which were their homes. These feelings, of course, had been amplified by quantities of drugs consumed, but we heard and felt it in others who seemed more or less sober—an uneasiness and loneliness that camaraderie and crowds could not assuage. I heard it, too, in the months after Woodstock, from people who felt let down by the lack of fellow feeling in the world they returned to, by the absence of the indomitable hope that seemed to them to suffuse Bethel.

* You never know who your friends and teachers will be. I was already learning this during several years of psychotherapy and meditation and from time spent ministering to the so-called “mentally ill“—as well as hippies. It was possible, I was finding, to find solace, friendship, and even wisdom in unlikely places and with unexpected people. Woodstock reinforced this mightily.

During the three days of the festival I met apparently hapless kids with remarkable skills in erecting shelters, scrounging and preparing food, and tending to the ill and crazed. I was impressed over and over again by the exuberant effectiveness of Wavy Gravy’s Hog Farm tribe, the courtesy of celebrities like Joan Baez who really did believe in “power to the people,” the kindness and good sense of those who volunteered to help out.

It all came home to me, appropriately enough, on the way back home, in a small plane that Sharon and I shared with the chief of police of Beverly Hills, who had come to supervise security. “Great kids,” he said. “Great festival. Great view,” he added as he gestured toward the Manhattan skyscrapers over which we were flying. “People will be talking about this for a long time.”

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

Going to Israel and Gaza

Dear Friends,

I’m getting ready to get on the plane for Tel Aviv, and begin this round of work in Israel and Gaza. (Read about our current work in the middle east here.)  You can get more info on the work we’ve done in psychological trauma relief in Kosovo, Israel, Gaza, and in the US here.

We plan to spend a few days working in Israel with our team of CMBM-trained professionals there, then (hopefully) make our way into Gaza to train 150 more professionals (on top of the 90 already trained) in mind-body skills that will help them to help heal the widespread terrible anxiety, anger, depression, posttraumatic stress disorder, and grief resulting from the latest conflict. We believe this work will eventually reach hundreds of thousands of people in Gaza, not to mention Israel–we believe we’re the only program working in both Israel and Gaza.

Right now, we’re just hoping to get in and start making a difference to the people who have suffered so much from this conflict.  This work is so difficult, and so necessary. We hope you’ll hold the safety of our team and the success of our mission in your minds and hearts— 

Sending all my best,

Jim

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

Free Webinar Lesson 4: Other Useful Techniques and Advice for Participants

Title: Free Webinar Lesson 4: Other Useful Techniques and Advice for Participants
Location: http://www.mblwellness.com/unstuck
Description: The last free webinar in a four-part series, “A Natural Approach to Treating Depression,” Dr. Gordon offers more resources and guidelines to help you on your journey.

Lesson 4: Other Useful Techniques and Advice for Participants

Key lessons: Dr. Gordon discusses a variety of other techniques that are effective in treating depression; he provides some final advice and words of encouragement for participants.

Download pack still available at www.mblwellness.com!
Start Time: 8:30pm EST
Date: November 24, 2008

Free Webinar Lesson 3: Exercise and Movement

Title: Free Webinar Lesson 3: Exercise and Movement
Location: http://www.mblwellness.com/unstuck
Description: The third free webinar in a 4-part series; tune in to hear Dr. James Gordon discuss the mental and physical benefits of exercise, and offer some easy guidelines for getting started.

Lesson 3: Exercise and Movement

Key Lessons: Physical exercise can significantly improve mood; Dr. Gordon provides advice on how to start an exercise program; Dr. Gordon shows a movement technique he has taught around the world.

The free download pack available at www.mblwellness.com includes MP3 relaxation exercises and guides to meditation!!

Start Time: 06:30:00 pm EST (note time change)
Date: November 22, 2008

Free Webinar Lesson 2: Relaxation/Stress Management

Title: Free Webinar Lesson 2–Relaxation/Stress Management
Location: http://www.mblwellness.com/unstuck
Description: The second free webinar in a 4-part series, Dr. Gordon discusses relaxation and stress reduction techniques and exercises in handy video form.

Lesson 2: Relaxation/Stress Management

Key lessons: Stress and depression are connected; simple relaxation exercises can help with the symptoms of depression; Dr. Gordon teaches a relaxation exercise. (The Unstuck pack contains useful tools for this lesson.)

Don’t forget to download the free Unstuck resource pack at www.mblwellness.com!
Start Time: 8:30pm EST
Date: November 20, 2008

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