“I don’t think I would have made it through grad school without this class.”
This is a quotation from a Duke student who participated in Koru, a course to help students with stress that has its inspiration in mindfulness meditation and The Center for Mind-Body Medicine’s mind-body skills group model.
Koru, which is a Maori symbol for growth around a stable center, began at Duke University in 2007 and has since then transformed the lives of hundreds of Duke students.
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The other day after my workout, I headed to the sauna to savor some quiet time to detox and unwind. Shortly after I got settled in to my warm cocoon and a meditative state, another woman came in to do the same, or so I thought. Wrapped in her terry cloth robe, she immediately reached into her pocket, pulled out her smartphone and began texting away.
Many things have happened lately to make me fearful of others and of life itself. My world seems to be filled with people who hold unfounded grudges that baffle me and choose to say vindictive things for no other reason than spite. We’ve had deaths and serious illnesses, difficult medical prognoses. Family members whose actions are more about greed than family values. Job losses and insecurity. It’s been difficult to hold on to the trust and acceptance that got me through past challenges. I see fear peeking out of every corner, tugging at me, knocking on the door, enticing me to believe that the world is full of anger, resentment, greed and struggles. Fear is ready to haunt me, settle into my stomach and my bones. In fact, I can already feel it in my body, aching and throbbing.
Shame is an inevitable component of binge eating disorder, so although it’s the most common of eating disorders, it’s rarely discussed.
Binging was a carefully hidden secret for me since my early teen years. I remember getting upset over a running injury and devouring a chocolate cake. Not a piece of cake — a whole chocolate cake — and it was still mostly frozen. Binging was my normal; I didn’t believe change was possible. So even as I got degrees in nutrition and ate more nourishing foods, there were still nights where I’d polish off a can of frosting, and suffer through the inevitable self-loathing hangover.
I learned to meditate over 20 years ago. It opened the doors to a lifelong practice of meditation techniques, including Vipassana and yoga, and spiritual exploration with wonderful teachers. As I practiced and practiced, I noticed that I was able to listen more deeply to both my patients and myself, and felt less stressed in my daily work as a medical doctor.
It wasn’t until 15 years ago when I began to work with The Center for Mind-Body Medicine that I learned the importance of teaching my patients these skills, too. Stress is a contributing factor for 80% of all chronic illness in our country, and numerous studies have shown the power of meditation and mind-body skills to reduce the effects of stress and even reverse illness. I talk at length about this in my book, The Immune System Recovery Plan, A Doctors 4-Step Program for Treating Autoimmune Disease. At Blum Center for Health we teach these skills in Mind-Body Groups, following the model developed by The Center for Mind-Body Medicine.
On day one of the Mind-Body Medicine Professional Training Program, our first large group modality is shaking and dancing. “Oh no,” I think, “I get to shake this body I usually ignore, in front of 250 people I don’t know. How silly will I look and will released energy make me sick in some way like throwing up or hurting my legs or my replaced hip joints?” A breath of relief comes as Dr. Gordon says we are to close our eyes. What was I thinking anyway? I am in a room of professional health care providers, with a doctor standing right next to me.
Every meeting at The Center for Mind-Body Medicine starts with a minute or so of Soft Belly Meditation, which is deep breathing with the simple mantra, “soft….belly”.
Most interns and guests look a little wide-eyed at the first meeting here when the meditation is announced. Perhaps they’re thinking “What have I gotten myself into?” or “Who are these people?!” I know I did, when I started working here. But after attending meetings at other companies and meetups, where you launch into business without the benefit of a meditation, I definitely notice a difference.
Our signature mind-body medicine technique is something Founder and Director James Gordon, MD calls “Soft Belly”, by way of encouraging each of us to relax — which few of us instinctively do these days.
We sit quietly, breathing in through our nose and out through our mouth, which both calms the sympathetic nervous system and awakens the parasympathetic nervous system, creating a feeling of relaxation in the mind and body. Dr. Gordon suggests we think “soft” as we breathe in and “belly” as we breathe out, reminding ourselves to relax our belly so we can take in full, healing breaths rather than shallow, tense ones.
Since my first Mind-Body Medicine Professional Training Program in 2006, there have been so many moments in which I have given quiet thanks for all that I have learned and experienced with the Center. The moment captured in this photo is but one of many. Having facilitated mind-body skills groups in all kinds of places with all kinds of people, young and old, I have noticed so many common themes, including one I’ve heard Jim refer to as the “equal opportunity group experience.”
On a recent trip to London, I was interviewed during Depression Awareness Week about my book Unstuck’s UK release by The Guardian newspaper. The reporter was particularly interested in CMBM’s Global Trauma Relief program and our work to bring population-wide psychological healing to places around the world that are afflicted by war and natural disaster. You can read the piece here:
I’m certainly pleased that the author recognizes CMBM’s groundbreaking efforts to teach and support hundreds of thousands of people in Kosovo, Israel, Gaza, Haiti, Southern Louisiana, as well as US military returning from Iraq and Afghanistan. It’s a shame, however, that his tone is so dismissive of integrative medicine and that he fails to recognize the fundamental importance of self-care for psychological and physical healing.
Please note that as of this writing, corrections are being made online for several factual errors, including the following:
- In Gaza, we trained 90 clinicians initially, only a few of these were “educators” (as the article states)
- CMBM now has 160 groups meeting in Gaza each week, not 48, as reported.
Beyond factual errors, though, I’m disappointed in the tone of the article. I want to emphasize that our approach to psychological trauma relief is not about “belief,” as the article repeatedly implies. It is based on hard evidence that is just as rigorous – actually more so – than most of that provided by the drug companies he seems to accept as the standard.
It is a common misconception (and prejudice) that psychological and nonpharmaceutical research is less stringent and reliable than clinical drug trials. Each of the approaches that we use, including meditation, guided imagery, biofeedback, autogenic training, yoga, self-expression in words and drawings, and movement and exercise, has a significant research base, one which demonstrates decreases in stress levels and improvement in mood. The CMBM approach combines these into a comprehensive program, and The Center for Mind-Body Medicine takes great care in scientifically researching, documenting, and publishing our findings of our approach in peer-reviewed journals. We recently published a randomized controlled trial (RCT) on our work with war traumatized children in Kosovo that shows an 80% decrease in symptoms of PTSD (read the abstract here).
This was the first RCT of any intervention with war-traumatized children, and sometime in the next few months, we will be publishing a study (in the International Journal of Stress Management) that shows similar results—80% decrease in PTSD symptoms, significant decreases in depression and hopelessness—in war-traumatized youth in Gaza. This study is particularly important because the gains that were achieved over ten weeks of once-weekly group sessions were largely maintained at seven months’ follow-up—in spite of ongoing conflict and severe economic hardship.
The point is that this approach is not alternative. It is fundamental. It makes human and scientific sense. We have an approach that works with large groups of people in developed countries as well as those ridden by disaster. It is flexible, inclusive, and culturally acceptable. And the groups in which we train caregivers can be led by anyone—teachers, and religious and community leaders, as well as health professionals; and the scientific evidence for its effectiveness continues to accumulate. And as the article states, CMBM will continue to be there to provide our program of mind-body medicine for people suffering from psychological trauma, to teach them, and help them help themselves.