We often forget that skin is one of our organs and also the largest one. It acts as a barrier between our internal organs and the outside world with all its aggressions, and we should take good care of it. When we get sunburned not only do we damage our skin immediately (do I have to remind you about the pain, the burning sensation, the unbearable contact of clothes and sheets, the horrible looking peeling, etc.?) but also in the long-run. The long-term consequences are even worse when sunburns occur during childhood and repeatedly. We all know we have to use sunscreens and avoid the hours of the day when the sun is the strongest, and wear a hat and so on — but do we? Well, I am embarrassed to admit I failed the test not so long ago and got one BAD sunburn. I got it all wrong. Add first sun exposure of the year, no sunscreen, worst time of the day, and you get — the lobster woman.
I was recently at dinner with friends — all of us acupuncturists with various backgrounds — and we were deep in discussion about how to describe what it is that we do. One said, “I call myself a Chinese Medicine Practitioner because that’s what I studied — all aspects of it (needles, herbs, movement & philosophy).” I wondered aloud, “Do you think that right now, there is a group of healers in China having dinner together saying, ‘I call myself a Western Medicine Practitioner because that’s what I studied – love those MRI’s and cortisone injections!’ ”
We tossed around the use of the term “Chinese Medicine.” What we are really pointing to when we use this term is ancient wisdom — not wisdom that is only exclusive to China, either but threaded through all the ancient world religions and traditions. It is the wisdom of observing the natural movements of life and the power of nature to heal the body, mind, and spirit.
One epiphany helping me deepen my healing abilities was realizing my own wounds. The Center for Mind-Body Medicine training and the small group sessions opened me to this experience. One key element aiding my discovery was that of the genogram. In drawing my genogram (a generational diagram showing relationships) I was able to visualize familial conflicts and bonds helping me realize why I had become an obstetrician-gynecologist. I had struggled with my decision to become an OBGYN for a few years; the drain of being on call and running the business of private practice had taken its toll and I was burning out. Dr. Gordon describes that through genograms one may see multigenerational patterns of conformation and inspirational family strengths. Taking this concept further, one could say that the genogram is able to give one a life’s path.
Introducing….Mindful. We’re already partial to being mindful, but now there’s a magazine all about it–the latest findings, the latest programs, the most wonderful stories–the juicy bits. The October edition features an interview with Center founder and director Dr. James Gordon called “A Journey to the Center of Yourself,” 8 pages of his sage perspectives with beautiful illustrations. As soon as we got our hands on copies, staff members were pouring over the interesting articles cover-to-cover, from “At NASA, Meditation is Rocket Science” to “To Pause and Protect”, the cover story about Oregon police officers learning mindfulness techniques, to “Children Helping Children”… oh, my! Do I need to say we are all hooked?
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.
I love taking my dog, Stella, to our local dog park. Sometimes I think I enjoy the experience even more than she does. Nothing makes me laugh more than seeing her zipping around the park at top speed, ears flat against her head, eyes wide, tongue hanging out of her mouth in that expression of pure joy that dogs master so well. Whatever trials and tribulations my day has wrought go right out the window when I watch her play.
Dogs are “man’s best friend,” a name earned not just for their loyalty but also for their unconditional love for us—and we love them back. People in the U.S. spend an increasing amount of money each year on their animals. And it’s not just dogs; we’re spending more and more money on all of our pets, from fish, rodents, and reptiles, to cats, and even horses. In 2012 Americans spent $53.3 billion, and that number is expected to hit $55.5 billion this year. If the cost of owning an animal is so high, how exactly does this relationship benefit us?
Yoga is NOT just for people with beautiful bodies or those that have flexible bodies. Yoga offers tools that can be adapted to your unique needs. Are you stiff? Have joint problems? Pain? Overweight?
We did a workshop for our team while we were in Haiti last week– at a church retreat center, a little, open, green place at the bottom of a hill in the middle of Petionville, bird-filled flowering trees, some fresh, if very warm air—an oasis.
More than 60 of those who completed our Advanced Training in Mind-Body Medicine came for the day—from Port-au-Prince, Petionville, Leogane, and even from further out in the countryside.
They were quiet at first, then fairly bursting with stories about the work they’d done, with children in schools; with patients in hospitals; with Catholic, Protestant, and Voudoun parishioners; with students and colleagues at universities and professional schools; and family members, friends, and neighbors.
