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
Our exciting training program, CancerGuides® II will be offered June 11-14, here in DC (along with Food As Medicine). You can help us as we offer our groundbreaking, integrative trainings by telling everyone you know about the programs, posting the fliers in your offices and clinics, handing them out on the street, etc. etc. Download a flier here.
A quick note: CancerGuides II is absolutely appropriate and accessible for cancer survivors and their families, not only for professionals. Everyone will have the opportunity to meet leaders in the field of integrative care, and to get the most up-to-date practical information–about nutrition, yoga, massage, Chinese medicine, and cutting-edge alternative therapies among many other topics. We would love to see you there, and there are generous partial scholarships available. Check out the website (see above) to learn more.
I hope you understand that you all – staff and faculty, along with our Board, and all those who support and participate in our programs – are the foundation for all we do, the juice that keeps nourishing our work, nourishing me, and helping us to grow. I’m so eager to hear from you and to see you soon, or to meet you for the first time at one of our exciting upcoming trainings.
It’s stunningly, suddenly it seems to me, green here in Washington. It feels like the season and its recent holy days match the message and the mood of our work – change and hope, new growth and greater freedom, leavened by compassion and forgiveness and, for me as well, gratitude for who you are and all we’ve done together and will continue to do. “Old things are passed away…all things are new” is what it says in the New Testament. Thank you.
Dennis Jaffe, my old friend who is both a CMBM and a Saybrook Board member, got things started, and Lorne Buchman, the Saybrook President, has embraced our vision from the beginning and made sure that it infuses our partnership. The negotiations were long but we’re all happy now. I am going to be the Dean of Saybrook’s new Graduate College of Mind-Body Medicine and our program (Professional & Advanced Training Programs in Mind-Body Medicine, Supervision by faculty, plus Food As Medicine Training) is going to be required and central to the core curriculum for both Saybrook Masters and PhD degrees in Mind-Body Medicine.
This means a wonderful opportunity for CMBM to reach and teach more bright, eager, and idealistic participants, for those who want our work to be central to an advanced degree to have that opportunity, and for me (and our faculty) to help shape a graduate curriculum which will be exciting, attractive, and fun too. We’ll be getting the word out about the Saybrook degree and they’ll be telling people about Center programs. Dan Sterenchuk, our Director of Finance and Administration, is going to be working closely with me on all this. He’s thrilled and of course so am I; Dan does such an amazing job, makes everything easier and better for everyone he works with, and we enjoy our adventures together. Everyone else at The Center is really excited too.
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,
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.
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.
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,
I spent Monday afternoon, February 23, 2009, testifying on the strengths of integrative healthcare and our hope for healthcare reform at the hearing, “Principles of Integrative Health: A Path to Health Care Reform” by the Senate Committee on Health, Education, Labor, and Pensions (HELP). The video is comprehensive—click to read shorter coverage in the Huffington Post.
My colleagues (including Wayne Jonas, M.D. of the Samueli Institute, Robert Duggan, M.A., M.Ac. (UK), Dipl.Ac. (NCCA), of Tai Sophia, and others from institutions and the private sector) and I sincerely hope the time has come to change from a “disease-care” system to one truly centered on the patient and our wellness as a nation. Our current system is expensive, and ineffective at keeping us healthy. Turning to costly drugs ridden with side effects before trying natural approaches and wellness techniques is bankrupting our treasury and our health as a nation.
More to come—check out the video, and check back here for updates. It’s a very busy time for us here at the Center!