Many people who have come to these groups are, we hear, sleeping well for the first time; chronic pains are receding; kids who’ve lost parents and homes are able to focus. The need to talk about what has happened, to share the feelings that continue to well up, is everywhere. The groups have become a place to go—to get relief, to “be at home,” to learn “something that works”.
Amy, Linda, JJ, and I all teach and answer questions–stretching mind and body; how to deal with someone who is, or may be suicidal; how to stay “present” and empathetic without being overwhelmed by needs that cannot be met.
Linda Metayer presides with grace and clarity, gives a lecture on biofeedback and autogenic training that is a model of economy. It’s a pleasure to watch her and to listen as she explains the next steps we will take together—the ongoing supervision, the site visits that we’ll make to our trainees’ groups, the workshops we’ll all be offering in the community.
We also outline our plans to develop a leadership team that will work closely with our international faculty in providing supervision and in training hundreds, perhaps thousands, more Haitians to use our work with hundreds of thousands.
The next morning, we meet with the first nine members of that leadership team: highly energetic, talented people who have deeply been moved by our approach and have begun to lead groups in hospitals, churches, school, and tent camps. Among them are a child psychiatrist, a pediatrician and neonatologist, and a medical student; several psychologists, a consultant to the Ministry of Health who is a professor as well; and an accountant who has left his practice for the more-than-full-time job of leading a tent camp and teaching mind-body medicine. I’ll tell you much more about them in future entries.
In the meantime, here’s a picture of our crew—Haitians and Americans together.
David Leonhardt’s “prostate cancer test” (The New York Times, July 8, 2009) is a good but incomplete one for healthcare reform.
In addition to removing financial incentives for high tech intervention, we need to educate clinicians in the impartial, critical analysis of all therapeutic options, and in supporting their patients as they act on the choices they make. For 10 years, The Center for Mind-Body Medicine has trained health professionals and patient advocates to do precisely this, as “CancerGuides®.”
We need as well to realize that expensive, Draconian treatment and “watchful waiting” are not our only choices. There is, as Dean Ornish is showing with peer-reviewed studies on prostate cancer - and a number of us are doing with heart disease, diabetes, chronic pain, depression and post traumatic stress disorder – a far more promising third way. It is grounded in techniques of self-care – dietary modification, physical exercise, and mind-body approaches like meditation and yoga – and in group education and support.
This approach holds great promise for treating and preventing chronic illness of all kinds and for saving large sums of money. It should be central to healthcare reform.
A shortened version of this was published in the New York Times online Letters section on July 21, 2009.
Gina Kolata’s April 24, 2009 front page New York Times story (“Advances Elusive in the Drive to Cure Cancer“) on the significant failure of our near-forty-year “war on cancer” provided a sobering and necessary corrective to inflated claims about cures already arrived or just around the corner. Kolata rightly chides those in the pharmaceutical, medical, and health food industries who claim that their approach promises a cure and notes our national failure to fund and launch truly innovative studies. She appropriately takes to task clinicians who use deceptive prognostic terminology: “progression free survival” does not, to the dismay of people who are so labeled, mean longer survival. On the other hand, Kolata’s actual or implied dismissal of the potent preventive and therapeutic power of diet and exercise, and of the role that attitude, mood, and social support can play in enhancing quality of life and perhaps prolonging survival, is ill-informed and potentially dangerous.
Though there is indeed some disagreement about the value of “high-fiber or low-fat” [my underlining] diets in preventing cancers of various kinds, there is a general consensus, shared by the National Cancer Institute, that diet plays a significant role in at least 35-40% of all cancers. In recent years it has become abundantly clear, for example, that obesity has an important role in making us vulnerable to cancer and to its recurrence. And there is considerable evidence that certain kinds of diet can have significant anti-cancer properties and effects: epidemiological studies show that populations with diets high in the omega-3 fats that are present in fish oil have a lower incidence of several cancers; one study published in the Journal of The National Cancer Institute in 2006 shows that reducing dietary fat may increase survival time for women with breast cancer. And then there is the data on specific foods: cruciferous vegetables (broccoli, cauliflower, cabbage, etc.) have significant, repeatedly observed anticancer effects; tomatoes may help prevent prostate cancer; and soy may be useful for the prevention of breast cancer in premenopausal women.
Kolata does not, curiously, discuss exercise, but appears to marginalize it along with nutrition, as she presents the case of a fit vegetarian woman, Phyllis Kutt, whose breast cancer has recurred. Exercise is not of course a panacea, but it does appear to be a powerful tool in both preventing cancer and forestalling its recurrence. One important study, published in 2005 in The Journal of The American Medical Association , showed that 3-5 hours of walking per week significantly reduced the rate of breast cancer recurrence.
Stress, which Kolata also chooses to ignore, appears to be another important and perhaps remediable factor in hastening recurrence. Though the evidence is still weak that stress causes cancer (the exception may be overwhelming stress, as in bereavement, divorce, or massive trauma), studies are accumulating which show that chronic stress may speed up recurrences. In particular, it appears that high levels of hormones like cortisol that stress produces can inhibit enzymes that would otherwise help protect us against cancer.
Finally, group support, which has also been shown to be so helpful in improving quality of life, though not necessarily (here the data is mixed) extending life, is also given short shrift. Kolata tells a horror story of a support group whose members, apparently unable to deal with their own fears, rejected Kutt and forced her out of the group after her cancer had recurred.
For more than ten years my colleagues and I at The Center for Mind-Body Medicine have accepted the challenge of exploring and clarifying the limitations, as well as the benefits, of conventional cancer care and of bringing an open-minded but critical perspective to therapies that are said to complement or be alternatives to them. We have been training what we call CancerGuides(R)–health and mental health professionals and patient advocates who can provide informed and compassionate guidance to people with cancer and their families as they navigate among the bewildering array of therapeutic options and professional opinions. Our CancerGuides learn to cut through the hype about conventional care as well as complementary and alternative approaches. They work collaboratively with people with cancer and their families to create comprehensive programs of care which include evidence-based nutritional and herbal approaches, exercise, massage, acupuncture, and stress-reducing mind-body techniques as well as appropriate conventional therapies. They learn to help people with cancer put all therapeutic and preventive studies on a “level playing field” in which evidence for every approach, whether called “conventional” or “alternative,” is looked at with the same thoughtful, critical gaze.
The oncology professionals and patient advocates we train (sometimes nonprofessionals who have themselves faced the challenges of cancer and its treatment can be the most discriminating and skillful of guides) help those they are guiding to ask the right, and often hard, questions of their oncologists. We also help these CancerGuides to develop the sensitivity that is necessary to encourage and support each person with cancer to make choices that are appropriate to his or her unique situation.
We teach our trainees mind-body approaches (guided imagery, meditation, biofeedback, yoga, etc.) and expressive therapies (written exercises, drawings, and movement) that are so helpful in reducing chronic stress (and levels of stress hormones) and in dealing with the difficult choices and challenges that cancer and its treatment presents. Finally, over time, we train these CancerGuides to lead groups that are genuinely supportive, groups that help people with cancer come to terms with their fears rather than (like Ms. Kutt’s group members) shun those who provoke them, groups where true compassion trumps emotional convenience.
We as a nation have certainly not won the war on cancer. But we have learned over the last forty years that there are things each of us can do to reduce the risk of cancer and, in some instances, slow or forestall its recurrence. We have learned also that acting on our own behalf to create programs in which self-care is integral is, itself, stress-reducing and therapeutic, helping people with cancer to overcome the feelings of helplessness and hopelessness that so often debilitate them. And we have found too, as so many people with cancer would testify, that such efforts often become an opening to remarkable self-discovery and psychological and spiritual growth.
There is no silver bullet for most cancers, or sure cure for those whose cancers have advanced. But creating a comprehensive program that includes diet, exercise, stress management, and genuine support, a full array of options critically examined, may offer a measure of scientifically grounded common-sense help from which all of us can take heart.
James S. Gordon, M.D., a psychiatrist, is creator of the CancerGuides(R) training program and Founder and Director of The Center for Mind-Body Medicine. He is the author, with Sharon Curtin, of Comprehensive Cancer Care: The Integrating Alternative, Complementary, and Conventional Therapies and of Unstuck: Your Guide to the Seven-Stage Journey Out of Depression.
Read more about the upcoming CancerGuides training, June 11-14th in Washington DC
As appeared on The Huffington Post